Der Anaesthesist
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[The cardiovascular effects of sevoflurane].
The cardiovascular effects of sevoflurane as published from clinical and experimental studies are reviewed with respect to general haemodynamics and organ perfusion. Sevoflurane appears to be quite similar to isoflurane, with some minor exceptions. In adult patients and volunteers, sevoflurane has not been associated with increases in heart rate, whereas isoflurane and desflurane caused significant increases in heart rate at higher concentrations. ⋯ In several multi-center studies where patients with coronary artery disease or at high risk for coronary artery disease were randomised to receive either sevoflurane or isoflurane for cardiac or non-cardiac surgery, the incidence of myocardial ischaemia and infarction did not differ between treatment groups. In both human and animal models, sevoflurane preserves cerebral blood flow and reduces cerebral metabolic rate much like isoflurane. Considering its favourable pharmacokinetic properties, the introduction of sevoflurane into clinical practice appears to be a promising extension of the anaesthetic spectrum.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Incidence and quality of dreaming during anesthesia with propofol in comparison with enflurane].
Since the introduction of propofol into clinical practice, dreaming during general anaesthesia has been frequently reported with this drug. We investigated the incidence and character of these dreams with regard to distinction from intraoperative awareness and in comparison with habitual dreams or dreams during general anaesthesia with enflurane. ⋯ We conclude that sensory experiences during propofol anaesthesia are not stimulus-related perceptions or awareness, but dreams similar to normal ones. In view of the absence of clear signs of stimulus-related response, we presume that dreaming is a specific side effect of propofol. Because of the absence of difficulties, dreaming during propofol anaesthesia appears not to be a disadvantage with regard to the quality of anaesthesia.
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The inhalational anaesthetic fluor-methyl-trifluor-1-(trifluoromethyl)-ethylether sevoflurane has been known for more than 20 years and is structurally related to the currently available volatile anaesthetics. This anaesthetic is characterized by a low blood/gas partition coefficient of 0.69 and high fat solubility, leading to a sharp rise in alveolar concentration and quick anaesthesia induction. As opposed to desflurane, sevoflurane does not boil at ambient temperature, thus making a special vaporizer unnecessary. ⋯ As opposed to methoxyflurane, which may be nephrotoxic due to its microsomal metabolism in kidney tissue, sevoflurane does not seem to cause clinical inhibition of renal function even at plasma fluoride levels above 50 mumol/l, a concentration thought to be associated with renal tubular impairment. A possible reason for this observation is lower metabolism of sevoflurane within renal tissues. Due to its quick onset and fast elimination, sevoflurane is an interesting new volatile anaesthetic offering various clinical advantages.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Comparison of sevoflurane and isoflurane in ambulatory surgery. Results of a multicenter study].
A multicenter, randomized, comparative phase III study evaluating the effect of sevoflurane versus isoflurane in adult outpatients was performed. The aim of the study was to compare (1) maintenance of anaesthesia and (2) how rapidly and easily the patients emerge from the anaesthetic and recover. ⋯ Sevoflurane was as safe as isoflurane for anaesthesia in adult outpatients. Patients who received sevoflurane had statistically significantly shorter recovery parameters than isoflurane patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparative study of the use of sevoflurane and propofol in ambulatory surgery].
Cost-containment strategies increase the demand for day-case surgery. In outpatients, a short time of stay in the post-anaesthesia care unit and a short interval to discharge home are of great importance. After general anaesthesia, mental and psychomotor functions are impaired to varying degrees by different anaesthetics. Therefore, the choice of anaesthetic may influence the discharge times of outpatients. In this study, the recovery characteristics of sevoflurane versus propofol anaesthesia were compared in adult outpatients. ⋯ The results indicate that in urological and ophthalmological day surgery, the early recovery and the return of mental and psychomotor function in the first 60 min after anaesthesia is faster following sevoflurane than after propofol. No differences in ambulation times became evident. Sevoflurane may offer clinical advantages over propofol when used for maintenance of anaesthesia during outpatient surgical procedures.