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1. |
Informed consent to anaesthesia |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 517-519
M. Barneschi,
G. Novelli,
G. Miccinesi,
E. Paci,
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ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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2. |
150 years of anaesthesia-a long way to perioperative medicine: the modern role of the anaesthesiologist |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 520-523
H. Van Aken,
D. Thomson,
G. Smith,
J. Zorab,
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ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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3. |
Post-tetanic burst count and train-of-four during recovery from vecuronium-induced intense neuromuscular block under different types of anaesthesia |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 524-528
Y. Saitoh,
H. Tanaka,
Y. Fujii,
K. Makita,
K. Amaha,
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摘要:
Recovery of neuromuscular blockade after vecuronium 0.2 mg kg−1was measured by post-tetanic burst count (PTBC) and train-of-four (TOF) in 120 adult patients anaesthetized by one of four techniques: neuroleptanaesthesia or one minimum alveolar concentration of isoflurane, enflurane, or sevoflurane. Onset of recovery was taken when there was reflex movement in response to carinal stimulation. The time course of recovery measured by burst count was similar for all four types of anaesthesia. Recovery of each of the twitches of the TOF was significantly shorter under neuroleptanaesthesia than under isoflurane, enflurane, or sevoflurane anaesthesia [times to return of T1were 41.4 ± 5.4, 51.5 ± 10.6, 52.2 ± 10.0, or 55.3 ± 11.2 min (mean ± SD).P< 0.05]. The burst count at the onset of reflex movement was less under neuroleptanaesthesia than under isoflurane, enflurane, or sevoflurane anaesthesia (16.3 ± 4.8, 26.7 ± 6.7, 27.7 ± 6.8, 28.0 ± 8.4,P< 0.05). The ratio of first twitch to control twitch at the onset of reflex movement was the same for all four types of anaesthesia.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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4. |
Intercostal nerve blockade with a mixture of bupivacaine and phenol enhance the efficacy of intravenous patient-controlled analgesia in the control of post-cholecystectomy pain |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 529-534
P. Maidatsi,
N. Gorgias,
A. Zaralidou,
V. Ourailoglou,
M. Giala,
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摘要:
Prolonged nerve conduction blockade has been proposed to result from the summed effects of charged and neutral local anaesthetics. Thirty-seven patients were randomly allocated to receive intravenous patient-controlled analgesia alone or combined with intercostal blockade (T7-T11) with a mixture of 0.45% bupivacaine and 0.6% phenol for post-cholecystectomy analgesia. Adequacy of pain relief was measured by patient scores on a 10-cm visual analogue scale and by dose-demand ratio, amounts of loading dose and total consumption of morphine and also the duration of patient-controlled analgesia in each group. No differences were found between groups in post-operative scores, dose-demand ratios and loading doses of morphine. However, in the combined treatment group, a significantly lower total consumption of morphine (P< 0.05), associated with a shorter duration of patient-controlled analgesia (P< 0.02) and a decreased mean number of unsuccessful demands (P< 0.001) were recorded. Intercostal blockade with bupivacaine-phenol supplements intravenous patient-controlled analgesia for post-cholecystectomy pain relief.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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5. |
Cardiovascular responses, arterial oxygen saturation and plasma catecholamine concentration during upper gastrointestinal endoscopy using conscious sedation with midazolam or propofol |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 535-543
V. Oei-Lim,
C. Kalkman,
J. Bartelsman,
J. Res,
H. van Wezel,
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摘要:
