British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of recovery after neuromuscular blockade by atracurium or pancuronium.
Thirty patients were randomly allocated to receive either atracurium or pancuronium for neuromuscular blockade during surgery. At the end of the operation residual paralysis was antagonized with neostigmine. ⋯ Double vision was significantly more frequent at up to 1 h when pancuronium had been used. At no time was there any significant difference between the two groups in respect of the 5-s head lift or, after 30 min, in the measurement of inspiratory force.
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In summary, CPB provides a complex set of physiological circumstances during which the patient is subjected to severe physiological alterations with surprisingly few adverse sequelae. Our ultimate goal in performing medical research is to provide scientific insights that improve patient care. Results of studies of animal models may not always be applicable to man. Although CPB possesses faults inherent to any experimental model, it nonetheless provides a unique opportunity to study safely and effectively a variety of physiological and pharmacological variables that affect cardiovascular functions in man.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind, multiple-dose comparison of buprenorphine and morphine in postoperative pain of children.
In a randomized double-blind study of 57 children (aged 6 months-6 yr), pain following lateral thoracotomy was relieved with repeated i.v. doses of morphine 100 or 50 micrograms kg-1, or buprenorphine 3.0 or 1.5 micrograms kg-1. The same drug and dosage were continued and cardioventilatory indices, pain intensity and sedation measured for an observation period of 24 h. The sums of the pain intensity differences were equal in all groups. ⋯ The total consumption of both morphine and buprenorphine was less when the smaller bolus doses were used. Two patients developed a degree of ventilatory depression following repeated doses of buprenorphine. Buprenorphine was equal to morphine as a postoperative analgesic.
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The haemodynamic effects of propofol, given as a single dose of 2 mg kg-1 immediately followed by a continuous infusion of 6 mg kg-1 h-1, were studied in 10 elderly patients premedicated with lorazepam 1 mg i.v. All patients breathed room air spontaneously. ⋯ Cardiac output was not affected at any time nor were stroke volume and heart rate. We conclude that the arterial hypotension associated with the induction and infusion of propofol is mainly a result of a decrease in afterload without compensatory increases in heart rate or cardiac output.