Propacetamol as adjunctive treatment for postoperative pain after cardiac surgery.

Unlabelled: Postoperative pain management after cardiac surgery has been mainly based on parenteral opioids. However, because opioids have numerous side effects, coadministration of non-opioid analgesics has been introduced as a method of reducing opioid dose. In this prospective, randomized, double-blinded study, we evaluated the efficacy of propacetamol, an IV administered prodrug of acetaminophen (paracetamol), as an adjunctive analgesic after cardiac surgery.

Quality assurance in anaesthetic practice: comparison between two methods in detecting complications.

Background: Reliable identification and documentation of complications is an essential part of a well-functioning quality system (QS) in anaesthetic practice. The criteria for the complications have to be appropriate. The QS of Kuopio University Hospital fulfils the ISO 9002 standard.

Laparoscopic or open cholecystectomy: a prospective randomised trial to compare postoperative pain, pulmonary function, and stress response.

Objective: Open cholecystectomy (OC) has been superseded by laparoscopic cholecystectomy (LC) for the treatment of cholelithiasis, although this fashion has not been validated by prospective studies. Our aim was to compare the two techniques.

Design: Prospective, randomised, open study.

No difference between bupivacaine in 0.9% and 8% glucose for spinal anaesthesia in small children.

Background: Baricity is one of the most important factors to influence the characteristics of distribution of the local anaesthetic and hence success and spread of the blockade. Bupivacaine is rendered hyperbaric by adding glucose. The effect of differing degrees of hyperbaricity remains to be evaluated.

Hyperbaric bupivacaine for spinal anaesthesia in 7-18 yr old children: comparison of bupivacaine 5 mg ml-1 in 0.9% and 8% glucose solutions.

We have compared two hyperbaric bupivacaine solutions for spinal anaesthesia in 7-18-yr-old school-aged children in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam orally. Half of the patients were sedated with either midazolam or thiopental.

Needle design does not affect the success rate of spinal anaesthesia or the incidence of postpuncture complications in children.

Background: In adults, pencil-point spinal needles are believed to be less traumatic and therefore to be superior compared to cutting-point needles with respect to success rate and postpuncture complications. The aim of this randomised, parallel groups and prospective study was to record the success rate and to evaluate the incidence of complications following spinal anaesthesia with the two types of needles in children.

Methods: We studied 215 children aged 1 to 18 years.

Intravenous ketoprofen and epidural sufentanil analgesia in children after combined spinal-epidural anaesthesia.

Background: Epidural opioid analgesia has become more popular for postoperative pain treatment in children. Epidural opioids are associated with adverse effects such as respiratory depression, excessive sedation, protracted vomiting, urinary retention and pruritus. Following minor surgery, ketoprofen has a synergistic effect with opioids, resulting in an improved analgesia without increase in incidence of adverse effects.

The effect of intravenous ketoprofen on postoperative epidural sufentanil analgesia in children.

Unlabelled: We compared the effect of IV ketoprofen and placebo as an adjuvant to epidural sufentanil analgesia after major surgery. We used a prospective, randomized, double-blinded, placebo-controlled, parallel-group study design in 54 children aged 1-15 yr who received a standardized anesthetic. Either IV ketoprofen or saline was administered in addition to an epidural sufentanil infusion, which was adjusted as required clinically.

Epidural analgesia with bupivacaine does not improve splanchnic tissue perfusion after aortic reconstruction surgery.

Inadequate splanchnic tissue perfusion is relatively common during and after aortic surgery. We hypothesized that vasodilation caused by thoracic epidural analgesia improves splanchnic blood flow and tissue perfusion after aortic surgery. In this prospective, randomized, controlled study, we studied 20 patients undergoing elective aortic-femoral or aortic-iliac reconstruction surgery.

Spinal anaesthesia for paediatric day-case surgery: a double-blind, randomized, parallel group, prospective comparison of isobaric and hyperbaric bupivacaine.

We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.

Ketorolac, diclofenac and ketoprofen are equally efficacious for pain relief after total hip replacement surgery.

We have compared the efficacy of ketorolac 30 mg i.v. followed by infusion at a rate of 90 mg/15.

Postdural puncture headache and transient neurologic symptoms in children after spinal anaesthesia using cutting and pencil point paediatric spinal needles.

Background: In the last decade the use of spinal anaesthesia (SA) in paediatric anaesthesia has increased. In adults, pencil point spinal needles are supposed to be less traumatic and hence to be superior compared with cutting point needles in respect of postpuncture complaints. In children, the use of spinal needles with a special tip design have not been compared.

Does morphine premedication influence the pain and consumption of postoperative analgesics after total knee arthroplasty?

Evidence of pre-emptive analgetic effect of opioid would offer great potential benefit to patients with postoperative pain, a better pain relief with less opioid. The aim of this double blind randomised trial was to study the effect of intramuscular morphine premedication on postoperative pain. Forty-one patients undergoing total knee arthroplasty were randomly allocated to four groups.

Comparison of 25 G and 29 G Quincke spinal needles in paediatric day case surgery. A prospective randomized study of the puncture characteristics, success rate and postoperative complaints.