Hypoventilation as a consequence of deep intravenous sedation is the most frequently reported cause of cardiac arrest during upper gastrointestinal endoscopy (UGIE). Haemodynamic stress can contribute to myocardial ischaemia; therefore, this study was designed to observe prospectively the cardiorespiratory changes during UGIE using either midazolam or propofol for conscious sedation. Thirty-four patients, aged 50 years and older, ASA physical status I-III, scheduled for elective UGIE with sedation, were studied. Oxygen saturation, heart rate, non-invasive blood pressure and Holter ECG were recorded continuously starting 15 min before sedation until 15 min after the endoscopy. In addition, plasma catecholamine concentrations were determined. The results of this study are consistent with previous reports that cardiopulmonary events may occur during endoscopy, with or without sedation. Both midazolam and propofol sedation may provide some protection against haemodynamic stress in response to insertion and manipulation of the endoscope, but sedation can also contribute to the occurrence of hypoxaemia.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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6. |
A prospective study comparing intravenous tenoxicam with rectal diclofenac for pain relief in day case surgery |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 544-548
S.-A. Colbert,
C. McCrory,
D. O'Hanlon,
M. Scully,
A. Tanner,
M. Doyle,
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摘要:
In a prospective, randomized, double-blind study, we compared intravenous tenoxicam with rectal diclofenac for post-operative pain relief after day case arthroscopy or laparoscopic sterilization. Intravenous tenoxicam (40 mg) was administered as a single bolus at induction, or rectal diclofenac (100 mg) was administered immediately after induction. Both groups were similar with respect to age, weight, sex of the patients, the operation performed and the operative time. There were no significant differences observed between the groups for pain scores at 30 min, 60 min and 24 h post-operatively. The time to first analgesic requirement, the dose of pethidine administered and total analgesic requirements in the first 24 h post-operatively were equivalent in both groups. In view of the similar efficacy of both of these drugs, patient preference and ease of administration, the use of tenoxicam is appropriate in many patients undergoing day case surgery.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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7. |
A double-blind study of axillary brachial plexus block by 0.75% ropivacaine or 2% mepivacaine |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 549-552
A. Casati,
A. Leoni,
G. Aldegheri,
M. Berti,
G. Torri,
G. Fanelli,
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摘要:
Axillary brachial plexus block using 20 mL of 0.75% ropivacaine or 2% mepivacaine was compared in a prospective, randomized, double-blind study of two groups of 15 patients. The times to onset of sensory and motor block and to resolution of motor block, as well as the time to onset and degree of post-operative pain were recorded by an observer blinded to the identity of drug. Times to onset of sensory block were similar in the two groups (ropivacaine 10 min, mepivacaine 8 min). Resolution of motor block in the operated hand and the time to first requirement of post-operative analgesia occurred later with ropivacaine (9 h 50 min and 10 h) than with mepivacaine (3 h 50 min and 6 h),P<0.01 for both measurements. Nine patients who received ropivacaine and two patients who received mepivacaine did not require further post-operative analgesia (P<0.05). Ropivacaine is less toxic than other long-acting local anaesthetics, and 0.75% ropivacaine may be better for brachial plexus block when fast onset is required and prolonged pain relief is useful.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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8. |
Effects of sevoflurane and isoflurane on free radical formation in the post-ischaemic reperfused heart |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 553-558
S. Kashimoto,
M. Kume,
K. Ikeya,
T. Kumazawa,
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摘要:
Sevoflurane has been reported to generate oxygen free radicals. We have investigated whether sevoflurane or isoflurane enhances oxygen free radical formation in the post-ischaemic reperfused heart. An isolated rat heart-lung preparation was used. Thirty male Wistar rats were allocated to four groups: control, no drug, 2.5% sevoflurane and 1.4% isoflurane. The heart was perfused initially at a cardiac output of 30 mL min−1and a mean arterial pressure of 70 mmHg. Ten minutes after the start of perfusion, the heart was rendered globally ischaemic for 10 min by reducing the preload and afterload to zero. Then, the heart was reperfused for 10 min. At the end of reperfusion, the heart was freeze dried for 6 days. The perfusate blood was collected just before and just after ischaemia and at the end of reperfusion. The formation of hydroxyl radicals in perfusate