ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Sixty ASA I and II patients scheduled for laparoscopic cholecystectomy or inguinal herniotomy were randomly assigned to one of two groups: Group one (n= 30): induction with thiopentone 4-6 mg kg−1, fentanyl 2 μg kg−1, pancuronium 0.03 mg kg−1, and succinylcholine 1 mg kg−1, maintainance with halothane (0.8-1.5%), and N2O in O2(FiO2= 0.33). Group two (n= 30): induction with propofol 2-3 mg kg−1, fentanyl 2 μg kg−1, pancuronium 0.03 mg kg−1, and succinylcholine 1 mg kg−1, maintainance with propofol 6-10 mg kg−1h−1, and O2in N2(FiO2:0.33). Seven of the patients experienced nausea in each group with group one having higher emetic scores. Six patients in group one vomited compared to none in group two (P< 0.05). The overall incidence of emetic sequelae (nausea or vomiting) was 43% in group one and 23% in group two (P= 0.17). Patients with propofol anaesthesia had lower emetic scores and higher recovery scores compared with those after thiopentone/halothane anaesthesia.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The effect of topical lignocaine applied to the eye muscles, on the incidence of the oculocardiac reflex during squint surgery of the medial rectus was investigated in 56 healthy children aged between 3-14 years. Three groups were studied. One (n= 16): stimulation of the reflex without lignocaine; 2 (n= 10): stimulation of the reflex after topical administration of 1 mg kg−1lignocaine 2% to the medial part of the eye after induction of anaesthesia; 3 (n= 30): stimulation of the oculocardiac reflex without, and after a 5 min interval under the influence of lignocaine. Topical administered lignocaine significantly attenuated the OCR (105 vs. 68 bpm group II vs. group I:82 vs. 63 bpm in group III). Severe bradycardiac rhythm disturbances, in particular cardiac stand-still, were not observed after lignocaine had been applied. Systemic side effects of lignocaine were not seen.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Many adults are distressed by painful investigations or treatment, including venepuncture. The early effects of Eutectic Mixture of Local Anaesthetics (EMLA) 5%, on relief of pinprick pain in the antecubital area was investigated and compared with EMLA plus glyceryl trinitrate and with a placebo cream in 100 patients. Topical analgesia after application of EMLA developed within 5 min in 69% and within 10 min in 83% of those tested, significantly different from placebo, (P= 0.01).

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

In order to test the hypothesis that the effects on ventilation of nasal inhalation of sevoflurane during induction of anaesthesia differ from those of oral inhalation, 20 patients underwent inhalation induction of anaesthesia with sevoflurane 5% either through the nasal route or the oral route. In 10 patients who breathed through the nose (N-group), there was an immediate decrease in tidal volume with no change in respiratory duration whereas no similar change was observed in the 10 patients who breathed through the mouth (O-group). The time from the start of sevoflurane inhalation to the onset of sleep was significantly shorter in the O-group compared with the N-group [86.2 ± 4.4 (mean ± SE) vs. 115.0 ± 8.4 sec,P<0.01].

