Anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Alfentanil in daycase anaesthesia. Assessment of a single dose on the quality of anaesthesia and recovery.
The effect of the addition of a single dose of 7 micrograms.kg-1 of alfentanil to a propofol/enflurane anaesthetic on the quality of anaesthesia and recovery was assessed. A total of 53 ASA grade 1 or 2 patients who underwent daycase dental surgery were allocated randomly to receive either alfentanil or saline. The study was blinded so that neither the anaesthetist nor the assessor was aware of which solution had been given. ⋯ The rate of recovery was similar in the two groups and no patient required hospital admission after the final assessment at 3 h. Drowsiness was only mild to moderate in both groups at 24 h. A single dose of alfentanil can be administered safely as part of a daycase anaesthetic without increasing morbidity, although there appears to be little advantage in doing so.
-
Randomized Controlled Trial Clinical Trial
The influence of diamorphine on spinal anaesthesia induced with isobaric 0.5% bupivacaine.
In a randomised, double-blind study, the effect of addition of 1 mg of diamorphine to 4 ml of 0.5% bupivacaine for spinal anaesthesia was studied in two groups each of 30 patients presenting for either transurethral genito-urinary surgery, or for lower limb arterial surgery or inguinal herniorrhaphy. Addition of 1 mg diamorphine to intrathecal 0.5% bupivacaine produced a prolonged and satisfactory analgesia in more than half the patients undergoing lower limb arterial or inguinal surgery, and the analgesic requirements of the remainder during the first postoperative 24 h were much less than those who received bupivacaine alone. In the urological surgery set there were no significant differences between the group who received bupivacaine and diamorphine, and the group who received bupivacaine alone. The mixture of diamorphine 1 mg in 4 ml 0.5% bupivacaine was slightly less hypobaric (0.9981 at 37 degrees C) than bupivacaine alone.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between propofol and desflurane anaesthesia for minor gynaecological laparoscopic surgery.
Fifty-seven healthy female patients who underwent gynaecological laparoscopic surgery received either desflurane or propofol for induction and maintenance of anaesthesia. Inhalational induction was generally well tolerated, and consciousness was lost in approximately 2 min (mean end-tidal concentrations of desflurane were 8.3% with 60% nitrous oxide, and 7.1% with oxygen). Recovery of consciousness and orientation were more rapid in patients in whom anaesthesia was maintained with desflurane than with propofol, but there were no differences in psychomotor function test scores at 30 min. The data suggest that desflurane provides controllable anaesthesia and rapid recovery of consciousness after laparoscopic surgery.
-
Comparative Study
Atracurium after an anticholinesterase. Does prior reversal with edrophonium or neostigmine influence the response to atracurium?
This study documents the response to atracurium (75 micrograms.kg-1) administered 30 min after a pancuronium- or tubocurarine-induced neuromuscular block has been reversed with either neostigmine (50 micrograms.kg-1) or edrophonium (0.5 mg.kg-1). Twenty-one ASA 1 or 2 patients were studied, of whom 11 received neostigmine and 10 edrophonium. ⋯ After atracurium (75 micrograms.kg-1), minimum values for the single twitch response compared with control were 52% and 66% in the neostigmine and edrophonium groups respectively. Prior administration of atracurium appears to potentiate the neuromuscular blocking effects of atracurium administered 30 min later.