Local bupivacaine-epinephrine infiltration combined with general anesthesia for adult tonsillectomy.

Conclusion: Use of a solution of bupivacaine (5 mg/ml)-epinephrine (5 microg/ml) (BE) is beneficial in reducing intraoperative bleeding and decreasing the operation time in adult (adeno)tonsillectomy patients.

Objective: Pain and intra- and postoperative bleeding are problems associated with tonsillectomy/adenotonsillectomy. In order to make tonsillectomy/adenotonsillectomy better suited to outpatient surgery, solutions to these problems should be found.

Comparison of alfentanil and morphine in the prehospital treatment of patients with acute ischaemic-type chest pain.

Patients with acute myocardial ischaemic pain would benefit from rapid pain relief. The clinical usefulness of alfentanil, which has a rapid onset of action, was therefore assessed as the initial pain relieving opioid in patients suffering from acute myocardial ischaemic pain. The effects of alfentanil were compared with those of morphine in the prehospital treatment of 40 haemodynamically stable patients suffering from acute ischaemic-type chest pain.

Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children.

Background: Sevoflurane inhalation induction of anaesthesia is widely used in paediatric anaesthesia. We have found that this method is frequently associated with epileptiform electroencephalogram (EEG) in adults, especially if controlled hyperventilation is used.

Methods: We assessed EEG during sevoflurane inhalation induction in 31 children, aged 2-12 yr.

Tracheal intubation without the use of muscle relaxants: remifentanil or alfentanil in combination with propofol.

Background: Alfentanil-propofol combination provides adequate conditions for tracheal intubation without neuromuscular blocking drugs in most patients. Providing an option for intense opioid effect without compromising recovery after short operations, remifentanil might offer benefits over alfentanil, especially in ambulatory surgery. In this study intubating conditions after remifentanil-propofol were compared to those after alfentanil-propofol.

Ketoprofen, diclofenac or ketorolac for pain after tonsillectomy in adults?

We have compared the analgesic and opioid sparing effect of three i.v. non-steroidal anti-inflammatory drugs with placebo in a randomized, double-blind, placebo-controlled study in 80 adult patients after elective tonsillectomy.

Effect of esmolol on the hemodynamic and electrocardiographic changes during laryngomicroscopy under propofol-alfentanil anesthesia.

Laryngomicroscopy is a short-lasting procedure, which causes considerable hemodynamic and ECG changes. Therefore it sets specific demands on anesthetic care. In this double-blind randomized work, we studied hemodynamic and ECG changes in patients during laryngomicroscopy in jet ventilation under propofol-alfentanil anesthesia with and without esmolol, a short-acting beta1-adrenergic receptor blocking agent.

Effects of four anticholinesterase-anticholinergic combinations and tracheal extubation on QTc interval of the ECG, heart rate and arterial pressure.

Background: Imbalance in cardiac sympathetic tone causes prolongation of the QTc interval of the ECG. On the other hand, impairment of the parasympathetic control of the heart rate caused by anticholinesterase-anticholinergic combinations might also affect the cardiac sympathetic tone and hence the QTc interval of the ECG. The main purpose of the present study was to compare the effects of four anticholinesterase-anticholinergic combinations used for the antagonism of the neuromuscular block on the QTc interval of the ECG, heart rate and arterial pressure.

Comparison of subhypnotic doses of thiopentone vs propofol on the incidence of postoperative nausea and vomiting following middle ear surgery.

Background: Middle ear surgery is associated with a high incidence of emetic sequelae and propofol has been reported to have antiemetic activity in subhypnotic doses.

Methods: In a double-blind, randomized study, the patients received either thiopentone 1.0 mg.

Effect of esmolol on the heart rate, arterial pressure and electrocardiographic changes during laryngomicroscopy.

Background: Laryngomicroscopy causes considerable haemodynamic and ECG changes and therefore requires high doses of anaesthetic agents, which prolong recovery. In this double-blind randomized work, we studied the effect of esmolol, a short-acting beta-adrenergic receptor-blocking agent, on haemodynamic and ECG changes during laryngomicroscopy under thiopental-alfentanil-isoflurane-suxamethonium anaesthesia.

Methods: Forty ASA class I-II patients (mean age 43 +/- 11 yr) were allocated to receive either esmolol 1 mg.

QT interval of the ECG, heart rate and arterial pressure during anaesthetic induction: comparative effects of alfentanil and esmolol.

In a double-blind study the effect of esmolol and alfentanil on the QT interval of the ECG corrected by the heart rate (QTc), heart rate and arterial pressure during anaesthetic induction was studied in 59 oxycodone- and atropine-premedicated ASA class I-(II) patients with a mean age of 26 yr (range 15-50 yr). The patients were randomly allocated to one of the four groups: saline, esmolol 2 mg.kg-1, esmolol 3 mg.

Effect of transdermal hyoscine on nausea and vomiting after surgical correction of prominent ears under general anaesthesia.

In a double-blind, randomized study, we have compared the efficacy of transdermal hyoscine with placebo in the reduction of nausea and vomiting in 50 patients, ASA I-II, after surgical correction of prominent ears under general anaesthesia. In the placebo group, 28%, 4% and 48% of patients suffered nausea, retching and vomiting, respectively, during the first 24 h after anaesthesia. The corresponding values in the hyoscine group were 12%, 0% and 16% (P < 0.

