Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Apr 1996
Comparative StudyMalignant hyperthermia (MH) diagnostics: a comparison between the halothane-caffeine- and the ryanodine-contracture-test results in MH susceptible, normal and control muscle.
Recent studies demonstrated different contracture responses in muscle from malignant hyperthermia susceptible (MHS) compared to normal (MHN) individuals following exposure to the plant alkaloid ryanodine in-vitro. To confirm if ryanodine has a specific action in MHS muscle, the effect of a single concentration was investigated in skeletal muscle from MHS, MHN and control subjects using a new evaluation technique. In-vitro contracture test (IVCT) and MH diagnosis were performed according to the European Protocol in 86 patients sent to us for MH diagnostic testing and in 24 controls. ⋯ These results suggest that MHS muscle has a higher sensitivity to ryanodine. However, the protocol should be investigated for reproducibility and validation of thresholds by other laboratories. Ryanodine can help to improve MH diagnostic tests.
-
Acta Anaesthesiol Scand · Mar 1996
Randomized Controlled Trial Clinical TrialEffect of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for post-cesarean section pain relief.
Nausea and vomiting are important side effects following administration of epidural morphine for post-Cesarean section pain relief. Stimulation of the P-6 (Neiguan) acupoint is a traditional Chinese acupuncture modality used for antiemetic purpose; it has been found to be effective. The aim of this study was to evaluate the antiemetic effect of P-6 acupressure in parturients given epidural morphine for post-Cesarean section pain relief. ⋯ The results demonstrate that prophylactic use of acupressure bands bilaterally on the P-6 acupoint can significantly reduce incidence of nausea and vomiting after epidural morphine for post-Cesarean section pain relief.
-
Acta Anaesthesiol Scand · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled premedication by i.v. midazolam for ambulatory surgery.
Applying the principle and equipment of patient-controlled analgesia, this double-blind randomised study was designed to determine the premedication dose of midazolam and to provide information about the need for preoperative anxiety control. The effects of patient-controlled premedication by i.v. midazolam were compared to those of a 1-hour i.v. infusion of a fixed dose of 4 mg. Two groups of 25 patients were studied prior to ambulatory surgery. ⋯ Reduced doses of midazolam self-administered via a patient-controlled device can result in a relaxed preoperative period and amnesia in ambulatory surgery patients. However, the level of anxiety before premedication was low, which calls into question the legitimacy of the patient-controlled premedication in this kind of population. The expense of the pump was not justified by the small number of patients using it, probably because they were worried by the technical nature and the invasiveness of this technique.
-
Acta Anaesthesiol Scand · Mar 1996
Randomized Controlled Trial Clinical TrialIs preoperative ketorolac a useful adjunct to regional anesthesia for inguinal herniorrhaphy?
Nonsteroidal antiinflammatory drugs (NSAIDs) have become a popular component of analgesia regimens, particularly in combination with narcotics. We questioned whether there might also be a place for their use in conjunction with regional anesthesia and whether there was a preferable route for NSAID administration. ⋯ Beyond the analgesia provided by the regional anesthesia of the ilioinguinal and field blocks, the preoperative use of ketorolac further reduced postoperative pain scores and the need for additional postoperative analgesic medication. Comparable outcomes for the i.v., i.m. and i.w. groups indicate the lack of any benefit to concentrating the non-steroidal anti-inflammatory drug at the wound (i.w.) or to achieving high blood levels rapidly (i.v.). In conclusion, ketorolac is a useful supplement to ilioinguinal plus field block regional anesthesia for hernia surgery and is most effective administered parenterally.