Search PubMed⌕ Search

Biomedical subjects

G Rolly

Publications and source records attributed to G Rolly.

At least 91 records · Page 5Linked to original sources
PubMed1989

[A comparison of hemodynamic changes with sufentanil-O2 and fentanyl-O2 anesthesia for coronary bypass grafting].

Hemodynamic changes were investigated in twenty patients undergoing coronary artery bypass grafting. Thirteen patients received sufentanil-O2 anesthesia and seven patients had fentanyl-O2 anesthesia. Systolic, diastolic, as well as mean arterial blood pressures, heart rate and rate pressure product (RPP) were measured before and after intubation, one minute after skin incision, and one minute after sternotomy. The sufentanil group received 3-5 micrograms.kg-1 of sufentanil for induction and a continuous infusion of 2.5-5.0 micrograms.kg-1.hour-1. The fentanyl group received 10 to 20 micrograms.kg-1 for induction and a continuous infusion of 12.5 micrograms.kg-1.hour-1. In sufentanil group, a decrease of systolic as well as mean arterial pressure, heart rate and RPP was observed following induction. These results showed effective blocking of the sympathetic reflex by sufentanil. In the fentanyl group, immediately after intubation, an increase in systolic pressure, mean pressure, heart rate and RPP was observed. Particularly RPP increased to more than 12000 at this moment. Diastolic pressure was not significantly changed in each group. Stable hemodynamic parameters with no ST-T change were noticed during surgical procedure in each group. We conclude that sufentanil is a superior narcotic agent than fentanyl for the patients undergoing CABG, and it effectively blocks sympathetic reflex activity.

Aged↗
PubMed1989

A contribution to the monitoring of neuromuscular blockade: an evaluation of the Datex Relaxograph.

The Datex Relaxograph is a neuromuscular transmission monitor, which measures the degree of neuromuscular blockade during anesthesia. In order to evaluate the reliability of the Relaxograph, results, obtained with this apparatus, were compared with simultaneous mechanical measurements obtained with the Myograph 2000 (Biometer). Although there was a good correlation between the two throughout the study, a shift towards mechanical responses was observed in all cases. Subsequently, the Relaxograph was used to evaluate atracurium and vecuronium when given accordingly to the priming principle. Results show that neither drug offers major clinical advantages over the other. In a third study, a new bolus-constant infusion regimen of atracurium was evaluated. Results show that it produces a predictable and stable neuromuscular blockade.

Adult↗
PubMed1988

Propofol for arthroscopy in outpatients. Comparison of three anaesthetic techniques.

Sixty unpremedicated adult patients, undergoing arthroscopy, received propofol 2 mg kg-1 for induction of anaesthesia, before random allocation to three groups receiving one of the following: a continuous infusion of propofol supplemented with nitrous oxide in oxygen (group I); isoflurane and nitrous oxide in oxygen (group II); a continuous infusion of propofol in combination with repeated bolus doses of alfentanil (group III). The results showed no major differences in cardiovascular variables between the groups. Ventilation rate was highest in group II. Early recovery was less smooth and showed slight impairment in group III compared with the other groups. The data suggest that induction of anaesthesia with propofol followed by maintenance with isoflurane or continuous infusion of propofol is preferable for this procedure.

Adolescent↗
PubMed1988

Effect of propofol on elevated intracranial pressure. Preliminary results.

The effects of a bolus injection of propofol on mean intracranial pressure were studied in six adult, comatose patients who had severe head injuries. Propofol 2 mg/kg was given intravenously over 90 seconds when the mean intracranial pressure reached or exceeded 25 mmHg. Arterial blood gas values, heart rate and central venous pressure remained stable at all measurements. Arterial blood pressure decreased statistically significantly (p less than 0.05) within one minute after propofol administration. The mean (SEM) intracranial pressure decreased statistically significantly (p less than 0.05) at 30 seconds and at 1 and 2 minutes, from 25 (3) to 11 (4) mmHg. The cerebral perfusion pressure decreased statistically significantly from 92 (8) mmHg at all measurements (p less than 0.05). The lowest value at 3 minutes was 50 (7) mmHg but in four patients at that time the perfusion pressure was below 50 mmHg.

