British journal of anaesthesia
-
Randomized Controlled Trial Clinical Trial
Dose-response relationships for edrophonium and neostigmine antagonism of mivacurium-induced neuromuscular block.
We have studied the dose-response relationships for neostigmine and edrophonium during antagonism of neuromuscular block induced by mivacurium chloride. Sixty-four ASA group I or II adults were given mivacurium 0.15 mg kg-1 during fentanyl-thiopentone-nitrous oxide-isoflurane anaesthesia. Train-of-four stimulation (TOF) was applied to the ulnar nerve every 10 s, and the force of contraction of the adductor pollicis muscle was recorded. ⋯ The doses of neostigmine required to achieve 50% (ED50) and 70% (ED70) recovery of the first twitch after 10 min were 2 (1.5-2.5) micrograms kg-1 and 4.7 (4.1-5.4) micrograms kg-1 (mean (95% confidence intervals)), respectively. Corresponding ED50 and ED70 values for edrophonium were 2.8 (0.75-10.2) micrograms kg-1 and 9.2 (3.6-23.6) micrograms kg-1, respectively. These values corresponded to neostigmine:edrophonium potency ratios of 1.4 (0.4-2.4) and 1.95 (0.9-2.9) for first twitch ED50 and ED70 height, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Clinical Trial
Tropisetron for postoperative nausea and vomiting in patients after gynaecological surgery.
In a double-blind study, we have compared the prophylactic antiemetic effect of tropisetron 5 mg (Navoban, a 5-HT3 receptor antagonist) with that of placebo, both given as a short i.v. infusion approximately 15 min before wound closure in patients undergoing gynaecological surgery. Perioperative anaesthetic care was standardized and patients were observed for at least 24 h after operation. ⋯ Vomiting occurred in 26% of tropisetron-treated patients, compared with 59% of placebo-treated patients (P = 0.006); 69% of tropisetron-treated patients suffered nausea, compared with 88% of placebo-treated patients (P = 0.05). In addition, patients judged the antiemetic treatment with tropisetron as more effective than the placebo treatment (visual analogue score 71 vs 51 mm (P = 0.003)).
-
Randomized Controlled Trial Clinical Trial
Clonidine combined with sufentanil and bupivacaine with adrenaline for obstetric analgesia.
Clonidine produces analgesia via a non-opioid mechanism and it may be used as an interesting adjuvant to local anaesthetics and opioids in obstetric analgesia. To examine the effects of the addition of clonidine to bolus injections of bupivacaine, adrenaline and sufentanil, we enrolled 50 women receiving extradural analgesia for vaginal delivery into a double-blind study. They were allocated randomly to two groups: group A received a 10-ml extradural solution of bupivacaine 12.5 mg combined with adrenaline 25 micrograms and sufentanil 10 micrograms; group B received the same solution with clonidine 30 micrograms. ⋯ During the first and second stages of labour, there was no difference between the two groups in duration of analgesia after the first injection (142 min in group A; 127 min in group B), number of injections (1.8 in group A; 1.9 in group B) and the total bupivacaine requirements (33.9 mg in group A; 34 mg in group B). The quality of analgesia was evaluated as very good in both groups (23/25 in group A; 24/25 in group B). The degree of motor block or the frequency of other side effects were not enhanced by clonidine.(ABSTRACT TRUNCATED AT 250 WORDS)
-
We studied mid-latency auditory evoked potentials (MLAEP) during induction of general anaesthesia with ketamine 2 mg kg-1. MLAEP were recorded before, during and after induction of general anaesthesia on the vertex (positive) and mastoid (negative) positions. Latencies of the peak V, Na, Pa, Nb, P1 and amplitudes Na/Pa, Pa/Nb and Nb/P1 were measured. ⋯ Amplitudes and latencies of MLAEP did not change during induction of general anaesthesia with ketamine. Primary processing of auditory stimuli in the primary auditory cortex seemed to be preserved under ketamine. Suppression of sensory (auditory) information processing must take place at a higher cortical level in a dissociative manner.