Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialDesflurane induces more cerebral vasodilation than isoflurane at the same A-line autoregressive index level.
Clinical use of desflurane in neuroanesthesia remains under debate. Comparison of dose-dependent vasodilatory properties between desflurane and isoflurane, the more traditional volatile agent for clinical neuroanesthesia, requires equianesthetic dosing of the agents. Reproducible neurophysiological measurements of the level of anesthesia in an individual, e.g. the A-line autoregressive index (AAI), can be used for an equipotent dosage of two volatile agents in the same individual. ⋯ Desflurane was associated with more cerebral vasodilation than isoflurane at the same depth of anesthesia, as indicated by the AAI. This attributes further reason for caution in the use of desflurane in clinical neuroanesthesia. The difference between desflurane and isoflurane in the MAC fractions required for the same AAI level confirms the limitations of MAC in defining the level of anesthesia.
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialRandomized, double-blind study comparing postoperative effects of treatment timing with histamine H-receptor antagonist cimetidine.
The purpose of this study was to evaluate the effect of timing of preoperative, postoperative, and placebo administration of the H(2)-antagonist cimetidine on postoperative pain management and the incidence of side-effects. ⋯ Our results suggested that neither preoperative nor postoperative administration of cimetidine 4 mg kg(-1) provided a pre-emptive or preventive analgesic advantage for postoperative pain or morphine consumption, and that the use of cimetidine failed to reduce the incidence of nausea or vomiting.
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialCerebral state index during anaesthetic induction: a comparative study with propofol or nitrous oxide.
Confidently predicting the depth of anaesthesia for the individual patient and independently of drug(s) type using EEG-based monitors has proven difficult. This open, randomized, explorative study of day surgical patients evaluates the ability of the Cerebral State Monitor (Danmeter AB, Odense, Denmark) of anaesthetic depth to identify loss of response (LOR) using either propofol or N(2)0 for induction. ⋯ The Cerebral State Index(trade mark) behaves as other depth of anaesthesia monitors with a progressive decrease during propofol induction but loss of consciousness with N(2)0 results in no change in CSI.
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialPalmar skin conductance compared to a developed stress score and to noxious and awakening stimuli on patients in anaesthesia.
The number of fluctuations in the skin conductance per s (NFSC) as a measure of the sympathetic nervous system may be a tool for monitoring physiological stress during surgery and general anaesthesia. The purpose of this study was to find the sensitivity and specificity of the NFSC when compared to a peroperative clinical stress score. Moreover, different patterns of skin conductance responses were compared with the BIS score to find out if the mean level of skin conductance (SC) and NFSC monitoring could differentiate between awakening and noxious stimuli. ⋯ The NFSC is sensitive to clinical stress during surgical stimulation. Moreover, the combined use of SC and NFSC may have a potential to differentiate between situations of stress due to inadequate hypnotic effect vs. inadequate analgesic effect.