ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Fifteen patients undergoing elective thoracic surgery were studied in order to investigate the efficacy of high frequency jet ventilation of the non-dependent lung with respect to arterial oxygenation. During the study PaO2, PaCO2, arterial pressures and heart rate were recorded during ventilation of both lungs in the lateral decubitus position during one-lung ventilation and during high frequency jet ventilation of the non-dependent lung. Mean PaO2was 28±8.75 kPa and mean PaCO2was 5.4±0.7 kPa during control. During one-lung ventilation, PaO2dropped to 10.8±2.57 kPa and PaCO2rose to 6.3±0.9 kPa. With high frequency jet ventilation to the non-dependent lung, mean PaO2increased to 25±6.75 kPa and PaCO2decreased to 5.16±0.9 kPa respectively. Arterial pressures and heart rate remained stable during the study period. In conclusion high frequency jet ventilation of the non-dependent lung was effective in providing arterial normoxaemia and normocapnia during one-lung ventilation.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors compared the acceptance and efficacy of rectal and nasal administration of midazolam (MDZ) for premedication. Ninety-five ASA I and II paediatric patients (8 months to 12 years) scheduled for elective surgery were randomly allocated to two groups. Group R received 0.3 mg kg−1of rectal midazolam (in 5 mL saline). Group N received 0.2 mg kg−1of nasal midazolam (5 mg ml−1). Both groups were divided in two subgroups according to age (group RA (≤6 years,n6 years,n=18), group NA (≤6 years,n6 years,n=16)). At the time of premedication, tolerance to the administration was confirmed. Twenty min after rectal or 10 min after nasal administration the quality of sedation was recorded. The nasal midazolam, in commonly used dosages, induced a sedation similar to that following rectal administration with a shorter delay of onset. Nasal administration was more often painful than rectal administration. Swallowing (nasal midazolam) and concerns about modesty (rectal midazolam) were more frequent in older children. Because of its poor tolerance, nasal premedication should be reversed for cases where there is no alternative. Rectal premedication should be avoided in older children.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The analgesic efficacy of tenoxicam, a newer injectable non-steroidal anti-inflammatory drug, for post-operative analgesia after abdominal or orthopaedic surgery in ASA Grade I/II patients is reported. Two hundred and fifty-six patients received a single dose of tenoxicam 40 mg intravenous (i.v.) at the end of surgery and this was repeated 24h later. These patients were compared, with respect to pain or adverse events, with 258 patients that received placebo. All patients were monitored for the next 72 h. Overall, tenoxicam provided reliable analgesia with comparable pain scores at rest, moving and coughing. The cumulative rescue PCA-morphine consumption was always lower in the tenoxicam treated patients and was most marked at 4 and 24h after the second injection of tenoxicam. This effect was more pronounced after abdominal surgery. The intravenous administration of tenoxicam was associated with a low incidence of adverse events and a high tolerability.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This study was designed to investigate the incidence of critical events in breathing following light general anaesthesia compared with normal sleep during the first 12 h after transfer from the recovery room. There were no significant differences in the incidence of apnoea or desaturation episodes between normal sleep and the post-operative recovery period. There was a close correlation between the pre-operative and post-operative incidence of apnoea (r=0.93), pre-operative and post-operative desaturation periods (r=0.81), pre-operative and post-operative mean SpO2values (r=0.54) and pre-operative and post-operative minimal SpO2values (r=0.90) in all the patients. In the early post-operative period, breathing patterns and oxygenation were similar to those observed during normal night-time sleep in elderly patients undergoing ophthalmological surgery.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

We studied the haemodynamic changes induced by pneumoperitoneum (PP) in elderly patients with increased cardiac risk (ASA class III;n=10; age 72.3±8.8 years, mean±SD,Pn=12; age 55.6±11.8 years; group 1). Thermodilution measurements were performed after induction of general anaesthesia (T1), after onset of PP (T2, intraabdominal pressure 14 mmHg) and after additional 15° head-up tilt (T3). In both groups PP, as compared with T1, induced a significant increase in mean arterial pressure (MAP, mmHg, group 1: 77±14 to 96±18,PPPPPPPP−5: 1415±375 to 1873±412,PP−1m−2: 2.3±0.3 to 1.9±0.3,PP=0.76) and oxygen delivery index (DO2I, mL min−1m−2: 388±54 to 324±61,PP=0.77) decreased in group 1 but not in group 2. Heart rate, stroke index, pulmonary vascular resistance, arteriovenous oxygen content difference and oxygen consumption index were unchanged. After head-up tilt MAP (mmHg, 92±15,PPPPPPPP1in both groups, SVR (dynes s cm−5, 1575±372,P=0.13 / 1793±528,P

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A prospective survey was conducted among anaesthesiologists to determine their criteria for excluding a patient from autologous blood donation prior to total hip prosthesis. Information on patients operated on during a 5-week period was obtained using a questionnaire, consisting of a set of possible responses to simple questions, matched with some parametric values. Sixty-eight of the 99 patients included in the survey underwent surgery without donation. Age was the main cause for exclusion (34%). The age of patients excluded because of their age alone was 75±11 years (standard deviation). The age of patients excluded from donation and who did not subsequently receive homologous blood was comparable with that of patients not autotransfused but who received homologous blood (68±4 vs. 69±6 years, respectively). Post-operative haemoglobin concentrations were similar whether transfusion was performed or not, and regardless of the origin of blood given. Since age is no longer taken into consideration at the time of transfusion, it is likely that exclusion of a patient from autologous blood donation because of age is an arbitrary choice.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Ninety patients undergoing scheduled upper limb orthopaedic surgery were studied to determine the optimal anaesthetic dose using the 'orthogonal two-needle technique'. The patients were randomly assigned to one of three groups to receive one of three different volumes (20, 30 and 40mL) (n=30) of anaesthetic solution (a mixture of equal parts of 0.5% bupivacaine with adrenaline 1:200 000 and 2% lignocaine). A significant correlation was found between the volume injected and the anaesthetic spread for all tested areas. A better analgesic spread to all the major branches of the plexus was obtained when increased volumes of anaesthetic solution were injected. The comparisons between the 20 mL group and the other two groups are significant in all the tested areas, as well as the comparisons between 30 and 40 mL groups in the areas innervated by radial and musculocutaneous nerves. Only the area innervated by the axillary nerve showed a weaker volume-analgesia relation, confirming the elusiveness of this area to anaesthesia in the axillary approaches. The improved results observed using greater amounts of anaesthetic solution might result from a higher intrasheath pressure with disruption of sheath septa, or from a greater availability of drug for all the terminal branches of brachial plexus, or both.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The number of protocol-eligible patients, refusing to participate in a clinical trial is often not mentioned. The aim of this study is to report the number of refusers and to evaluate the reasons for not participating in a clinical study concerning post-operative pain relief and to assess the potential influence on the final study results. Patients refusing to participate in the study were recorded and evaluated for reasons of refusal. The post-operative pain relief techniques applied in this trial are commonly used, but nevertheless the refusal rate was higher than expected. When it was mentioned that an epidural technique was a part of the trial, 16.7% of the total protocol-eligible group refused. The responses of those offered an epidural could be divided into two groups: the adamant pros and cons to this technique. It can be concluded that in order to be able to judge the validity of results and thus for good clinical practice, the number of patients refusing to participate in a clinical trial and their reasons, should be mentioned in all publications.

ISSN:0265-0215    

出版商:OVID    

年代:1997

数据来源: OVID