Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 1996
Randomized Controlled Trial Clinical TrialReduction of propofol pain--fentanyl vs lidocaine.
To compare the local efficacy of lidocaine and fentanyl in reducing propofol injection pain (PIP), we conducted a prospective randomized double-blind study in 75 ASA I and II adult patients. When administered 20 seconds before propofol with a venous tourniquet, lidocaine but not fentanyl or placebo, reduced the incidence of moderate to severe pain on subsequent injection of propofol (P < 0.001). ⋯ Fifteen (60%) in the fentanyl group (n = 25) experienced moderate or severe degrees of pain, compared with 15 (60%) in the saline group (n = 25). We conclude that lidocaine, acting locally, reduce propofol injection pain while fentanyl does not.
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Middle East J Anaesthesiol · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intubation conditions under propofol in children--alfentanil vs atracurium.
We have assessed tracheal intubating conditions in 45 ASA I-II children, aged 4-14 years, undergoing elective ear, nose and throat surgery. After the induction dose of propofol 2.5 mgkg-1, Group I received alfentanil 10 ugkg-1, Group II received alfentanil 20 ugkg-1 and Group III received atracurium 0.5 mgkg-1 for tracheal intubation. The mean arterial pressure (MAP), heart rate (HR), arterial oxygen saturation (SaO2), end tidal carbondioxide (ETCO2) and intubation conditions were investigated. ⋯ There were no significant differences in the overall assessment of intubating conditions between the three groups. Intubations were accomplished in 94% of the patients in Group I and II, and 100% of the patients in Group III. We conclude that the combination of propofol and alfentanil conditions for treacheal intubation in children and attenuate the hemodynamic responses to layngoscopy and tracheal intubation.
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Middle East J Anaesthesiol · Oct 1996
Case ReportsHazards of nitrous oxide administration in presence of venous air embolism.
Nitrous oxide administration in presence of venous air embolism results in its volume augmentation. The present case report of a 50-year old patient undergoing posterior fossa tumor excision in the sitting position demonstrates the hazards of nitrous oxide in presence of venous air embolism. Administration of 66% nitrous oxide 140 minutes after the incidence of air embolism resulted in a significant decrease of end-tidal carbon dioxide tension, moderate hypotension, and tachycardia, suggesting volume augmentation of the air embolism. ⋯ Shapiro and colleagues suggest the use of nitrous oxide challenge as a diagnostic aid in deciding when lung excretion of intravascular air is complete. However, our case report implies that nitrogen washout was not complete 140 minutes after venous air embolism incidence. Accordingly, we recommend to stop nitrous oxide administration once air embolism is suspected and to refrain from its re-administration throughout the rest of surgery.