blood and heart was measured with high-performance liquid chromatography using salicylic acid. Hydroxyl radicals react with salicylic acid, yielding 2,3-, 2,4-, 2,5- and 3,4-dihydroxybenzoic acid (DHBA). Before and after ischaemia, there were no significant differences in cardiac output, systolic pressure, heart rate and right arterial pressure among the groups. The concentrations of 2,3-, 2,4-, 2,5- and 3,4-DHBA in the perfusate blood after ischaemia and reperfusion were significantly higher than those before ischaemia in all groups. However, there were no differences in the DHBA levels among groups. This study indicates that sevoflurane and isoflurane do not enhance hydroxyl radical formation in the postischaemic reperfused heart.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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9. |
Total intravenous anaesthesia with gamma-hydroxybutyrate (GHB) and sufentanil in patients undergoing coronary artery bypass graft surgery: a comparison in patients with unimpaired and impaired left ventricular function |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 559-564
S. Kleinschmidt,
U. Grundmann,
T. Knocke,
M. Silomon,
F. Bach,
R. Larsen,
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摘要:
The haemodynamic effects of anaesthesia with gamma-hydroxybutyrate (GHB)/sufentanil for elective coronary artery bypass grafting (CABG) were investigated and compared in patients with unimpaired left ventricular function (ejection fraction ≥45%, left ventricular end diastolic pressure ≤16 mmHg) and patients with impaired left ventricular function. In 38 consecutive patients scheduled for CABG (21 with unimpaired and 17 with impaired left ventricular function), anaesthesia was induced with etomidate, sufentanil and pancuronium. After tracheal intubation, the lungs were normoventilated (end tidalPCO24.9-5.6 kPa) with an oxygen-air mixture (FIO20.5). Total intravenous anaesthesia was maintained with GHB (20 mg kg−1h−1after a 'priming dose' of 40 mg kg−1) and sufentanil (2 μg kg−1h−1). Haemodynamic measurements were made after induction of anaesthesia and at various times in the prebypass period. Patients in both groups showed similar haemodynamic trends. Mean arterial pressure showed a maximum reduction of 10%, whereas heart rate and right- and left-sided filling pressures remained unchanged within the groups after the induction of anaesthesia. Cardiac index remained unchanged in both groups, although values differed between the groups. A total of 14 out of 21 patients (67%) with unimpaired and 10 out of 17 patients (59%) with impaired ventricular function required supplementary administration of opioids to control temporary hypertension after sternotomy. No episodes of myocardial ischaemia were detected during the study period using ST segment analysis (leads II and V5). The results of this study suggest that GHB provides adequate haemodynamic conditions in the prebypass period and may be a suitable agent for TIVA also in patients with impaired left ventricular function undergoing CABG.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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10. |
Increased nausea and dizziness when using tramadol for post-operative patient-controlled analgesia (PCA) compared with morphine after intraoperative loading with morphine |
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European Journal of Anaesthesiology,
Volume 15,
Issue 5,
1998,
Page 565-570
K. Ng,
S. Tsui,
J. Yang,
E. Ho,
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摘要:
Thirty-eight ASA I-III patients undergoing lower abdominal operations were randomly allocated to receive either morphine (group M, patient-controlled analgesia bolus = 1 mg of morphine) or tramadol (group T, patient-controlled analgesia bolus = 10 mg of tramadol) for post-operative patient-controlled analgesia (PCA) after receiving morphine intraoperatively. There were no between-group differences in the pain, sedation or vomit scores. The nausea scores were significantly higher in group T in the initial 20 h and between 32 and 36 h (P< 0.01, 0-4 and 8-12 h;P< 0.05, 4-8, 12-16, 16-20 and 32-36 h). The incidence of dizziness was also significantly higher in group T (68.4% vs. 31.6%, group T vs. group M,P< 0.05). There was no difference in the overall satisfaction. We conclude that the use of tramadol, compared with morphine, for post-operative PCA after intraoperative loading with morphine is associated with more nausea and dizziness, but with similar sedation, quality of analgesia and patient satisfaction.
ISSN:0265-0215
出版商:OVID
年代:1998
数据来源: OVID
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