European journal of anaesthesiology. Supplement
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Eur J Anaesthesiol Suppl · Sep 1995
Clinical TrialThe effect of dose and the rate of stimulation on the action of rocuronium.
We studied the effect of administering multiples of the ED90 dose of rocuronium on the onset, duration and recovery index of neuromuscular block. The effect on onset time differed from that reported using train-of-four stimulation. This led us to investigate the effect of increasing the rate of ulnar nerve stimulation 10-fold. This resulted in an approximately 50% reduction in the time to complete block.
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Eur J Anaesthesiol Suppl · May 1995
ReviewPre-emptive analgesia: evidence, current status and future directions.
Although some studies of pre-emptive analgesia have reported small reductions in post-operative pain or analgesic consumption in favour of pre-incisional vs. post-incisional or post-operative treatment, most have not demonstrated any benefit at all. This paper reviews recent evidence supporting the effectiveness of pre-emptive analgesia and discusses factors that may be responsible for the lack of consistent results. ⋯ Given the constraints of clinical research and current standards of practice, it is unlikely that studies of pre-emptive analgesia using conventional analgesics or local anaesthetics will yield large reductions in post-operative pain or analgesic consumption. Extending the pre-emptive treatment well into the post-operative period using balanced, multimodal analgesia, may prolong the initial advantage conferred by the pre-operative blockade and possibly interfere with the development of long-lasting pain.
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Day surgery has a remarkable overall record of safety. To provide safe anaesthesia and as little post-anaesthetic psychomotor and cognitive impairment as possible after longer and more extensive operations performed in ambulatory surgical facilities, we must carefully assess home readiness and instruct patients in such a way that they receive and understand all relevant information. ⋯ Recommendations not to drive after anaesthesia or sedation vary between 24 and 48 hours, depending on the duration of anaesthesia. It is hoped that the recently introduced short-acting drugs will further improve outcome of day surgery by providing fast exit and early return to normal daily activities.
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Eur J Anaesthesiol Suppl · May 1995
Randomized Controlled Trial Clinical TrialEffect of premedication on 'Diprifusor' TCI.