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Biomedical subjects

G Rolly

Publications and source records attributed to G Rolly.

At least 109 records · Page 6Linked to original sources
PubMed1985

Epidural sufentanil for postoperative pain relief.

An open pilot study was undertaken to evaluate the analgesic properties of epidurally administered sufentanil in the early postoperative period. After orthopaedic surgery of the lower extremity, four different groups of five adult patients each received either 15 micrograms (group 1), 30 micrograms (group 2), 50 micrograms (group 3) or 75 micrograms (group 4) sufentanil via an epidural catheter previously used for the surgical procedure. Results were satisfactory in groups 3 and 4 with very good relief of pain and a mean duration of action of 372 and 307 minutes respectively. Dosage above 50 micrograms did not seem to improve the quality or duration of pain relief, although the onset of action was faster with 75 micrograms. Sedation was always present in patients with effective analgesia. In the present study respiratory depression was not evident, but three patients complained of itching and two of urinary retention.

Adolescent↗
PubMed1985

Cumulative experience with propofol ('Diprivan') as an agent for the induction and maintenance of anaesthesia.

In 60 unpremedicated patients, anaesthesia induction time decreased when the time taken to inject a bolus of 2 mg/kg propofol was decreased from 60 s to 5 s. Apnoea at induction was noted in all groups but the degree of cardiorespiratory depression was not influenced by the rate of injection. In premedicated patients both 1.5 mg/kg and 2.0 mg/kg were effective doses for induction of anaesthesia. In comparison with thiopentone 4 mg/kg, propofol produced a greater degree of arterial hypotension and a smaller increase in heart rate. Preliminary results with an infusion of propofol for maintenance of anaesthesia suggest that rapid recovery can be achieved after operations of long duration.

Adolescent↗
PubMed1984

Physiopathologic changes during anesthesia administration for gynecologic laparoscopy.

The physiopathologic effects of CO2 pneumoperitoneum on the respiratory and cardiovascular systems were studied in seven patients during gynecologic laparoscopy and volume-controlled ventilation. The CO2 pneumoperitoneum and Trendelenburg position induced a statistically significant decrease in CTL and a significant increase in CVP, PaCO2 and PACO2.

Adult↗
PubMed1984

Cardiovascular, metabolic and hormonal changes during isoflurane N2O anaesthesia.

Isoflurane was used in 10 ASA I or II female patients, undergoing hysterectomy. It was given at a constant inspired concentration of 1.3% in a 50% N2O/50% O2 mixture, after induction of anaesthesia using etomidate (0.3 mg kg-1) and intubation following pancuronium (0.1 mg kg-1). No analgesic supplement was given. The patients were hyperventilated minimally (PaCO2 4.7-5.3 kPa). At standardized times (before induction, after induction, 5', 25', 50' and 75' min after surgical incision, awake and awake +60'), cardiovascular (blood pressure, cardiac output, stroke volume, heart rate), respiratory (blood gases), metabolic (oxygen consumption, blood glucose) and hormonal (noradrenaline, adrenaline, cortisol, prolactin) changes were measured. Blood pressure changes were very moderate (mean values were lower than before induction), but heart rate was increased significantly. Decreases in stroke volume and changes in cardiac output were not significant. Oxygen consumption was decreased below basal values during surgery. Blood glucose levels increased significantly in the course of surgery and remained raised postoperatively. Adrenaline and noradrenaline levels increased significantly. At each examination time, cortisol levels were decreased significantly. Prolactin levels had decreased significantly 75 mins after incision and remained low 60 mins after awakening.

Adult↗
PubMed1984

Isoflurane anesthesia for resection of pheochromocytoma. A report of two cases.

