Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Jun 2010
Randomized Controlled Trial Comparative StudyTramadol versus low dose tramadol-paracetamol for patient controlled analgesia during spinal vertebral surgery.
Pain intensity may be high in the postoperative period after spinal vertebral surgery. The aim of the study was to compare the effectiveness and cost of patient controlled analgesia (PCA) with tramadol versus low dose tramadol-paracetamol on postoperative pain. A total of 60 patients were randomly divided into two groups. ⋯ The number of side effects, additional analgesic requirement and the total dose of tramadol were lower in Group P than in Group T. However, the total cost of postoperative analgesics was significantly higher in Group P than in Group T (p < 0.001). We conclude that PCA using tramadol-paracetamol could be used safely for postoperative pain relief after spinal vertebral surgery, although at a higher cost than with tramadol alone.
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Kaohsiung J Med Sci · May 2010
Randomized Controlled TrialEffects of fentanyl-lidocaine-propofol and dexmedetomidine-lidocaine-propofol on tracheal intubation without use of muscle relaxants.
The aim of this study was to compare the effects of fentanyl or dexmedetomidine when used in combination with propofol and lidocaine for tracheal intubation without using muscle relaxants. Sixty patients with American Society of Anesthesiologists stage I risk were randomized to receive 1 mg/kg dexmedetomidine (Group D, n = 30) or 2 mg/kg fentanyl (Group F, n = 30), both in combination with 1.5 mg/kg lidocaine and 3 mg/kg propofol. The requirement for intubation was determined based on mask ventilation capability, jaw motility, position of the vocal cords and the patient's response to intubation and inflation of the endotracheal tube cuff. ⋯ After intubation, the rate pressure product values were significantly lower in Group D than in Group F (p < 0.05). We conclude that endotracheal intubation was better with the dexmedetomidine-lidocaine-propofol combination than with the fentanyl-lidocaine-propofol combination. However, side effects such as bradycardia should be considered when using dexmedetomidine.
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Kaohsiung J Med Sci · Apr 2010
Randomized Controlled Trial Comparative StudyComparison of spinal, low-dose spinal and epidural anesthesia with ropivacaine plus fentanyl for transurethral surgical procedures.
The aim of This study was to compare spinal, low-dose spinal, and epidural anesthesia using ropivacaine and fentanyl combinations for transurethral surgical procedures. Sixty patients with American Society of Anesthesiologists scores of I-III were allocated into three groups. After pre- loading with 5 mL/kg normal saline, patients in the spinal anesthesia group (Group S) received 15 mg of hyperbaric ropivacaine plus 25 microg of fentanyl intrathecally; patients in the epidural anesthesia group (Group E) received 112.5 mg of ropivacaine plus 25 microg of fentanyl epidurally via an epidural catheter; and patients in the low-dose spinal anesthesia group (Group L) received 10 mg of hyperbaric ropivacaine plus 25 microg of fentanyl intrathecally. ⋯ No complications or adverse effects were observed in any patient. We conclude that all three anesthetic techniques may be used safely and are appropriate for transurethral surgical procedures. However, low-dose spinal anesthesia with ropivacaine plus fentanyl may be preferable in transurethral surgery because we reach an adequate sensorial level with less motor blockade.
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Kaohsiung J Med Sci · Oct 2007
Randomized Controlled TrialLightwand-guided endotracheal intubation performed by the nondominant hand is feasible.
The aim of this study was to evaluate the efficiency of lightwand-guided endotracheal intubation (LWEI) performed using either the right (dominant) or left (nondominant) hand. Two hundred and forty patients aged 21-64 years, with a Mallampati airway classification grade of I-II and undergoing endotracheal intubation under general anesthesia, were enrolled in this randomized and controlled study. Induction of anesthesia was initiated by intravenous administration of fentanyl (2 microg/kg) and thiopentone (5 mg/kg), and tracheal intubation was facilitated by intravenous atracurium (0.5 mg/kg). ⋯ A higher incidence of intubation-related oral injury and ventricular premature contractions (VPC) was found in group D compared with groups L and R (oral injury: group D 8.5%, group L 1.3%, group R 0%, p = 0.005; VPC: group D 16.3%, group L 5%, group R 7.5%, p = 0.04). We concluded that LWEI performed by either dominant or nondominant hands resulted in similar efficiency, and could be a suitable alternative to traditional laryngoscopy. It is both feasible and logical for an experienced anesthesiologist to use the nondominant hand to perform LWEI.
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Kaohsiung J Med Sci · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effect of two different doses of 0.75% glucose-free ropivacaine for spinal anesthesia for lower limb and lower abdominal surgery.
We compared the clinical efficacy and safety of two doses of ropivacaine for spinal anesthesia in Chinese patients undergoing lower limb and lower abdominal surgery. In this randomized, open-label study, 40 patients were divided into two groups: group A received 3.5 mL (26.25 mg) of 0.75% glucose-free ropivacaine, and group B received 4.5 mL (33.75 mg). Sensory and motor blocks were assessed during and after surgery through to complete recovery. ⋯ While shivering was more frequent in group B during the operation, the difference was not significant. Otherwise, there were no differences in adverse effects during and after surgery. We conclude that both doses of 0.75% glucose-free ropivacaine, 26.25 mg (3.5 mL) and 33.75 mg (4.5 mL), have the same efficacy and safety in Chinese patients undergoing spinal anesthesia for lower limb and lower abdominal surgery.