A comparison of a 25 G with a 29 G Quincke needle was performed in paediatric day case surgery. Sixty healthy children aged 1 year to 13 years were randomly allocated to have spinal anaesthesia with either 25 G or 29 G Quincke needle without an introducer needle. There was a failure rate of 10% with the 29 G spinal needle compared with 0% with the 25 G needle.

Comparison of spinal anaesthesia with epidural anaesthesia in paediatric surgery.

202 children aged 2 months to 17 years, undergoing elective paediatric operations below the umbilicus, were allocated randomly to receive either spinal (SA) or epidural anaesthesia (EA). SA was more efficacious since 8 children of 102 needed supplementation with general anaesthesia, in contrast to EA where 24 children of 100 were supplemented with general anaesthesia and 6 with fentanyl. The haemodynamic stability was maintained during EA, whereas during SA 6 patients were given medication to increase heart rate/blood pressure.

Breathing pattern and gas exchange in emergency and elective abdominal surgical patients.

Objective: To evaluate the effects of intra-abdominal surgical emergency on breathing pattern and gas exchange and compare it with the changes induced by elective abdominal surgery.

Design: Prospective clinical study.

Setting: Abdominal surgical departments in a university hospital.

Propofol-nitrous oxide versus thiopentone-isoflurane-nitrous oxide anaesthesia for uvulopalatopharyngoplasty in patients with sleep apnea.

A randomized prospective study was performed to compare the recovery in 41 patients undergoing uvulopalatopharyngoplasty (UPPP) with either propofol-nitrous oxide-fentanyl or thiopentone-isoflurane-nitrous oxide-fentanyl anaesthesia. The patients were referred to UPPP after examination including polysomnography and otorhinolaryngological examination. The propofol group received propofol 2 mg.

Ibuprofen in the treatment of postoperative pain in small children. A randomized double-blind-placebo controlled parallel group study.

The efficacy of ibuprofen as a pre-emptive analgesic for postoperative pain was investigated in 81 children in the age between one and four years subjected to elective surgery. The patients were randomized into two groups receiving rectally either ibuprofen 40 mg.kg-1.

Effect of single-dose omeprazole and ranitidine on gastric juice acidity and volume in patients undergoing laparotomy.

The effects of oral omeprazole and oral ranitidine on gastric fluid volume and pH were compared in 95 elective surgical patients, randomly assigned to one of three groups. The patients received either 80 mg of omeprazole or 300 mg of ranitidine orally at 6.00 on the morning of surgery.

Effect of dihydroergotamine on leg blood flow during combined epidural and general anaesthesia and postoperative deep vein thrombosis after cholecystectomy.

The effects of dihydroergotamine (DHE) on the circulation of the leg during combined epidural and general anaesthesia were studied to determine if DHE would enhance leg blood flow and prevent postoperative deep vein thrombosis in a double-blind trial of 40 elderly female patients subjected to cholecystectomy. Central and big toe temperature, arterial blood pressure, heart rate, calf volume and arterial inflow of the leg by electrical impedance plethysmography and the venous outflow by Doppler method were measured. DHE 0.

[Pediatric surgery. A comparison of spinal anesthesia and general anesthesia].

Forty patients aged 2 to 5 years who were admitted for paediatric operations were randomly assigned to have either spinal or general anaesthesia. Spinal anaesthesia was achieved with isobaric bupivacaine 0.5% at a dose of 0.

Does the anesthetic method influence the postoperative breathing pattern and gas exchange in hip surgery? A comparison between general and spinal anesthesia.

We studied the effects of elective hip surgery, performed under either spinal (SA, n = 10) or general anesthesia (GA, n = 10), on breathing pattern and gas exchange. Measurements were made with respiratory inductive plethysmograph and indirect calorimetry in two positions before and after surgery. The method of anesthesia had no effect on the severity of postoperative hypoxemia.

The effects of morphine, morphine plus scopolamine, midazolam and promethazine on cerebrospinal fluid histamine concentration and postoperative analgesic consumption.

The effects of morphine (0.14 mg/kg), morphine (0.14 mg/kg plus scopolamine (0.

The effect of prophylactic use of famotidine, ranitidine, and sodium citrate in upper abdominal surgery.

The effects of famotidine (40 mg), ranitidine (300 mg) and sodium citrate (30 ml) on the gastric pH and volume were tested in 114 patients undergoing upper abdominal surgery. Gastric content was aspirated through a multiorifice tube immediately after intubation, at the end of operation and after a recovery room period of one hour. All three drug regimens significantly increased the mean gastric pH value compared with the control group.

[Comparison of bupivacaine hydrochloride 0.5% and bupivacaine carbonate 0.5% in interscalene plexus anesthesia].

Carbonated local anesthetics are less acidic than the hydrochlorides and require less buffering by the tissues. Rapid buffering and diffusion of the carbon dioxide enables free base to be deposited in high concentrations on nerve fibres. Carbon dioxide increases the intracellular hydrogen ion concentration, thus increasing the amount of active cation at the receptor site.