Modification of the haemodynamic responses to induction of anaesthesia and tracheal intubation with alfentanil, esmolol and their combination.

The purpose of this double-blind randomized work was to study the effect of alfentanil and esmolol and their half-dose combination on the increases of heart rate and arterial pressure and on the prolongation of the QTc interval of the ECG occurring during anaesthetic induction. Sixty ASA class I-II patient with mean age ranging from 26 to 32 yr among the groups. Patients were allocated to one of four equal groups to receive saline, esmolol 2 mg.

Prevention of nausea and vomiting with transdermal hyoscine in adults after middle ear surgery during general anaesthesia.

In a double-blind, randomized study, we have compared the efficacy of transdermal hyoscine in the prevention of nausea and vomiting with placebo in 60 young, ASA I-II patients after middle ear surgery during general anaesthesia. In the placebo group, 27% and 43% of patients suffered from nausea and vomiting, respectively, during the first 24 h after anaesthesia. The corresponding values for both symptoms in the hyoscine group were 10% (P < 0.

Tracheal intubation after induction of anaesthesia with propofol, alfentanil and lidocaine without neuromuscular blocking drugs in children.

In a double-blind study, intubating conditions and haemodynamic responses were assessed in two age-groups of 45 ASA I-II children, with mean ages of 2.4 and 6.3 years, premedicated with oral midazolam and atropine.

Evaluation of postural stability by computerised posturography following outpatient paediatric anaesthesia. Comparison of propofol/alfentanil/N2O anaesthesia with thiopentone/halothane/N2O anaesthesia.

Simple clinical tests, like Romberg's test or a walking test, have proved to be inadequate guidelines for safe discharge after outpatient anaesthesia. A randomised study was therefore planned to compare postural stability measured by computerised posturography in 31 oral midazolam-atropine premedicated children aged 6.9 (s.

QT interval, heart rate and arterial pressures using propofol, thiopentone or methohexitone for induction of anaesthesia in children.

The effects on corrected QT interval (QTc), heart rate and arterial pressure were studied after induction with propofol 1.5, 2 or 2.5 mg.

A potentially hazardous interaction between erythromycin and midazolam.

Interaction between erythromycin and midazolam was investigated in two double-blind, randomized, crossover studies. In the first study, 12 healthy volunteers were given 500 mg erythromycin three times a day or placebo for 1 week. On the sixth day, the subjects ingested 15 mg midazolam.

[Interactions between lithium/rubidium and six muscle relaxants. A study on the rat phrenic nerve-hemidiaphragm preparation].

The cumulative concentration-response curves for alcuronium, metocurine, d-tubocurarine, suxamethonium, pancuronium and vecuronium alone or in combination with lithium or rubidium were measured using indirectly evoked twitch tension in the isolated rat phrenic nerve-hemidiaphragm preparation. In the experiments with lithium and rubidium, 10% and 2% of the sodium ions (118 mmol/l) of Krebs solution were replaced by lithium (11.8 mmol/l = 0.

Injection pain, cardiovascular changes and recovery following induction of anaesthesia with propofol in combination with alfentanil or lignocaine in children.

The effect of pretreatment with alfentanil 10 (Alf10), 15 (Alf15) or 20 (Alf20) micrograms.kg-1 on reducing injection pain caused by propofol was compared with lignocaine 10 mg mixed with propofol (Lign). This double-blind, double-dummy and randomized study included 100 children with a mean age of 4.

Oral atropine enhances the risk for acid aspiration in children.

Two modes of administration of an anticholinergic drug were compared in 58 healthy children undergoing adenoidectomy. The study was double-blind and randomized. All children were premedicated with oral midazolam 0.

Haemodynamic responses and prolongation of QT interval of ECG after suxamethonium-facilitated intubation during anaesthetic induction in children: a dose-related attenuation by alfentanil.

The haemodynamic response to endotracheal intubation and changes in the QT interval of ECG during anaesthetic induction were studied in 68 healthy children (5.5 years). The children were pretreated double-blindly with either alfentanil 10 micrograms/kg (A10), 25 micrograms/kg (A25), 50 micrograms/kg (A50) or saline (control) (17 children in each group) i.

Injection pain, intubating conditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with alfentanil.

In a double-blind study, propofol (P) 2-2.5 mg.kg-1 preceded by saline (Sal) or alfentanil (A) 20-30 micrograms.

Comparison of inhalation induction with isoflurane or halothane in children.

Thirty-six children (mean age 2.4 years) premedicated with oral chloral hydrate 70 mg kg-1 and atropine 0.03 mg kg-1 were anaesthetized with either 3.

Unconsciousness associated with midazolam and erythromycin.

An 8-yr-old boy suffering from an asymptomatic ventricular septal defect was given erythromycin for antibiotic prophylaxis before adenoidectomy. Sixty minutes after premedication with oral midazolam 0.5 mg kg-1 and oral atropine 0.

QT interval of the ECG, heart rate and arterial pressure using propofol, methohexital or midazolam for induction of anaesthesia.

The effects of propofol 2 mg/kg, methohexital 2 mg/kg or midazolam 0.3 mg/kg were studied on the QT interval of the ECG corrected by the heart rate (QTc), heart rate and arterial pressure during induction of anaesthesia in 87 ASA class I-(II)-patients. The patients were randomly allocated to one of the three anaesthetic groups.