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We have investigated the effect of nitrous oxide on the middle ear pressure, comparing inhalational anaesthesia with nitrous oxide and halothane and total intravenous anaesthesia with propofol-alfentanil. Fifty patients with normal healthy ears were divided into two groups. In one group (n= 25), anaesthesia was induced with thiopentone 6 mg kg−1, and maintained with halothane 1% and nitrous oxide 66% in oxygen. In the other group (n= 25), anaesthesia was induced with alfentanil 25 μg kg−1and propofol 2 mg kg−1, and maintained with an infusion of alfentanil 10 μg kg−1min−1for the first 10 min and then with 0.5 μg kg−1min−1and with propofol 10 mg kg−1h−1for the first 10 min, 8 mg kg−1h−1for the following 10 min and 6 mg kg−1h−1thereafter. Patients were ventilated with an oxygen-air mixture (F1O2= 0.33). Middle ear pressures were measured during the pre-, intra- and post-anaesthetic period in both ears. A progressive rise was observed (P<0.05) in the first group, whereas values were within the normal limits clinically and there was no statistically significant change in those receiving total intravenous anaesthesia during the intra-anaesthetic period. The time to reach peak pressure with inhalational anaesthesia was 60 min (181.5 mmH2O) and to return to normal was 30 min (49.5 mmH2O) after cessation of nitrous oxide administration. The incidence of nausea and vomiting was less in the patients not receiving nitrous oxide.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Thirty patients undergoing laparoscopic gynaecological sterilization, as day-cases, were randomly allocated to receive either total intravenous anaesthesia (TIVA) with a propofol and alfentanil mixture or a standard inhalational technique. Immediate recovery, as measured by times to awakening, cooperation and orientation, and psychomotor recovery, as measured by 'P' deletion studies, were not significantly different between the two groups. TIVA produced a significant reduction in post-operative nausea at both 1 and 2 h post-operatively, as measured by a visual analogue scale (P<0.01). No patient in the TIVA group vomited whereas two vomited in the inhalational group. There were no differences between the two groups with respect to suitability for discharge home and no incidences of awareness. We conclude that TIVA with a propofol and alfentanil mixture provides satisfactory anaesthesia for gynaecological sterilization, with good recovery characteristics and a low incidence of post-operative nausea and vomiting.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We report two cases of severe forearm oedema occurring because of extravasation of intra-venous fluid at the sites of a concealed intra-venous cannula connected to an automatic infusion pump (IMED 960 IMED, Ireland), with one of the cases causing acute ischaemia to the hand.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Forty-one patients of ASA classes I or II, undergoing elective surgery, were divided into two groups: young, 18-41 years (mean 31), and elderly, 64-79 years (mean 71). The integrated evoked compound electromyogram of the adductor pollicis muscle elicited by stimulation of the ulnar nerve was used to monitor the neuromuscular block of the non-depolarizing muscle relaxant mivacurium. An initial dose of mivacurium 0.15 mg kg−1allowed six excellent, nine good, three adequate and three poor intubations in the young group, and nine excellent, eight good, three adequate and no poor intubations in the elderly group. Patients recovered until 1-2 stimuli of the train-of-four were visible, and an infusion of mivacurium was started (0.5 mg kg−1h−1). At 3 min intervals the rate was adjusted by ±0.05 mg kg−1h−1(±10% initial rate), as indicated during anaesthesia which was provided by nitrous oxide in oxygen, infusion of propofol, and fentanyl supplements. In the first 30 min, the young group had their mivacurium requirement increased to 111.4% (0.56 mg kg−1h−1), which was reached in the first 15 min, after which it gradually decreased to 92.9% (0.46 mg kg−1h−1). The elderly group's requirements decreased from the start, to 78.5% (0.39 mg kg−1h−1). The difference between the two groups was significant (P<0.05). After the first 30 min, both groups requirements decreased, with time, but with no statistically significant differences.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

In patients with acute transient myocardial ischaemia, changes in left ventricular filling produce alterations in transmitral diastolic flow velocity and isovolumic relaxation time. In this study a scoring system derived from isovolumic relaxation time and indices from transmitral flow velocity was used to evaluate perioperative transient myocardial ischaemia. Fifty three patients with known coronary artery disease or at risk were studied. Ischaemic events were assessed using Doppler transoesophageal echocardiography midoesophageal left ventricular four-chamber view planes. Diastolic Doppler ratios of peak early to atrial peak (E/A), deceleration time, deceleration rate and isovolumic relaxation time were scored using standard methods. An evaluation of peri-operative ischaemic events could be important for patients with a nonischaemic cause for abnormal segmental wall motion, as the use of a two-dimensional scoring system has limitations. Acute changes in the Doppler ratio of peak early to atrial peak must be interpreted cautiously during surgery. Diastolic dysfunction commonly occurs during ischaemia and recognition of this may alter the approach to monitoring as well as to treatment.

ISSN:0265-0215    

出版商:OVID    

年代:1996

数据来源: OVID