Articles: general-anesthesia.
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Anesthesia and analgesia · Jul 1996
Randomized Controlled Trial Clinical TrialHemodynamic responses to an epinephrine test dose in adults during epidural or combined epidural-general anesthesia.
The efficacy of an epinephrine test dose during epidural and combined epidural-general anesthesia is unknown. Thirty-two patients were randomized to receive 2% lidocaine at either a high (25 mL) or low (12 mL) thoracic level of epidural anesthesia followed by general anesthesia with 1 minimum alveolar anesthetic concentration nitrous oxide and isoflurane. ⋯ Incidences of identification of intravascular injection from hemodynamic responses were similarly reduced for systolic blood pressure (100% vs 44%) and heart rate (100% vs 38%). The standard 15-micrograms epinephrine test dose is unaffected by low thoracic levels of epidural anesthesia, but may have decreased sensitivity for detection of intravascular injection during high thoracic levels of epidural anesthesia, especially during general anesthesia.
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Regional anesthesia · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of spinal versus general anesthesia on postoperative pain and analgesic requirements in patients undergoing lower abdominal surgery.
Attempts to reduce central sensitization after tissue injury have led to the concept of preemptive analgesia. The aim of this study was to evaluate the effect of spinal versus general anesthesia on postoperative pain and analgesic requirements in patients undergoing lower abdominal surgery. ⋯ Postoperative pain after lower abdominal surgery can be significantly decreased if the surgery is performed with use of SA.
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative pain relief in children following extraction of carious deciduous teeth under general anaesthesia: a comparison of nalbuphine and diclofenac.
In a randomized double-blind study 60 children, undergoing the extraction of carious deciduous teeth under day-case general anaesthesia, were assigned to receive either intravenous nalbuphine hydrochloride 0.3 mg kg-1 (n = 21), one or more diclofenac suppositories 12.5 mg to a dose of 1-2 mg kg-1 (n = 19), or no analgesia (n = 20). The duration of anaesthesia was longer in the diclofenac group (9.6 min, SD 3.5) compared with control (7.2 min, SD 2.6) and nalbuphine (6.9 min, SD 3.0) groups respectively (P < 0.05). There were no statistically significant differences in post-operative pain scores during the 45 min post-operative period studied between the three groups using an objective pain score. We conclude that using this methodology we were unable to demonstrate any statistically significant differences between the analgesic effects of either intravenous (i.v.) nalbuphine or diclofenac suppositories compared with control.
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General anaesthesia for a patient with tuberous sclerosis was complicated by epilepsy. The choice of drugs was related to control of his fits and intercurrent therapy. Thiopentone, vecuronium, and nitrous oxide with isoflurane were satisfactory.
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Arch Pediat Adol Med · Jul 1996
Levels of consciousness and ventilatory parameters in young children during sedation with oral midazolam and nitrous oxide.
To determine the ventilatory effects and levels of consciousness achieved during sedation with the combination of oral midazolam and inhaled nitrous oxide. ⋯ The combination of oral midazolam, 0.5 mg/kg, and up to 60% inhaled N2O caused mild ventilatory depression in some children and resulted in a progression from conscious to deep sedation beginning at 30% N2O. When using this particular combination of sedatives, practitioners should monitor each child's mental status continuously and adhere to the appropriate published guidelines for the monitoring and management of such patients.