Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Clinical TrialAdditive analgesic effect of codeine and paracetamol can be detected in strong, but not moderate, pain after Caesarean section. Baseline pain-intensity is a determinant of assay-sensitivity in a postoperative analgesic trial.
A randomized, double-blind, placebo-controlled single oral dose study was done in order to examine whether codeine has an additive analgesic effect to that of paracetamol for moderate and strong postoperative pain after abdominal surgery. The maximum recommended single dose of paracetamol 1000 mg (Paracet) was compared with a combination of a submaximal dose of paracetamol 800 mg plus codeine 60 mg (Paralgin forte) and placebo for pain relief after Caesarean section in 125 patients. ⋯ This study thus confirms that codeine has additive analgesic effect to paracetamol in pain after surgery. Our results show the importance of initial pain intensity in postoperative assessment of analgesic drugs. Assay-sensitivity and test power are increased by selecting patients with sufficiently high initial pain intensity and by comparing groups of patients with identical surgery and similar demographic variables.
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intubating conditions after rocuronium and suxamethonium following "rapid-sequence induction" with thiopentone in elective cases.
Rocuronium (Org 9426) was shown to have the fastest onset of action of all currently available non-depolarizing neuromuscular blocking drugs and to provide intubating conditions similar to those of suxamethonium 60 to 90 s after administration. We compared the intubating conditions after rocuronium and suxamethonium following rapid-sequence induction of anaesthesia. ⋯ The authors conclude that rocuronium is a suitable alternative to suxamethonium for rapid tracheal intubation even under unsupplemented thiopentone anaesthesia, at least in elective, otherwise healthy patients. Its use for rapid-sequence induction under emergency conditions, however, needs further investigation.
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Clinical TrialRectal administration of morphine in children. Pharmacokinetic evaluation after a single-dose.
There is limited knowledge about the pharmacokinetics of morphine and its metabolites after rectal administration in children. In this study the pharmacokinetics of two different rectal formulations of morphine were examined and compared with intravenous morphine. ⋯ The rectal morphine hydrogel has pharmacokinetic properties which makes it a useful formulation for premedication and pain alleviation in paediatric patients.
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Clinical TrialThermoregulatory response in female patients during lower abdominal surgery in the head-down tilt position.
The head-down tilt (HDT) position suppresses sympathetic nervous activity. We investigated the effect on thermoregulation of the HDT position during lower abdominal surgery under general anaesthesia. ⋯ During lower abdominal surgery the head-down tilt position does not augment core hypothermia in spite of suppressed peripheral vasoconstriction, and the renin-angiotensin system may be of importance for thermoregulation.
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Acta Anaesthesiol Scand · Apr 1996
Preoperative evaluation of intubation conditions in patients scheduled for elective surgery.
Prediction of a difficult airway is a continuing problem. Several tests have been developed in order to overcome this problem. It has been proposed that using more than one test could increase the degree of predictability. ⋯ It was possible to predict differenties in all seven patients, but it was found that only the Mallampati gradation and the atlanto-occipital angle contributed significantly to predictability. The cost of predicting further difficulties in all patients with a difficult laryngoscopy was a false positive prediction in a further 13 patients who had no problems with laryngoscopy or intubation. By increasing the specificity of the tests the number of false positive classifications could be reduced to 10 patients, but this would have led to the missing of one patient with a difficult laryngoscopy.