Adult↗
PubMed1988

Comparison of evoked electromyography and mechanical activity during vecuronium-induced neuromuscular blockade.

The relationship of compound electromyography to mechanical myography was investigated in 20 patients given vecuronium in a dose of 0.1 mg kg-1. Mechanical response was affected less quickly and recovered faster than the electrical response. Although there was a good correlation between the two throughout the study, a shift towards mechanical responses was observed in all cases for the onset of blockade and recovery from blockade. Moreover, during recovery the mechanical responses became greater than the control value in all patients. This was also reflected in the statistically significant difference (P less than 0.05) of the regression lines relating tension and electromyography (TI as well as train-of-four ratio) between onset of, and recovery from, neuromuscular block.

Electromyography↗
PubMed1988

Double-blind comparison between nalbuphine and pentazocine in the control of postoperative pain after orthopedic surgery.

A double blind randomized study was done to compare Nalbuphine 20 mg I.M. to pentazocine 30 mg I.M. for postoperative pain relief after orthopedic surgery. This dose of pentazocine was choosen according to reports in the literature and to our standard practice. Sixty patients entered the study and were observed regularly till up 6 h post injection. The test drug was given when a pain score of 6 was shown on a VAS from 0 to 10. Onset, duration and quality of pain relief were significantly superior for nalbuphine with 50% of the patients still having no or only moderate pain at the end of the observation period. Cardiovascular and side effect were in both groups minor.

Adult↗
PubMed1987

The position of the patient during neurosurgical procedures on the posterior fossa.

Different parameters were measured on patients in six different positions during infratentorial surgery. One group of data served to prove that such patients were in a steady-state as far as their cardiovascular and ventilatory function was concerned. The other measured parameters concerned the intracranial pressure, the intracranial venous pressure and the cerebral perfusion pressure. It appeared from the comparison of these data, that the lateral sitting (45 degrees) position had important advantages and that in this position the possibility of unfavourable features (such as air-embolism) was minimized.

Blood Pressure↗
PubMed1987

Intrathecal sufentanil as a supplement to subarachnoid anaesthesia with lignocaine.

The combination of low-dose sufentanil with lignocaine for subarachnoid anaesthesia was studied in a double-blind comparative trial in 40 urological patients. Patients were allocated randomly to two groups and received 5% heavy lignocaine 1.5 ml together with either 1.5 ml of sufentanil 5 micrograms ml-1, or physiological saline 1.5 ml. No statistically significant differences were observed between the two groups with respect to analgesia or anaesthesia. The only clear benefit of the addition of a low dose of sufentanil to lignocaine was the significantly longer period of postoperative analgesia. There was no significant difference in the number of patients requiring supplementary analgesics. Side-effects were similar in both groups.

Adjuvants, Anesthesia↗
PubMed1987

Propofol combined with nitrous oxide-oxygen for induction and maintenance of anaesthesia.

After a bolus of 2 mg/kg, propofol was given by continuous infusion (150 micrograms/kg/minute for 30 minutes and then 100 micrograms/kg/minute) supplemented with nitrous oxide for anaesthesia during ear surgery in 12 patients. Cardiovascular changes were not significant except for a decrease in heart rate after 60 minutes. Acid-base balance was unaffected by the amount of fatty emulsion. Cortisol levels showed a nonsignificant decrease during the prolonged administration of propofol but had recovered completely by one hour following anaesthesia. Mean blood concentrations of propofol were 10.5 micrograms/ml (SEM 1.2) at the onset of unconsciousness, between 3.4 and 4.5 micrograms/ml during continuous infusion and 2.9 micrograms/ml (SEM 0.3) on awakening. Patients opened their eyes 6 minutes (SEM 1) after discontinuation of the infusion, and were responsive at 7.5 minutes (SEM 0.5), which suggests that propofol infusion can be used safely for surgery of 2 hours' duration.

