Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural infusion of morphine/bupivacaine with fentanyl/bupivacaine for postoperative pain relief.
The efficacy and safety of postoperative analgesia with continuous epidural infusion of either morphine or fentanyl in combination with bupivacaine were evaluated in 85 patients, ASA physical status I or II, undergoing thoracic and/or upper abdominal surgery. Patients were treated with one of the combinations for 48 h after surgery. The morphine/bupivacaine group (MB; n = 45) received morphine at the rate of 0.2 mg.h-1, and bupivacaine at the rate of 10 mg.h-1 for the first 24 h or 5 mg.h-1 for the second 24 h; the fentanyl/bupivacaine group (FB; n = 40) received fentanyl at the rate of 20 micrograms.h-1, and bupivacaine at the rate of 10 mg.h-1 for the first 24 h or 5 mg.h-1 for the second 24 h. ⋯ No significant differences were observed between the groups in assessment of pain. The incidence of hypotension (P < 0.05) and pruritus (P < 0.05) was higher in group MB than in group FB. None of the patients developed respiratory depression in either group.
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Acta Anaesthesiol Scand · May 1994
Randomized Controlled Trial Clinical TrialEffect of prior administration of succinylcholine on duration of action of vecuronium during enflurane anaesthesia.
The effects of succinylcholine, which was given to facilitate tracheal intubation on the duration of action of subsequently administered vecuronium bromide, were evaluated in 54 adult patients who underwent abdominal surgeries under enflurane anaesthesia. The electromyographic response to train-of-four ulnar nerve stimulation was measured. Twenty-seven patients received 1 mg.kg-1 of succinylcholine, followed by 0.15 mg.kg-1 of vecuronium when the electromyographic response recovered to 50% of control after succinylcholine-induced neuromuscular blockade. ⋯ The duration of blockade induced by the initial 0.15 mg.kg-1 of vecuronium was 56.5 +/- 12.8 (mean +/- s.d.) min for the group with succinylcholine, and 58.5 +/- 21.5 min for the control group. In both groups, the average duration of four consecutive supplemental doses of vecuronium was approximately 35 min. No significant differences between groups were found in the duration of neuromuscular blockade induced by initial and supplemental doses of vecuronium.
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Acta Anaesthesiol Scand · May 1994
Brain energy metabolism and blood flow during sevoflurane and halothane anesthesia: effects of hypocapnia and blood pressure fluctuations.
The effects of halothane and sevoflurane on cat brain energy metabolism and regional cerebral blood flow (rCBF) were evaluated during normo- and hypocapnia. Brain energy status was evaluated with phosphorous nuclear magnetic resonance spectroscopy (31P-MRS) and rCBF was measured by the hydrogen clearance method. A high concentration of halothane (3 MAC) impaired brain energy metabolism, while even a higher concentration of sevoflurane (4 MAC) had no untoward effect on brain energy metabolism. ⋯ We conclude that hyperventilation and fluctuating blood pressure contribute to the occurrence of abnormal brain energy metabolism during halothane and sevoflurane anesthesia. This is more pronounced with halothane than with sevoflurane. The hypocapnia-induced abnormality during exposure to 2 MAC of either agent was due to decreased CBF associated with low perfusion pressure, indicating that there was no direct effect of these anesthetics on cerebral energy metabolism.
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Acta Anaesthesiol Scand · Apr 1994
Haemodynamic effects of pneumoperitoneum and the influence of posture during anaesthesia for laparoscopic surgery.
The laparoscopic operating technique is being applied increasingly to a variety of intra-abdominal operations. Intra-abdominal gas insufflation, i.e. pneumoperitoneum (PP), is then used to allow surgical access. The haemodynamic effects of PP in combination with different body positions have not been fully examined. ⋯ CI showed a certain dependency on filling pressures. It is concluded that PP causes signs of elevated preload and afterload. The combination of PP and a head-up tilt is associated only with signs of an elevated afterload.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialDixyrazine premedication for cataract surgery. A comparison with diazepam.
Peroral dixyrazine (15-30 mg, n = 50) and diazepam (4-10 mg, n = 50) were used as premedicants for geriatric patients having cataract surgery under regional block. Compared to the diazepam patients, a larger number of the dixyrazine medicated patients appeared anxious, and there was a statistically significant difference between the groups, when summing up changes in anxiety throughout the study period. The dixyrazine patients needed more frequent supplementation with intravenous sedative drugs, compared with their diazepam counterparts. Peroral dixyrazine is an applicable choice for calm patients, when only slight sedation, or avoidance of somnolence are required.