Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
A haemodynamic comparison of epidural versus intrathecal sufentanil to supplement general anaesthesia for abdominal aortic surgery.
The present study was designed to evaluate the influence of epidural sufentanil (ES) and intrathecal sufentanil (IS) on the peri-operative haemodynamic responses during abdominal aortic surgery. Twenty-four ASA Grade II patients without clinical symptoms of coronary artery disease received, randomly, epidural (n = 12) or intrathecal (n = 12) sufentanil combined with light general anaesthesia for elective bifemoral grafting for aorto-iliac occlusive disease. The IS group contained significantly more hypertensive patients than the ES group. ⋯ Revascularization produced significant differences in HR, SVR and CI in both groups in comparison with the pre-declamping period. Notable was the maintenance of systemic blood pressure following revascularization due to preservation of sympathetic activity. It was concluded that both epidural and intrathecal sufentanil produce comparable and stable haemodynamics in this category of patients.
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Randomized Controlled Trial Clinical Trial
Epidural lidocaine with sufentanil and epinephrine for abdominal hysterectomy under general anaesthesia: respiratory depression and postoperative analgesia.
The purpose of this investigation was to compare the analgesic actions and side-effects of a 50 micrograms epidural bolus of sufentanil and 50 micrograms epinephrine, with a control group receiving saline and epinephrine. The method employed was a prospective, randomised, double-blind trial involving 40 ASA I or II patients for total abdominal hysterectomy. All received 1.5% lidocaine with 1/200,000 epinephrine epidurally before operation, until a block to T4 was established. ⋯ Glycopyrollate was given to 11/20 patients in the sufentanil group vs 1/20 in the control group (P less than 0.01) following bradycardia and hypotension. Clinical respiratory depression occurred in the sufentanil group; 5/20 patients required controlled ventilation following apnoea greater than 20 sec. It is concluded that epidural sufentanil causes considerable cardiorespiratory depression in the setting of general anaesthesia, and should be used with caution in the spontaneously breathing, anaesthetised patient.
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Comparative Study
Mivacurium infusion during nitrous oxide-isoflurane anesthesia: a comparison with nitrous oxide-opioid anesthesia.
To determine the potentiation of the neuromuscular blockade induced by a titrated infusion of mivacurium in the presence of isoflurane versus a nitrous oxide (N2O)-opioid anesthesia. ⋯ Isoflurane anesthesia reduces the infusion rate of mivacurium required to produce about 95% depression of neuromuscular function.
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Randomized Controlled Trial Clinical Trial
Flow increases with an enlarging intravenous catheter.
To determine the increase in flow of a hydratable enlarging intravenous (IV) catheter in anesthetized patients. ⋯ Flow through enlarging IV catheters placed in anesthetized patients increases after 1 hour. The percentage increase in flow is not as great as previously seen in vitro and may be due to skin, vein, and subcutaneous tissues preventing complete expansion.