ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Twenty-three patients undergoing elective coronary artery bypass graft surgery with moderate hypothermic bypass, under opiate-benzodiazepine anaesthesia were investigated during the first 7 h following surgery. Patients with recent myocardial infarct (<6 weeks), reduced left ventricular ejection fraction (<40%) or requiring inotropic support were excluded. During the first 3 h after surgery, higher oxygen uptake and oxygen extraction ratio were found in shivering patients (n= 5) compared with non-shivering patients (n= 16). A significant relation was found between oxygen uptake and the oxygen extraction ratio for the pooled data (R = 0.80 and 0.87, in shivering and non-shivering patients, respectively) as well as for the individual patients. A weaker relation was observed between cardiac output and oxygen uptake. The lack of adequate circulatory compensation could be related to the depressant effects of residual anaesthesia on the myocardium, surgical trauma, cardioplegic arrest and to peripheral vasoconstriction.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Sufentanil or a sufentanil-clonidine combination was evaluated to determine whether the basal rate in patient-controlled epidural analgesia (PCEA) might affect the daily consumption, quality of analgesia or incidence of side effects. Following Caesarean section delivery, 60 patients were randomly assigned to receive one of the four following PCA regimens (15 patients per group) for the relief of post-operative pain by the epidural route: sufentanil 2 μg mL−1in 0.9% NaCl, demand dose 5 μg i.e. 2.5 mL, (group S+ with, group S without an infusion at 2.5 mL hr−1) or sufentanil 2 μg mL−1+ clonidine 3 μg mL−1, demand dose 5 μg sufentanil + 7.5 μg clonidine i.e. 2.5 mL (group SC+ with and SC without an infusion of 2.5 ml hr−1). The other PCA settings (Bard I PCA pump) were a lock out interval of 10 min and a 1 h limit of 20 μg sufentanil and 30 μg clonidine i.e. 10 mL. The parameters measured were the analgesic drug consumption and number of dose demands during the first 24 h, pain scores at 6 h intervals, side effects and quality of sleep. The concurrent infusion increased the dose requirements regardless of the content of the syringe. Consumption of sufentanil was the highest in those patients receiving the plain solution with a basal infusion. Clonidine addition reduced the dose requirements but only significantly in those receiving the background infusion. Patients treated with the mixture tended to reach lower pain scores than those receiving sufentanil only without basal rate. Patients receiving the mixture with basal rate requested significantly fewer additional demands compared with the three other groups, but this did not influence the quality of sleep. Since side effects were more frequently registered in the patients in this group, it was concluded that the optimum regimen was the sufentanil-clonidine combination but with deletion of the basal rate.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

In order to assess if a mixture of phenylephrine/lignocaine is as effective as cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation, 99 patients receiving topical nasal analgesia either with cocaine 10% or a mixture of phenylephrine 1% and lignocaine 4% were studied in a randomized double-blind investigation. After topical analgesia a flexible fibreoptic endoscope was advanced through a nostril. Larynx, glottis and trachea were endoscopically sprayed with lignocaine. Following induction of anaesthesia a nasotracheal tube was inserted fibreoptically. Pain intensity and amount of epistaxis during endoscopy were assessed. Blood pressure, heart rate and ECG-ST segment were determined before and after topical nasal analgesia, after induction of anaesthesia and after nasotracheal intubation. There were no significant differences in pain intensity or epistaxis between groups during endoscopy, nor significant alterations in haemodynamic parameters or ST-segment. It is concluded that the mixture of phenylephrine and lignocaine is a useful alternative to cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The effects of different anaesthetics on the neutrophil oxidative responsein vitroare compared. Neutrophils were stimulated with small amounts of the bacterial peptide N-formyl-L-methionyl-L-leucyl-phenylalanine as a physiological, receptor-dependent stimulus. A new flow cytometry-based method capable of detecting the small amounts of H2O2generated by neutrophils in a heterogenous all-or-none response following submaximal stimulation with N-formyl-L-methionyl-L-leucyl-phenylalanine was used. Propofol and thiopentone suppressed the respiratory burst significantly (P<0.05 andP<0.01) in therapeutic concentrations, while midazolam and methohexitone inhibited significantly (P<0.01) only at concentrations greater than the therapeutic range. Impairment of the neutrophil response was primarily because of a reduction in the number of neutrophils participating in the respiratory burst and not of a proportional decrease of the fluorescence of all neutrophils.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Intrathecal midazolam for use as a post-operative analgesic when given alone and in conjunction with intrathecal diamorphine was assessed. Fifty-two patients scheduled for elective Caesarean section under spinal anaesthesia were randomly allocated to receive either bupivacaine (B), bupivacaine with diamorphine (BD), bupivacaine with midazolam (BM) or all three (BMD) by intrathecal injection. Post-operatively, no differences in visual analogue score (VAS), sedation or post-operative nausea and vomiting (PONV) could be demonstrated between groups. Patient-controlled analgesia system (PCAS) usage was significantly greater in group B when compared with the other groups. Pruritus was commoner in patients receiving diamorphine (BMD & BD). No side effects attributable to midazolam were identified. Intrathecal midazolam at this dose appears safe and has clinically detectable analgesic properties. The duration of useful analgesia appears to be short-lived.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The use of adrenaline added to bupivacaine during epidural analgesia for labour is controversial. The effects of epidural analgesia with bupivacaine containing adrenaline on maternal blood pressure and heart rate, uterine activity, progress of labour, fetal heart rate and Apgar scores, were assessed using visual analogue pain scores, upper level of sensory block and motor blockade in 60 parturients who were allocated randomly to receive: 10 mL of bupivacaine 0.25% plain (group I) or with adrenaline 5 μg mL−1(group II) or with adrenaline 1.66 μg mL−1(group III).The first stage of labour was significantly longer in group II than in group I [414±49 vs. 296±24 min (±SD)]. There were no other significant differences. It is concluded that adrenaline at 5 μg mL−1significantly prolongs the first stage of labour. Neither adrenaline 5 μg mL−1nor 1.66 μg mL−1has any beneficial effect.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The influence of haemodilution with colloids on somatosensory evoked potentials in non-premedicated volunteers is reported. In seven volunteers (randomized crossover design), blood (20 mL kg−1within 30 min) was removed and simultaneously replaced by gelatin 3% or hydroxyethylstarch 6%. After 30 min, blood was retransfused within 30 min. Median and posterior tibial nerve somatosensory evoked potentials were recorded from the cortex, second cervical vertebra, Erb's point and 1st lumbar vertebra, respectively. One volunteer experienced a severe allergic reaction to gelatin, therefore only six gelatin trials were evaluated. Haemodilution decreased the haematocrit from 39.8 ± 1.6% (mean ± SD) to 31.1 ± 2.0% (gelatin) and from 40.7 ± 1.7% to 29.8 ± 1.5% (hydroxyethylstarch), respectively. Retransfusion increased haematocrit to 34.4 ± 0.9% (gelatin) and to 34.2 ± 1.3% (hydroxyethylstarch). Neither haemodilution with gelatin nor haemodilution with hydroxyethylstarch or retransfusion influenced evoked potentials. In conclusion, the treatment of blood loss up to 30% of estimated blood volume with gelatin or hydroxyethylstarch will not affect somatosensory evoked potential monitoring provided normovolaemic conditions are maintained.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID