Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous propofol vs thiamylal-isoflurane for caesarean section, comparative maternal and neonatal effects.
Several studies on propofol (Diprivan) for induction of anaesthesia during caesarean section have demonstrated its safety, however, it safety during maintenance of anaesthesia is not yet fully evaluated. The present study was undertaken to compare the maternal and neonatal effects of propofol or isoflurane in 74 term parturients undergoing primary or repeat caesarean section. Patients were randomly assigned to two groups, propofol group (n = 37) received propofol 1.5-2.5 mg.kg-1 for induction followed by a continuous infusion of propofol of 0.05-0.2 mg.kg-1.min-1. ⋯ Maternal blood loss as well as intraoperative awareness and recovery time did not differ significantly between the two groups. Neonatal status as ascertained by Apgar scores, cord acid base status and the neurological and adaptive capacity scores (NACS) was equally good in both groups. It is concluded that propofol used for induction and maintenance of anaesthesia is a safe alternative to thiamylal/isoflurane for patients undergoing caesarean section and is associated with less hypertensive response during laryngoscopy and intubation.
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Acta Anaesthesiol Scand · Feb 1995
Randomized Controlled Trial Clinical TrialDesflurane analgesia for vaginal delivery.
The use of subanaesthetic concentration of inhalational anaesthetic for vaginal delivery offers many advantages to the mother and newborn. Desflurane, with the characteristics of rapid onset and minimal metabolism, may provide better analgesia and safety for labour pain control. Eighty healthy parturients were randomly assigned to receive either desflurane 1.0-4.5% and oxygen (n = 40) or nitrous oxide 30-60% in oxygen (n = 40). ⋯ Blood loss did not differ significantly, 364 ml for the desflurane group and 335 ml for the nitrous oxide group. There were no significant differences for neonatal Apgar score at 1 min or at 5 min or the NACS at 2 hr or 24 hr between the two groups. We conclude that desflurane in subanaesthetic doses is safe and effective inhalation agent for normal delivery but might be associated with amnesia.
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Acta Anaesthesiol Scand · Feb 1995
Randomized Controlled Trial Clinical TrialPotency and maintenance requirement of atracurium and vecuronium given alone or together.
A synergism exists between some competitive muscle relaxants. However, maintenance requirement of a combination of muscle relaxants has been evaluated only in paediatric patients. We studied 45 elective adult surgical patients (ASA I-II) during propofol-alfentanyl-N2O-O2-anaesthesia. ⋯ Thus, a significant potentiation was maintained also during the course of anaesthesia. A cAV had an effect like one intermediate-acting agent. If a cAV is used instead of using atracurium or vecuronium alone, the maximal reduction of drug consumption would be approximately 30%.
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Acta Anaesthesiol Scand · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialPrilocaine reduces injection pain caused by propofol.
Propofol, which is commonly used for outpatient anaesthesia, may evoke pain during infusion. Forty-eight patients (ASA-I-II) undergoing elective uterine dilatation and curettage received randomly in a standardised fashion: A: Propofol mixed with prilocaine; B: Propofol and lidocaine; C: Propofol with prilocaine+lidocaine (equal amounts) or D: Propofol and saline. The final ratio of propofol:local anaesthetic/saline was 9:1 in all mixtures. ⋯ Another twenty-two comparable patients were given 30 mg of ketorolac or an equal volume of saline intramuscularly 45-60 minutes prior to propofol. Ketorolac given before propofol did not reduce pain on injection. This indicates that inhibition of the cyclooxygenase pathway of arachidonic acid metabolism does not play a major role in the reduction of this pain.
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Acta Anaesthesiol Scand · Feb 1995
Case ReportsIntraoperative anaphylaxis caused by a hydatid cyst.
The incidence of the hydatid disease is still high in some regions of the Mediterranean. A serious, but rare, peroperative complication is IgE-mediated anaphylaxis, as a result of passing of the highly antigenic hydatid cyst content into the bloodstream. We present here a case of anaphylactic reaction in a patient who underwent surgical treatment of hydatid cyst.