Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1992
Randomized Controlled Trial Clinical TrialEffects of lidocaine aerosol on postoperative pain and wound tenderness following minor gynaecological laparotomy.
Twenty-four female patients undergoing sterilization through a minor lower laparotomy received, in a double-blind, randomized study, either lidocaine spray 200 mg or placebo in the surgical wound. Postoperative pain intensity was evaluated on a verbal and a visual analogue scale and wound tenderness with an algometer. ⋯ Pressure pain thresholds were higher (P less than 0.05) 2 h postoperatively in the lidocaine group, but not 4, 6 and 8 h postoperatively. In conclusion, topically applied lidocaine aerosol in the surgical wound leads to very short and clinically insignificant relief of postoperative pain.
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Acta Anaesthesiol Scand · Feb 1992
Randomized Controlled Trial Comparative Study Clinical TrialPropofol-fentanyl anesthesia compared to thiopental-halothane with special reference to recovery and vomiting after pediatric strabismus surgery.
Forty-four children, ASA physical status I or II, aged 1.5-14 years and admitted for strabismus surgery, were studied. The study compared the postoperative condition after two different anesthesia methods. All children were premedicated with midazolam rectally, received glycopyrrolate i.v. and were then randomised to one of two anesthetic methods: 1) induction with thiopental, maintenance with halothane or 2) induction with propofol supplemented with fentanyl, maintenance with propofol infusion. ⋯ Fewer children in the propofol/fentanyl group vomited postoperatively (P less than 0.05). The apprehension score was higher in the propofol/fentanyl group compared to the thiopental/halothane group (P less than 0.05). We conclude that children undergoing strabismus surgery anesthetized with propofol/fentanyl had more episodes of peroperative bradycardia, a lower incidence of postoperative vomiting and a shorter recovery time, and were more apprehensive during the initial postoperative period than children anesthetized with thiopental/halothane.
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Acta Anaesthesiol Scand · Feb 1992
High frequency of cough after intravenous bolus injection of Ketogan (ketobemidone + N,N-dimethyl-3,3-diphenyl-1-methylallylamine chloride) for postoperative pain relief.
The frequency of cough 15-45 s after intravenous administration of a low dose of the opioid receptor agonist ketobemidone given for postoperative pain relief was assessed in 121 patients undergoing gynaecological or obstetrical operations. In patients subjected to caesarean section under spinal anaesthesia using bupivacaine, the frequency of an early cough reaction was 50.7%, whereas in patients previously exposed to opioids during the surgical procedure the frequency was 11.1%. This side-effect of ketobemidone has not been reported before.
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Acta Anaesthesiol Scand · Jan 1992
Randomized Controlled Trial Comparative Study Clinical TrialPropofol anaesthesia versus paracervical blockade with alfentanil and midazolam sedation for outpatient abortion.
Propofol anaesthesia was compared with paracervical blockade in a prospective, randomized study of 59 abortion patients. All the patients received alfentanil 0.01 mg/kg i.v. at the start of anaesthesia and were randomized into two groups. Group R (regional, 31 patients): midazolam 0.1 mg/kg i.v. and paracervical blockade with 2 x 10 ml of mepivacaine 20 mg/ml + adrenaline 0.005 mg/ml. ⋯ Except for a better p-deletion score 30 min after the procedure in Group G, there was no difference in recovery function between the groups. Of the patients in Group G, 67% experienced postoperative pain compared with 23% in Group R. Maximum serum mepivacaine concentration (Group R) was reached at 15-30 min, range 1.5-5 micrograms/ml.
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Acta Anaesthesiol Scand · Jan 1992
Randomized Controlled Trial Clinical TrialAttenuating the hypertensive response to laryngoscopy and endotracheal intubation using awake fibreoptic intubation.
Blood pressure and pulse rate measurements were recorded in 35 patients undergoing endotracheal intubation during general anaesthesia (Group A), and 35 patients who had an awake fibreoptic intubation under local anaesthesia (Group B). The mean arterial pressure in Group A rose by a mean of 35 mmHg immediately after intubation, compared with a mean fall of 9 mmHg in Group B. The mean pulse rate in Group A rose by 24 beats per minute (b.p.m.) immediately after intubation, compared with a rise of 3 b.p.m. in Group B. ⋯ There was a statistically higher mean score in relation to nose discomfort in Group B (P less than 0.002). Awake fibreoptic intubation successfully reduces the pressor response to endotracheal intubation in normotensive adults. It is suitable for use in those patients who are at risk from the pressor response.