Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1993
Review[Is there an advantage to using opioid combinations by the peridural route?].
Epidural opioids provide a potent analgesia not devoided of side effects. In addition, epidural administration of lipid soluble opioids has no clear advantage over the IV route. Combination of epidural opioids with other analgesics may strengthen analgesia and may decrease the incidence of side effects because of a reduction in the amount of opioid administered. ⋯ Clonidine, which is a selective alpha-2-adrenergic agonist has been demonstrated to improve and to prolong analgesia produced by opioids in postoperative patients. Clonidine administration induces side effects, like sedation, bradycardia and hypotension, but allows to highly reduce the opioid dose. None of the combined techniques of analgesia implies that monitoring of the side effects of opioids has to be reduced.
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Cahiers d'anesthésiologie · Jan 1993
Review Comparative Study[A comparative study of recovery following maintenance of anesthesia with propofol or isoflurane. An attempt to synthesize current data].
Quality of recovery is a means to improve anaesthetic safety during postoperative time, in post-anaesthesia recovery room and especially when the patient returns to his unity. The comparison of recovery after maintenance of anaesthesia with propofol or isoflurane shows that, for 50 to 60 min surgical procedures, results are significantly better with isoflurane. Review of literature shows that, for less than 30 min operations, propofol seems to give best recovery. For more than 30 min operations, isoflurane enables better quality recovery.
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Cahiers d'anesthésiologie · Jan 1993
Review[Routes of administration of opioids excluding patient-controlled analgesia].
Opioid analgesics can be administered postoperatively by different routes. Pharmacokinetic peculiarities are evoked for the perimedullar, sublingual, oral, rectal, transcutaneous and intranasal ways.
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Recovery period after anaesthesia, even if short in ambulatory surgery, must not be neglected. Most of serious accidents occur in recovery period but recovery assessments are not clearly defined. ⋯ Tests of upper functions also exist but are not commonly and easily used. They don't disclaim physician responsibility and increase his task appreciably.