Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of sedation on weaning following coronary artery bypass grafting: propofol versus oxycodone-thiopental.
Propofol has been advocated for sedation in intensive care because of superior recovery characteristics. We hypothesised that the use of two totally different sedation methods after coronary artery bypass grafting should result in differences not only in extubation time, but also in breathing pattern and gas exchange during weaning and after extubation. ⋯ Propofol infusion and oxycodone-thiopental bolus dosages, titrated to the same sedation end point, resulted in similar time from admission to extubation, although the weaning period was shorter in the propofol group. In terms of breathing pattern, gas exchange, blood gases and haemodynamics, the methods were similar. Propofol, despite its attractive pharmacological profile, may offer no clinical benefit in short-term sedation after a moderate dose fentanyl anaesthesia in cardiac surgery.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialTracheal intubation without the use of muscle relaxants: remifentanil or alfentanil in combination with propofol.
Alfentanil-propofol combination provides adequate conditions for tracheal intubation without neuromuscular blocking drugs in most patients. Providing an option for intense opioid effect without compromising recovery after short operations, remifentanil might offer benefits over alfentanil, especially in ambulatory surgery. In this study intubating conditions after remifentanil-propofol were compared to those after alfentanil-propofol. ⋯ The best method was the combination of remifentanil 4 microg kg(-1) and propofol 2.5 mg kg(-1). This provided satisfactory intubating conditions in 93%, and prevented cardiovascular intubation response.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialComparison of hypotensive epidural anaesthesia and spinal anaesthesia on blood loss and coagulation during and after total hip arthroplasty.
Hypotensive epidural anaesthesia (HEA) is a technique for reducing peroperative blood loss by significantly lowering mean arterial pressure (MAP). ⋯ HEA resulted in reduced blood loss due to hypotension and reduced number of transfused PRC units during total hip arthroplasty. Based on lower prothrombin time value and higher D-dimer concentrations in the SPA group, the coagulation system might be better preserved during HEA than SPA.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of the hemodynamic effects of paracervical block and epidural anesthesia for labor analgesia.
Both paracervical block (PCB) and epidural analgesia are sometimes associated with hemodynamic effects potentially harmful to the well-being of the fetus. Our study was designed to test the hypothesis that PCB would have a more profound effect on maternal and fetal blood flow than epidural analgesia. ⋯ There were small differences in the effects of PCB and epidural analgesia on uteroplacental circulation as well as on maternal hemodynamics. PCB may have a vasoconstrictive effect on the uterine artery. This and the fact that the parturients required rescue analgesia more frequently after PCB than after epidural block speaks for the feasibility of the latter in obstetrics.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Clinical TrialA randomised study of lidocaine and prilocaine for spinal anaesthesia.
Transient neurologic symptoms (TNS) are common after lidocaine-induced spinal anaesthesia (SA). Recent data indicate that TNS may be less frequent after prilocaine-induced spinal anaesthesia, for which reason the isobaric solution was compared with lidocaine. ⋯ TNS occurred also after isobaric prilocaine SA. The frequency was not significantly different from that following lidocaine SA but larger studies are needed to establish the relative risk of TNS following SA induced by the two local anaesthetics. Isobaric prilocaine has a longer duration of action than an equal dose of lidocaine and may be an alternative drug for spinal anaesthesia of intermediate or short duration.