Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Mar 2002
Randomized Controlled Trial Comparative Study Clinical TrialA comparative study of the safety and efficacy of 0.5% levobupivacaine and 0.5% bupivacaine for epidural anesthesia in subjects undergoing elective caesarean section.
Levobupivacaine is the S(-)-enantiomer of the racemic bupivacaine. Data of pharmacological studies suggest that levobupivacaine has a lower potential of toxicity for central nervous and cardiovascular systems than does bupivacaine. The present study was undertaken to compare the safety and efficacy between levobupivacaine and bupivacaine in epidural anesthesia for Cesarean delivery. ⋯ The onset and fade-out of sensory and motor blockade, quality of anesthesia, muscle relaxation and overall quality of anesthesia as assessed were comparable between two groups. No significant maternal or neonatal adverse events were found between the treatment groups. In comparison, levobupivacaine had the efficacy and safety profile equivalent to bupivacaine in epidural anesthesia for Caesarean section.
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Acta Anaesthesiol. Sin. · Dec 2001
Randomized Controlled Trial Clinical TrialReversal of mivacurium chloride: edrophonium of spontaneous recovery in microscopic laryngeal surgery.
A double-blind, randomized study was designed to compare the recovery manner of mivacurium infusion with or without edrophonium reversal in microscopic laryngeal surgery. Neuromuscular blockade was quantified using the train-of-four stimuli to the ulnar nerve and quantification of the ratio of the fourth twitch to the first twitch. ⋯ Mivacurium, a short-acting nondepolarizing agent, is a suitable muscle relaxant for patients receiving microscopic laryngeal surgery. Recovery time with the use of edrophonium as reversal agent was shorter than with placebo, but extubation and discharge time did not differ in two groups. The time which could be saved by the use of edrophonium for reversal of mivacurium to hasten the maximal recovery appears to be less than a few minutes. Therefore, clinically, the value of routine use of edrophonium to obtain a faster recovery does not outweigh its demerits of cost and risk and is not worthy of recommendation.
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Acta Anaesthesiol. Sin. · Dec 2001
Randomized Controlled Trial Clinical TrialPremedication with low-dose oral midazolam reduces the incidence and severity of emergence agitation in pediatric patients following sevoflurane anesthesia.
Sevoflurane is a volatile anesthetic agent with low pungency, non-irritating odor, and low blood/gas partition coefficient that makes it an attractive alternative to halothane. However, a high incidence of emergence agitation (EA) has been reported in pediatric patients after sevoflurane anesthesia. The underlying mechanism of sevoflurane-induced EA remains unclear. Rapid recovery of consciousness (emergence) from sevoflurane anesthesia has been proposed as one possible mechanism. We, therefore, hypothesized that sedatives such as midazolam may counteract sevoflurane's rapid emergence and thus reduce the incidence and the severity of sevoflurane-induced EA. ⋯ Premedication with oral midazolam is safe, convenient and effective in decreasing the occurrence of sevoflurane-induced EA. It does not delay discharge from PACU and is suitable for outpatient surgery.
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Acta Anaesthesiol. Sin. · Dec 2001
Randomized Controlled Trial Clinical TrialPrevention of PONV with dexamethasone in female patients undergoing desflurane anesthesia for thyroidectomy.
Desflurane is associated with a higher incidence of 24-h postoperative nausea and vomiting (PONV) as compared with sevoflurane or isoflurane. Dexamethasone 5 mg i.v. is suggested to be the minimum effective dose for prophylaxis of PONV in women undergoing thyroidectomy with isoflurane anesthesia. The objective of this study was to investigate whether a 5 mg dose of dexamethasone could be enough for, or a larger dose at 8 mg, could be more capable of preventing PONV in women undergoing desflurane anesthesia for thyroidectomy. ⋯ The results of this study showed that in PONV prophylaxis, in female patients undergoing desflurane anesthesia for thyroidectomy, the effect of dexamethasone 8 mg was superior to that of dexamethasone 5 mg.
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Acta Anaesthesiol. Sin. · Sep 2001
Randomized Controlled Trial Clinical TrialEvaluation of learning effectiveness in endotracheal intubation by the use of a laryngoscope in combination with a flexible fiberoptic bronchoscope.
Accidental esophageal intubation may cause lethal complications when undetected. We developed a laryngoscope, which utilizes a laryngoscope blade incorporating with a flexible fiberoptic bronchoscope for teaching new learners. We compared two teaching methods, i.e. the traditional method and the new method we contemplated, for teaching new interns. ⋯ By using the new teaching method, the supervisor could easily teach and assess the success of the new learners. Besides, esophageal intubation could be reduced to a minimum with subsequent increase of success rate.