Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1987
Randomized Controlled Trial Comparative Study Clinical TrialThe use of midazolam and diazepam for sedation following aorto-coronary bypass surgery.
The new water-soluble benzodiazepine midazolam was compared in a randomized study to diazepam for postoperative sedation in fifty patients following aortocoronary bypass surgery with a sufentanil-anesthesia. Midazolam and diazepam were administered intravenously in repeated doses in conjunction with an opioid infusion (piritramide) from the end of surgery during a twelve-hour study period, patients being artificially ventilated. Midazolam scored better than diazepam for quality of sedation and cardiovascular stability during the period of mechanical ventilation and for respiration during the weaning period and after extubation, although no difference was found in weaning time from artificial ventilation and time of extubation. ⋯ The administration of a loading dose of midazolam 5 mg caused a slight, transient decrease in mean arterial pressure. Midazolam appeared to be a more effective sedative agent than diazepam for short-term administration during mechanical ventilation. No evidence of cumulation and prolonged recovery was seen.
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During a consecutive period of 24 months, 244 patients with a major trauma were admitted to the Intensive Care Unit. From this pool of patients 60 consecutively were selected who did fulfill the selected criteria. ⋯ We could conclude that no currently used diagnostic test may be seen as an accurate prediction of patients who still develop morbidity or mortality from cardiac contusion. Data from the literature suggest that at present only radionuclide angiography, direct hemodynamic measurement with construction of a Starling curve, and/or 2D-echocardiography may be useful in the identification of the patients at the greatest risk and predictive of the severity of the myocardial injury.
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Acta Anaesthesiol Belg · Jan 1987
Randomized Controlled Trial Comparative Study Clinical TrialCryoanalgesia for post-thoracotomy pain relief.
A randomized study comparing the postoperative requirements of narcotics of three groups of patients (Group I: no analgesia; Group II: internal intercostal nerve block; Group III: cryoanalgesia) was conducted. This study was performed in order to assess the efficiency of cryoanalgesia versus internal intercostal nerve block to obtain pain relief after thoracotomy. Regarding post-operative narcotic requirements (Piritramide-Dipidolor), there was no significant difference between Group I and Group II patients, but patients from Group III required a significantly lower amount of narcotics during the first 36 postoperative hours (p less than 0.01). We conclude that, although cryoanalgesia does not provide complete post-thoracotomy pain relief, it is however an easy and safe method and is more efficient than internal intercostal nerve block for pain relief after thoracotomy.
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Acta Anaesthesiol Belg · Jan 1987
Clinical Trial Controlled Clinical TrialA double-blind comparison of the efficacy of lorazepam FDDF versus placebo for anesthesia premedication in children.
Lorazepam was tried in a new formulation (FDDF) as premedication in twenty children, aged between 5-10 years. The study was performed in a double-blind fashion using lorazepam 1 mg and placebo in identical FDDF preparations. No significant differences were observed between the two treatment groups except for the recall of the venipuncture and awakening. ⋯ In both lorazepam groups awakening from anesthesia was prolonged. Side effects were reported in several patients receiving lorazepam. As lorazepam FDDF performed not better than a placebo as premedication for children its use is not recommended in pediatric anesthesia.
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Acta Anaesthesiol Belg · Jan 1987
Comparative StudyAtropine methylbromide and glycopyrrolate. A comparative study during reversal of neuromuscular block.
Two quaternary anticholinergics, atropine methylbromide (methylatropine bromide, MAB) and glycopyrrolate (ROBINUL) were compared as adjuncts to neostigmine for the reversal of residual nondepolarising neuromuscular block. MAB 0.75 mg in combination with neostigmine 2 mg produced a marked initial rise in heart rate. ⋯ The antisialogogue effects of the two anticholinergics were identical and the central nervous system status of the patients was similar. It is concluded that, with the doses used in this study, glycopyrrolate is a superior alternative to MAB and is the drug of choice if a quaternary ammonium anticholinergic is required.