British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of induction and recovery between sevoflurane and halothane supplementation of anaesthesia in children undergoing outpatient dental extractions.
We have compared sevoflurane and halothane in a double-blind controlled study for supplementation of nitrous oxide and oxygen anaesthesia in 80 children undergoing dental extraction as outpatients. Induction of anaesthesia was more rapid in those who received sevoflurane compared with those who received halothane (89 s compared with 127 s for loss of eyelash reflex). In both groups, mean duration of administration of anaesthesia was less than 4 min. ⋯ The incidence of complications during induction and maintenance was low in both groups and return to normal appetite and activity occurred in the majority of children on the same day. More children who received halothane suffered nausea after leaving hospital. We conclude that sevoflurane is a suitable alternative to halothane, with more rapid induction of anaesthesia, but in these short procedures, awakening time was slower than after halothane.
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Comparative Study Clinical Trial Controlled Clinical Trial
Metabolic effects of i.v. propacetamol, metamizol or external cooling in critically ill febrile sedated patients.
We have measured the metabolic response to sequential administration of propacetamol, metamizol and/or external cooling in 20 febrile patients under sedation and analgesia and during mechanical ventilation. There was no change in temperature (T degree) after propacetamol therapy, whereas after metamizol only a small decrease was noted (from 38.9 (SEM 0.2) to 38.5 (0.3) degrees C; P = 0.02). External cooling produced a significant decrease in T degree (39.1 (0.2) to 37.1 (0.2) degrees C; P < 0.0001) accompanied by a decrease in energy expenditure (EE) (2034 (73) to 1791 (88) kcal day-1; P < 0.004). ⋯ There were no other changes in haemodynamics or pulmonary gas exchanges. We conclude that propacetamol and metamizol did not produce a clinically significant decrease in T degree in febrile ICU patients whereas external cooling decreased both T degree and EE. The parallel decrease in body temperature and EE seemed to be related to opioid administration or sedation, or both.
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Randomized Controlled Trial Comparative Study Clinical Trial
Do anxiety or hypocapnia predispose to apnoea after induction of anaesthesia?
We have studied the incidence of apnoea after induction of anaesthesia in patients allocated randomly to receive a standardized dose of either propofol or etomidate. We measured anxiety before operation with a standard questionnaire and end-tidal carbon dioxide concentration from a mask during breathing 35% oxygen, before induction of anaesthesia. Respiration was measured by pneumotachograph and impedance pneumograph. ⋯ There was no relationship between apnoea and end-tidal carbon dioxide concentration in these patients. Anxiety did not relate to the incidence of apnoea with either induction agent. We conclude that apnoea after induction of anaesthesia with propofol is more likely if hypocapnia is present but we could not relate apnoea or hypocapnia to anxiety in the ward before operation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Blood loss during first trimester termination of pregnancy: comparison of two anaesthetic techniques.
We have compared the effects of two anaesthetic techniques on blood loss during suction termination of pregnancy. Forty-eight ASA grade I-II patients were allocated randomly to one of two groups: group 1 received propofol induction followed by a standard propofol infusion; group 2 received propofol induction followed by maintenance with 1% isoflurane. Both groups received bolus doses of either propofol (group 1) or isoflurane (group 2) if anaesthesia was too light. ⋯ Estimation of blood loss was performed by atomic absorption spectrometry. Mean blood losses were 40.4 ml for the isoflurane group and 18.8 ml for the propofol group. This difference was statistically significant (P = 0.0011), although actual volumes of blood loss were small and not clinically significant.