Isoflurane was selected as the main agent for induction and maintenance of anesthesia in two patients scheduled for resection of pheochromocytoma. The inspired concentration was calculated with a pocket computer (Sharp PC 1401) and adjusted to maintain an alveolar concentration of 1.5 to 1 MAC. With this technique, a stable heart rate was observed, without arrhythmias. The blood pressure stabilised at normal levels before surgery and only moderate hypertension was seen during tumor manipulation. No specific antihypertensive medication was needed. Transient hypotension after tumor resection was treated with ephedrine and volume replacement. Recovery of anesthesia was rapid and uneventful.

Adrenal Gland Neoplasms↗
PubMed1984

Practical experience with more than 60,000 closed circuit anesthesias. Traditional and future implications of the closed circuit concept.

In a twelve year period, over 60,000 anesthesias were administered using a completely closed anesthesia system. Our results show that even in these days, when the cost of anesthetic gasses and vapours are small compared to the total cost of operative medical treatment, a substantial reduction in cost is still possible by using Closed Circuit Anesthesia (CCA). During normal anesthetic practice using semi open or semi closed anesthesia systems 70% to 95% of the anesthetic gases and vapours are wasted, though this medical contribution to the environmental pollution with halogenated hydrocarbons is small compared to industrial and domestic output, we have a firm ideological standpoint in this matter, and we believe that also from this point of view we should minimise our "anesthetic wastes" as much as possible. Probably the most important reason to use CCA however is the optimal conditioning of the inspired gasses, and the increased monitoring possibilities. New promising anesthesia machines are under development, which will be able to administer CCA in a completely automatic fashion, this in contrast to the classic manually controlled and ventilated CCA systems.

Anesthesia↗
PubMed1983

Alfentanil/etomidate anaesthesia for endolaryngeal microsurgery.

Anaesthesia for laryngeal microsurgery by laser was conducted using etomidate and alfentanil. Patients' lungs were ventilated with air to avoid the danger of fire during the use of the laser. Thirty one patients received fentanyl/droperidol or pethidine for premedication. Anaesthesia was induced with etomidate 300 micrograms/kg and maintained with etomidate 30 micrograms/kg/minute. Alfentanil was given as an initial bolus of 40 micrograms/kg with subsequent increments of 15 micrograms/kg. Systolic arterial blood pressure and heart rate decreased significantly at some time intervals. Blood biochemistry and blood gases were within normal ranges, except for elevated PaO2 values during ventilation on pure oxygen. This technique adequately provided the requirements for prompt, smooth awakening, with a low incidence of nausea and vomiting.

Acid-Base Equilibrium↗
PubMed1983

Double blind study with nefopam, tilidine and placebo, for postoperative pain suppression.

A double-blind study involving 101 patients was done to assess the efficacy of parenteral nefopam (0.66 mg/kg) for postoperative pain suppression, in comparison to tilidine (1.67 mg/kg) or placebo. The difference in painfree duration for both active drugs compared to placebo is significant, but no significant difference was present between them; although tilidine was a little longer acting. At no moment a significant difference was present in the pain score of the patients receiving one of both active drugs. Only minor changes of blood pressure, heart rate and respiratory frequency were seen and marked side effects were not present in any of the patients.

Adolescent↗
PubMed1983

Comparative study of etomidate-alfentanil anesthesia with N2O/O2 or with air/O2.

Systolic, diastolic blood pressures, heart rate, glycaemia, blood gases and clinical status were studied preinduction, 10' after anesthesia induction and intubation, 3', 30', 60' and 90' after surgical incision, when awake on the operating table and 60' after awakening in 20 hysterectomy patients. Etomidate (0.3 mg/kg + continuous infusion), alfentanil (75 micrograms/kg + increments of 15 micrograms/kg) anesthesia was used with a N2O/O2 mixture (10 pt) or with air/O2 (10 pt), both at a FIO2 = 0.33. This technique gave a smooth induction and recovery. Cardiovascular changes were moderate. The additional dose of alfentanil was 5.25 +/- 0.65 mg in the N2O/O2 group and 6.45 +/- 0.85 mg in the air/O2 group. The incidence of vomiting was 15%. Statistical analysis of both groups indicated no major difference between the two types of anesthesia, for the cardiovascular, acid base data and glycaemia. This technique is a simple and effective way of anesthetising patients, but from a clinical point of view the etomidate/alfentanil anesthesia combined with N2O/O2 gives better results than when combined with air/O2.

