Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Lidocaine plus fentanyl for controlling cardiovascular reactions to laryngoscopy and intubation].
Administration of fentanyl or lidocaine alone often insufficiently suppresses the haemodynamic reaction to laryngoscopy and intubation. We therefore evaluated the combination of both substances in patients with good ventricular performance (EF > 60%) undergoing coronary bypass surgery. 20 patients were randomly assigned to Group 1 (G1) or Group 2 (G2). ⋯ Whitney-Mann test (U-test) served for statistical evaluation. If compared to baseline (M1), induction of anaesthesia caused in both groups a significant decrease of MAP (G1: 109 to 81 mmHg; G2: 97 to 77 mmHg), CO (G1: 6.2 to 5.2 l/min; G2: 6.6 to 5.2 l/min), CI (G1: 3.3 to 2.8 l/min m2; G2: 3.5 to 2.7 l/min m2) and RPP (G1: 12701 to 10201 mmHg min-1; G2: 11309 to 8070 mmHg min-1).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical comparison of various infusion regimens within the scope of postoperative on demand analgesia with fentanyl].
80 patients (ASA I-III, mean age 40-50 years, mean weight 59-68 kg) recovering from major gynaecological surgery (170-200 min) under balanced anaesthesia were randomly assigned to four groups to self-administer intravenous fentanyl during the early postoperative period. PCA devices were ODAC and Prominject with fentanyl demand doses of 34.5 or 34 micrograms, respectively, and lockout times of 1 or 5 min. Concurrent fentanyl infusion was none (group Prom), fixed-rate with 4 micrograms/h (group ODACf), tail-dose, i.e., a fixed-rate infusion with 17 mg/h for a maximum of 60 minutes following a valid demand (group Prom(t)), or adaptive, starting with 4 micrograms/h and being adapted to individual needs depending on total fentanyl consumption in the latest 60-minute period (group ODACa). ⋯ Mean duration of a single fentanyl bolus dose was highly variable, ranging from 58 to 90 min if calculated for the total observation period. Statistically significant differences were found for none of the above mentioned PCA parameters. As a trend, the adaptive-rate infusion strategy was favoured (lowest demand rate, best retrospective pain scores).(ABSTRACT TRUNCATED AT 250 WORDS)