Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Sep 1994
Randomized Controlled Trial Clinical TrialUse of esmolol to prevent hemodynamic changes during intubation in general anesthesia.
To assess the minimal effective dosage of esmolol to prevent hypertension and tachycardia during laryngoscopy and endotracheal intubation in fentanyl-pretreated anesthesia, a double-blinded, randomized study was conducted. Two hundred patients undergoing elective, noncardiac surgeries were randomly allocated into four groups: group A received saline, group B esmolol 20 mg, group C esmolol 40 mg and group D esmolol 60 mg intravenously. General anesthesia was induced with 0.1 mg/kg vecuronium, 5 micrograms/kg fentanyl and 0.3 mg/kg etomidate. ⋯ Hypertension (SBP > 180) was found in 18(36%) patients in group A, 19(38%) patients in group B, 9(18%) patients in group C, and 6(12%) patients in group D. When compared with group A, only group D had significantly lower incidence of these adverse events (p < 0.05). In conclusion, fentanyl 5 micrograms/kg could not completely prevent the hemodynamic changes associated with endotracheal intubation, and 60 mg esmolol was observed to have positive effect in helping to control these changes.
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Acta Anaesthesiol. Sin. · Sep 1994
Comparative Study Clinical Trial Controlled Clinical TrialComparative analgesic enhancement of alfentanil, fentanyl, and sufentanil to spinal tetracaine anesthesia for cesarean delivery.
Clinical investigations have shown that intrathecal local anesthetic combined with alfentanil, fentanyl, or sufentanil results in a synergetic interaction that improves perioperative analgesia. However, there are as yet few studies designed to compare equal potency dose of these three 4-anilinopiperidine analogues. This prospective study is an attempt to study the comparative analgesic properties of these three drugs. 156 parturients who had consented to spinal anesthesia for cesarean delivery, were anesthetized with 12 mg of tetracaine which was combined with various doses of these three opioids. ⋯ Postoperatively 10 micrograms of sufentanil delayed the onset of any postoperative pain from 106 to 286 min. Side effects such as pruritus, respiratory depression, nausea, and vomiting were not different from those of the control group. This study indicates that 10ug sufentanil appears to be better than alfentanil or fentanyl in improving intra- and postoperative analgesia in parturient undergoing hyperbaric tetracaine spinal anesthesia for cesarean section.
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Acta Anaesthesiol. Sin. · Sep 1994
Randomized Controlled Trial Clinical TrialThe effect of single bolus dose of esmolol for controlling the tachycardia and hypertension during laryngoscopy and tracheal intubation.
Tachycardia and hypertension usually accompany laryngoscopy and tracheal intubation. This response is undesirable, especially in patients with cardiovascular or intracranial diseases. Esmolol is a cardioselective, ultrashort-acting beta adrenergic blocking agent with a very short half-life. ⋯ The differences in SBP between the 100 mg group and placebo group were significant at the 3rd and 4th minutes (p < 0.05). Both bolus dosages of esmolol could effectively attenuate the tachycardia and hypertension produced by laryngoscopy and tracheal intubation. Furthermore, esmolol 200 mg presented a better hemodynamic stability than esmolol 100 mg during induction of anesthesia.
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Acta Anaesthesiol. Sin. · Sep 1994
Randomized Controlled Trial Clinical Trial[The influence of small dose intrathecal fentanyl on shivering during transurethral resection of prostate under spinal anesthesia].
Shivering during spinal anesthesia is a common complication in patients undergoing transurethral resection of prostate. The high incidence of shivering may be due to decreased core temperature secondary to peripheral vasodilation from sympathetic blockade and/or cold irrigation fluid. Shivering is known to increase O2 consumption, ventilation and cardiac output, which can result in morbidity to patients with limited cardiopulmonary reserves. ⋯ The shivering grade (1.0 +/- 0 vs 1.76 +/- 0.7) and accumulative shivering scores (2.4 +/- 0.8 vs 12.5 +/- 5.6) were also significantly decreased in the study group (P < 0.05). Obviously, there was no difference in the incidence of pharmacologic side effect. We concluded that low dose intrathecal fentanyl is a god method for decreasing both incidence and severity of shivering during spinal anesthesia.