Adjuvants, Anesthesia↗
PubMed1982

Clinical use of vecuronium (ORG NC 45) in balanced anesthesia. Comparison with pancuronium.

In 2 groups of 25 patients 0.1 mg/kg vecuronium (Org NC 45) or pancuronium, according to a randomised basis, was injected during balanced anesthesia (thiopental, fentanyl, dehydrobenzperidol and N2O). Intubation conditions 120 seconds after injection were satisfactory. After intubation, a heart rate increase was present with pancuronium (p less than 0.01), but not with vecuronium (difference: p less than 0.05); heartrate decreased 15 and 30 minutes after injection of vecuronium (p less than 0.01). The clinical duration of action of vecuronium was 32.7 +/- 2.4 min (Mean +/- SEM) and of pancuronium 73.5 +/- 4.8 min (p less than 0.01). Successive maintenance doses of 0.025 mg/kg of vecuronium had a duration of action of 23.1 +/- 1.7, 26.8 +/- 2.1, 27.6 +/- 4.0 and 24.0 +/- 2.8 min (diff. NS), showing no cumulative activity. The duration of action of identical doses of pancuronium were 56.9 +/- 3.1, 52.1 +/- 7.2 and 61.3 +/- 17.6 min (diff. NS), values nearly +/- 220% above those of vecuronium (p less than 0.01). Reversion of neuromuscular blockade after vecuronium with small amounts of neostigmine was clinically adequate.

Adult↗
PubMed1982

Etodolac in postsurgical pain: a double-blind dose-ranging efficacy study with aspirin and placebo.

A study was conducted to compare the analgesic activity of single oral doses of etodolac (25, 50, 100, 200, and 400 mg) with 650 mg aspirin and placebo. A total of 146 patients with moderate or severe pain from orthopedic or urologic interventions received one of the test medications 13-25 h after the beginning of surgery and according to a randomized allocation balanced as to initial pain intensity. Data for pain intensity and pain relief were collected at 1/2 h and then hourly for 8 h. Vital signs and adverse reactions were also recorded. One hundred and forty-two patients completed the study: four were excluded because of protocol deviations. The average response to 100, 200, and 400 mg of etodolac was superior to that of placebo. On the basis of SPID, TOTPAR, and duration of analgesia, 400 mg etodolac was also significantly more effective than 650 mg aspirin. Mild side effects probably or possibly related to etodolac were reported by three patients. This study provides evidence that etodolac in doses of 100 mg and higher is an effective and well-tolerated analgesic.

Acetates↗
PubMed1982

Use of chloroprocaine for obstetric analgesia.

The effects of low concentration chloroprocaine in continuous lumbar epidural analgesia during labor and delivery, were evaluated in 21 subjects. The final analysis was made on 18 parturientis, 9 receiving 1.5% (group A) and 9 1.33% chloroprocaine (group B), in a standard dose of 7-8 ml (first test dose 2-3 ml), and of 12 ml for the second stage of labor. Onset of analgesia occurred 7.4 +/- 1.2 (mean +/- S.D.) (group A) and 9.6 +/- 1.8 min. (group B) after injection (difference significant). Mean interval between first and second doses was 50.5 +/- 6.3 (group A) and 47.5 +/- 10.8 (group B) min. (difference N.S.). In group A 6 patients and in group B only 1 patient had a temporarily decrease in bloodpressure below 100 mm Hg. During routine monitoring, pathological F.H.R. patterns were recorded in 2 cases. Apgar scores and acid-base parameters were within normal limits in both groups (difference N.S.).

Adult↗