Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1987
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled analgesia: a controlled trial.
Thirty-six patients undergoing lower abdominal surgery were included in a prospective randomized controlled study to compare the effects of patient-controlled analgesia (PCA) and a standard intramuscular/intravenous treatment (conventional analgesia, CA) of postoperative pain. Morphine was used in both groups. There were no significant differences between the two analgesic regimens in respect of linear analogue pain scores, verbal pain-relief scores, amount of morphine used or side-effects. No treatment-induced alterations in vital values were experienced.
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Acta Anaesthesiol Scand · Nov 1987
Randomized Controlled Trial Comparative Study Clinical TrialReduction of pain at venous cannulation in children with a eutectic mixture of lidocaine and prilocaine (EMLA cream): comparison with placebo cream and no local premedication.
The local analgesic efficacy of a cream formulation of lidocaine and prilocaine (EMLA) in reducing pain at venous cannulation was investigated in children scheduled for elective surgery. Forty children participated in a double-blind, randomized comparison between EMLA and inactive placebo cream. Another group of 18 children without any local treatment was studied as an additional control material. ⋯ No significant hormone responses were, however, detected. The lidocaine concentrations measured in venous blood taken from the application site of EMLA cream were low, and there were no measurable levels of lidocaine in simultaneous blood samples from the opposite extremity. In our opinion EMLA cream is safe and alleviates effectively the pain associated with venepuncture, and thus deserves a place in the routine premedication of children.
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Acta Anaesthesiol Scand · Nov 1987
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialNo increased incidence of postoperative sore throat after administration of suxamethonium in endotracheal anaesthesia.
Sixty patients were divided into two groups (A and B) of 30 patients each to investigate the effect of using suxamethonium in endotracheal anaesthesia on the incidence of postoperative sore throat. The patients were anaesthetized with thiopentone, fentanyl, droperidol, N2O and pancuronium. ⋯ The type 2 error (beta) was low (the risk of overlooking a "true" difference in incidence of 0.20 was calculated to be 0.04). These results contradict those of a recent study, which demonstrated an increased incidence of postoperative sore throat following the use of suxamethonium in mask anaesthesia.
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Acta Anaesthesiol Scand · Nov 1987
Randomized Controlled Trial Comparative Study Clinical TrialBuprenorphine as premedication and as analgesic during and after light isoflurane-N2O-O2 anaesthesia. A comparison with oxycodone plus fentanyl.
Sixty patients undergoing gynaecological laparotomies under isoflurane anaesthesia received 0.4 mg of buprenorphine sublingually or 0.12 mg/kg of oxycodone intramuscularly in random order for preanaesthetic medication. Patients premedicated with buprenorphine were given buprenorphine before, during and after anaesthesia and patients premedicated with oxycodone received fentanyl before and during anaesthesia and oxycodone after anaesthesia. Buprenorphine premedication produced less drowsiness and sedation and alleviated patients' apprehension significantly (P less than 0.05) less than oxycodone. ⋯ In the ward (2 to 24 h after operation) sublingual buprenorphine provided pain relief as good as intramuscularly administered oxycodone. No differences were noted in the incidence or severity of emetic symptoms between the groups. It is concluded that buprenorphine can provide good postoperative pain relief for gynaecological laparotomies performed under light isoflurane anaesthesia, but patients need to be monitored carefully after operation because of the possibility of respiratory depression.
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Acta Anaesthesiol Scand · Nov 1987
Outcome and costs of intensive care. A follow-up study on patients requiring prolonged mechanical ventilation.
This historically prospective study analysed hospital costs and long-term outcome in 249 consecutive patients who required intensive care including intermittent positive pressure ventilation (IPPV) for 48 h or more. The mean age of the patients was 46.7 years and the mean duration on IPPV was 9.1 days. Mortality in hospital was 43%, increasing to 54.6% five years after admission. ⋯ The cost-benefit ratio, i.e. calculated cost per year of extended life until the age of 75 years, averaged 1420 USD (range 360-7980 USD). With the exception of patients suffering from cancerous diseases, the cost-benefit ratio found in this study was favourable in comparison to other high-cost medical care. This is further emphasized by the fact that for the years saved, the quality of life was mostly good.