Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialSevoflurane mask induction in adults: comparison of two inhalation techniques.
The efficacy and safety of two inhalation techniques for mask induction using high concentrations of sevoflurane (8%) were compared in female patients planned for short gynecological procedures in an out-patient setting. One group (n = 20) received single breath vital capacity rapid inhalation induction (VCRII), the other group (n = 20) multiple deep breaths inhalation induction (DBI). ⋯ The respiratory and hemodynamic side effects were also similar. The appreciation of the induction technique was comparable in both groups and most patients agreed to the same inhalation technique with a mask in future anesthetics.
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Acta Anaesthesiol Belg · Jan 1997
ReviewUse of intermediate acting muscle relaxants by infusion: the future.
The usefulness of newer intermediate-acting muscle relaxants rocuronium and cisatracurium when used by infusion has been reviewed briefly and their main features pointed out. Comparative features of atracurium, vecuronium and mivacurium have also been described. Both new agents may have advantages for use by infusion particularly for longer procedures, due to the lack of detectable metabolites with rocuronium and production of comparatively smaller amounts of metabolites with cisatracurium.
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Acta Anaesthesiol Belg · Jan 1997
Case ReportsAccidental overdosing with intraspinal morphine caused by misprogrammation of a Synchromed pump: a report of two cases.
Spinally administered opioids must be a last step in the therapeutical arsenal of chronic benigne pain. It is an invasive technique not free from adverse effects. Two chronic pain patients received an implantable Synchromed pump for treatment with spinal opiates after a trial period of resp. 3.5 and 5.5 months. ⋯ A short time development of tolerance to life threatening side-effects has been proven by this accidental administration of high-dose intraspinal opiates. It is critical that care providers are knowledgeable and well-trained about implantable infusion systems. Programmation and refills must always be performed with care.
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Anesthesia for day case or ambulatory surgery must be specifically tailored to meet its specialized goals, and the use of sevoflurane helps to meet these goals. Maintenance of sevoflurane anesthesia is associated with good titratability and short early recovery times. The rapidity and quality of recovery after sevoflurane anesthesia are as good or better than other available agents. ⋯ The cost of induction with sevoflurane is significantly less than the standard agent propofol, and is even less when sevoflurane is used for both induction and intubation. The costs of maintenance with sevoflurane are more than isoflurane but less than propofol, and can be reduced to low money amounts by the use of N2O and low fresh gas flows, as well as elimination of the anesthetic adjuvant drugs. These new, cost effective anesthetic techniques are useful additions to the spectrum of anesthetic choices for ambulatory surgery.