Acid-Base Equilibrium↗
PubMed1987

Epidural sufentanil versus intramuscular buprenorphine for postoperative analgesia. A double-blind comparative trial.

Epidural sufentanil 50 micrograms was compared with intramuscular buprenorphine 0.3 mg for postoperative pain relief. Patients were assigned randomly to one of two treatment groups and received both an intramuscular and epidural injection, one of which was a placebo. Onset of pain relief was faster and quality of analgesia superior during the first 2 hours in the patients who received epidural sufentanil but the duration of analgesia was longer in the buprenorphine group. Cardiovascular variables remained stable in all patients and no respiratory depression was observed. Side effects were more frequent following buprenorphine.

Adult↗
PubMed1987

Priming with vecuronium and atracurium--a comparison.

Vecuronium (V) and atracurium (A) were compared in a randomised study in premedicated patients undergoing laparoscopy for gynecological pathology. Both groups contained ten patients. Anesthesia was induced with fentanyl (0.1 mg) and thiopentone (1 mg/kg initially and subsequently 4 mg/kg). A priming dose of vecuronium (20 micrograms/kg) or atracurium (100 micrograms/kg) was given one minute before the intubating dose (60 micrograms/kg for vecuronium and 300 micrograms/kg for atracurium). Ninety seconds thereafter intubation was performed. Maintenance of anesthesia consisted of isoflurane at an inspiratory concentration of 1% in a mixture of O2/N2O (50%/50%) with small supplements of fentanyl. Neuromuscular block was monitored with the Datex Relaxograph. Results show that neither drug offers major clinical advantages over the other: there is no difference in speed of onset (V:T190sec 14.6 +/- 4.3%; A:T190sec 23.5 +/- 6.5%; Mean +/- SEM) and duration of neuromuscular block (V:T150sec 34.2 +/- 3.5 min; A:T150sec 41.3 +/- 2.8 min; Mean +/- SEM) and intubation conditions are almost identical.

Adjuvants, Anesthesia↗
PubMed1987

The use of combined high-frequency jet ventilation and intermittent positive pressure ventilation in bilateral bronchopleural fistulae.

Dissatisfaction with the results of conventional respiratory support has led to the use of high-frequency jet ventilation in desperate clinical situations with severe acute respiratory failure. We report a case of a 77 year old man with bilateral bronchopleural fistulae, who was ventilated with a combination of intermittent positive pressure ventilation and high-frequency jet ventilation. The hemodynamic and respiratory advances of this combination are discussed in an overview of the literature.

Aged↗
PubMed1987

A comparison of midazolam and diazepam for sedation during locoregional anesthesia.

Midazolam is a recently introduced benzodiazepine with a half life of 1-4 hours. Midazolam (0.15 mg/kg) has been compared with diazepam (0.2 mg/kg) for sedation during locoregional anesthesia in 60 premedicated patients. No difference among the two groups for heart rate, bloodpressure, respiratory rate and incidence, and duration of apnoea was noticed after an i.v. bolus administration. The recovery time was equal in both groups. Midazolam was significantly less painful at injection. The sedation pattern between both groups is only different at 60 minutes, where more better sedated patients are seen in the midazolam group. Except the pain at injection and a better sedation pattern after 60 min. the differences in the other parameters are only borderline.

Adult↗
PubMed1986

A combination of buprenorphine and naloxone compared with buprenorphine administered intramuscularly in postoperative patients.

Sixty patients suffering from moderate to severe pain following either orthopaedic or gynaecological surgery were treated with intramuscular buprenorphine (0.3 mg) or an intramuscular combination of buprenorphine (0.3 mg)/naloxone (0.2 mg) and the analgesic efficacy and safety of the two treatments was compared. The evaluation of efficacy showed that both treatments provided good analgesia which was apparent at the first assessment time (10 minutes) and continued for approximately 10 hours. Only seven patients suffered from unwanted side-effects with only drowsiness/sleepiness and nausea being reported by more than one patient. Over-all analysis of the results showed that there were no significant differences between the two treatments with regard to efficacy and safety.

