Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Clinical TrialThe effect of topical lignocaine on intubating conditions after propofol-alfentanil induction.
Recent studies have found satisfactory conditions for intubation of the trachea without using muscle relaxants using an intravenous technique combining propofol and alfentanil. In this study we evaluate intubating conditions with this method and either lignocaine applied topically in the larynx and trachea or placebo. ⋯ Induction of anaesthesia with propofol 2.5 mg/kg and alfentanil 30 micrograms/kg combined with 4 ml of lignocainespray 40 mg/ml into the larynx and trachea offered consistent and satisfactory intubation conditions. We thus recommend this method for tracheal intubation, where the use of muscle relaxants is not indicated.
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialContinuous thoracic epidural analgesia versus combined spinal/thoracic epidural analgesia on pain, pulmonary function and the metabolic response following colonic resection.
The neuroendocrine response following major surgery has not been previously influenced by either regional anaesthetic techniques or opioid analgesia probably due to insufficient intraoperative afferent neural blockade. In this study we attempted to determine whether significant inhibition of these pathways could be achieved by combining preoperative high spinal anaesthesia with postoperative thoracic epidural anaesthesia. In theory too, there may be additional benefits over perioperative thoracic epidural anaesthesia on pain and pulmonary dysfunction. ⋯ Thoracic epidural bupivacaine/diamorphine infusion provided excellent postoperative analgesia following colonic surgery. An intraoperative combined spinal/epidural technique conferred no additional benefit on analgesia, pulmonary function and the neuroendocrine response.
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialPropofol reduces emesis after sufentanil supplemented anaesthesia in paediatric squint surgery.
Squint surgery is associated with a high incidence of postoperative emesis. The purpose of this prospective study was to examine the influence of propofol and isoflurane anaesthesia on the incidence of postoperative nausea and vomiting in children. ⋯ Propofol-sufentanil anaesthesia results in less emesis and treatment during the early postoperative phase irrespective of N2O administration compared with propofol-induced isoflurane anaesthesia and may be recommended in children undergoing squint surgery.
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Clinical TrialThe efficacy of clonidine for reducing perioperative haemodynamic changes and volatile anaesthetic requirements in children.
Oral clonidine given as a premedicant in adults has been shown to reduce intraoperative inhalation anaesthetic requirements and provide perioperative haemodynamic stability. We conducted the current study to ascertain whether or not these beneficial effects of clonidine can be reproduced in children. ⋯ Oral clonidine premedication at a dose of 4 micrograms kg-1 provided intraoperative haemodynamic stability and reduced anaesthetic requirements in children. However, we are unable to extrapolate these observations to younger children and infants.
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Acta Anaesthesiol Scand · Jul 1996
Introducing epidural fentanyl for on-ward pain relief after major surgery.
Epidural opioids have been recommended for analgesia after major surgery. In this report we describe how we introduced a low-cost, on-ward, nurse-based acute pain service using epidural fentanyl after major surgery in the University Hospitals of Oulu and Kuopio. ⋯ With well-trained nurses, careful monitoring and appropriate protocols, epidural fentanyl infusion proved to be a feasible method for pain relief after major surgery on a surgical ward.