Der Anaesthesist
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Randomized Controlled Trial Clinical Trial
[Interactions of H2 antagonists and non-depolarizing muscle relaxants].
Many drugs potentiate the action of non depolarizing relaxants. These interactions are of clinical importance if such drugs are administered during the perioperative period. H2 Antagonists are increasingly often used for premedication. ⋯ Experimental investigation has shown that calcium reverses the cimetidine effects. It is therefore probable that the cimetidine--relaxant interaction occurs at the presynaptic level. Careful observation seems to be necessary if H2 antagonists, especially cimetidine, are administered intraoperatively at the same time as drugs that also enhance
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Randomized Controlled Trial Clinical Trial
[Decrease in paO2 following intratracheal application of a local anesthetic and a 0.9% sodium chloride solution. A prospective study on the use of fiberoptic bronchoscopy in ventilated patients during local anesthesia].
Flexible fiberoptic bronchoscopy of intubated patients can be performed in general or local anesthesia (LA). Up to now, no results have been published on the effects of LA for bronchoscopy in ventilated patients. We studied the hemodynamic changes caused by bronchoscopy under LA in mechanically ventilated patients and the effect of LA on the endoscopic decline in arterial pO2. ⋯ CONCLUSIONS. The study shows that in ventilator patients undergoing fiberoptic bronchoscopy in LA, the administration of the LA is an essential factor in the decline in paO2 associated with bronchoscopy. A similar fall in paO2 is observed by intratracheal
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Randomized Controlled Trial Clinical Trial
[The clinical significance of drug interactions between opiates and calcium antagonists. A randomized double-blind study using fentanyl and nimodipine within the framework of postoperative intravenous on-demand analgesia].
It is widely accepted that the nociceptive state and opiate-induced nociception are regulated at least in part by calcium ions. Animal experiments suggest that systemically or intracerebroventricularly applied calcium antagonizes analgesic effects, whereas calcium chelating agents or calcium channel blockers enhance them. Recently, von Bormann et al. [3] reported a fentanyl-saving effect in cardiovascular patients who had received an intraoperative infusion of nimodipine; this finding was discussed as a possible synergistic analgesic interaction. ⋯ Fentanyl consumption, pain scores (actual and retrospective), blood pressure, heart rate, respiratory rate, and side-effects were monitored. The mean duration of patient-controlled analgesia was 16 (P) to 19 (N) h, during which time 0.64 +/- 0.46 (N) to 0.79 +/- 0.43 (P) micrograms fentanyl/kg/h was demanded. Pain relief was very satisfactory in 92.5% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[Rectal premedication with midazolam in children. A comparative clinical study].
Anesthetic premedication by injection is usually poorly accepted by children, especially those under 10 years of age. Less disturbing for the child is oral premedication, but this increases the risk of aspiration and must be administered 1.5-2 h before anesthetic induction. This double-blind study was performed in children to investigate the efficacy, acceptance, and general safety of midazolam given rectally. ⋯ At this time 21.7% of the children in group I were tired/drowsy, whereas 50% in group II were tired/drowsy and 9.1% were asleep but easy to arouse. This effect was significantly greater in group II (P less than 0.01). Acceptance of the mask was comparable in both groups (Table 4) and was tolerated well to very well by 92-97% of the children. (ABSTRACT TRUNCATED AT 400 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[Frequency and severity of throat complaints following general anesthesia with the insertion of various endotracheal tubes].
Laryngeal and pharyngeal complaints following general anaesthesia are well-known problems. The frequency, extent, and intensity reported in several studies are at variance. Such transient postoperative problems should not be considered equivalent to traumatic airway injuries caused by endotracheal intubation. ⋯ The patients of groups A-D underwent oral intubation using lidocaine gel 2%; adequate cuff inflation was determined just after intubation. The patients were questioned every 24 h for 2 days postoperatively using an analogue scale and "open" and "closed" questions. The single groups were comparable in age, sex, height, weight, number of smokers, duration of operation (only groups A-D), and preoperative diseases of the upper airways.(ABSTRACT TRUNCATED AT 250 WORDS)