Adolescent↗
PubMed1985

Efficacy of the extradural administration of lofentanil, buprenorphine or saline in the management of postoperative pain. A double-blind study.

Sixty postoperative orthopaedic patients were randomly assigned to three equal groups to study, in a double-blind fashion, the analgesic effects, durations of action and side effects of the extradural administration of lofentanil 5 micrograms, buprenorphine 0.3 mg or physiological saline. No systemic analgesics were given before, during or after surgery, and all the patients had operations on the lower extremities under extradural analgesia (lignocaine and bupivacaine). Eleven millilitre of the test drug was injected at T12-L1 as soon as pain occurred in the postoperative period. We observed a long duration of action and a marked analgesic effect with lofentanil, a shorter duration of action and less pain suppression with buprenorphine and a rather marked placebo effect after saline. The only side effect noticed in this study was drowsiness in three patients in the lofentanil group and in two patients in the buprenorphine group.

Adult↗
PubMed1985

Effect of speed of injection on induction of anaesthesia using propofol.

Sixty unpremedicated patients (30 male) were randomly allocated to three groups. They received an induction dose of propofol 2 mg kg-1 over 5, 20 or 60 s to a forearm vein. Anaesthesia was maintained with conventional inhalation anaesthetic agents. Anaesthesia was induced satisfactorily in all 20 of the patients in the 5-s group, in 19 of the patients in the 20-s group and in 18 of the patients in the 60-s group. The rate of injection had a significant influence on induction time. Mean induction time increased from 21.5 to 34.7 and 50.5 s, when injection time was increased from 5 to 20 to 60 s, respectively. Similar induction times were found in male and female patients. There was no significant difference between the groups, in depth of anaesthesia obtained--as assessed by the eyelash reflex. Mean arterial pressure decreased to the same extent in all three groups. Two minutes after induction, mean systolic arterial pressure was reduced by 15.1, 13.5 and 19.3 mm Hg in the 5-, 20- and 60-s groups, respectively, and mean diastolic arterial pressure by 10.3, 13.2 and 13.7 mm Hg. Heart rate changes were insignificant. Apnoea of more than 10 s duration was seen frequently in all three groups, but the results suggest that the incidence was not influenced by the rate of injection. Three patients experienced mild pain at the time of injection. No major adverse reactions occurred during or after anaesthesia.

Adolescent↗
PubMed1985

Comparison of propofol and thiopentone for induction of anaesthesia in premedicated patients.

Thirty premedicated ASA I or II patients scheduled for minor gynaecological surgery, were randomly allocated to receive either 1.5 mg/kg or 2 mg/kg propofol of the new emulsion formulation, or 4 mg/kg thiopentone, given over 20 seconds. Anaesthesia was successfully induced in all 30 patients. The mean (SEM) induction times were for propofol 1.5 mg/kg 33.3(3.2) seconds, for 2 mg/kg 30.5(2.7) seconds and for thiopentone 34.6(2.7) seconds. The incidence of apnoea greater than 10 seconds, was respectively 60, 80 and 80%, and the mean duration of apnoea 30.8(5.3), 37.1(5.0) and 23.7(5.0) seconds. The mean systolic blood pressure decreased after propofol 1.5 mg/kg by 16.0 mmHg, after 2 mg/kg by 18.6 mmHg, and increased after thiopentone by 1 mmHg, 2 minutes after injection. Heart rate increased significantly 2 minutes after thiopentone by an average of 15.1 beats/minute, but not after propofol. Pain was not reported during or after the injection. No major adverse reactions occurred at induction or during maintenance of anaesthesia with an inhalation agent. One patient who received 2 mg/kg propofol and isoflurane vomited for 24 hours. The recovery of anaesthesia after propofol induction, was quicker than after thiopentone.

Adult↗