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At least 1,135 records · Page 63Linked to original sources
PubMed2000

Induction pain perception after premedication with propofol vs lidocaine: a pilot study.

Propofol, an intravenous (i.v.) sedative-hypnotic agent, is commonly used for the induction of general anesthesia. It has, however, a substantial potential for causing burning pain at the i.v. site. Several preinduction pharmacologic agents are used routinely to blunt or diminish this burning sensation. Little is published on the effect of a preinduction dose of propofol for pain reduction. Lidocaine, the most studied agent, is recommended by the manufacturer of propofol as a preinduction agent to minimize this burning sensation. If lidocaine could be eliminated, time and cost savings from decreased use of drug, syringes, needles, and alcohol swabs would be realized. The purpose of this study was to determine the clinical effectiveness of administering preinduction doses of lidocaine vs propofol for decreasing pain experienced during anesthetic induction with propofol. Thirty unmedicated patients, ASA physical status I or II, scheduled to undergo general anesthesia for a surgical procedure were included. Patients were randomly assigned, using a random number chart, to receive 20 mg propofol or 40 mg lidocaine intravenously before entering the operating room suite. A minimum of 30 seconds, but not more than 45 seconds, following the administration of randomized drug with open-flow i.v. fluid, the induction dose of propofol (2.5 mg/kg) was begun through the same i.v. site. When one half of the dose had been administered and cleared the tubing by visualization, the patient was asked whether any discomfort was felt in the hand. If the response was yes, the patient was asked to rate the pain as mild, moderate, or severe. Then, the anesthetic process continued normally. No statistically significant difference occurred in pain prevention between treatment groups. In the lidocaine group, 53% (8/15) of patients were pain-free; in the propofol group, 47% (7/15) were painfree. However, when pain occurred, it was more likely to be classified as severe by the propofol group, 50% (4/8), compared with the lidocaine group, 14% (1/7). No difference existed in the ability of propofol or lidocaine to decrease the incidence of pain during an induction dose of propofol. The incidence of severe pain, however, was more frequent in the propofol group. The small number of patients experiencing severe pain precluded statistical analysis. Blunting pain associated with propofol warrants further study.

Adolescent↗
PubMedDate not supplied

[Comparative study between midazolam and diazepam in upper gastrointestinal endoscopy premedication].

A prospective study evaluated and compared midazolam versus diazepam in the upper gastrointestinal endoscopy. Patients were excluded if they had experienced any of the following: intolerance to benzodiazepines, pregnancy, alcohol or drug addiction, and weakness chronic disease. Seventy one patients were assigned to two groups: 36 received diazepam (0,15 Mg/Kg. intravenous) and 35 midazolam (0,07 mg/kg.). Patients in the two study group were similar in regard to demographic data (sex, age, and weight). Midazolam resulted in a marked improvement of conscious sedation and the anxiolysis as compared with the group receiving diazepam (p<0.001). Amnesia were significantly more frequent in the midazolam group (total 77,14% and partial 17,14%) compared with diazepam group (total 11,11% and partial 2,77%). The present study show that midazolam improves patient tolerance lo endoscopy compared with diazepam (p<0.001).The selection of patients is very important, no clinically adverse events related to cardiopulmonary changes ocurred in any group.

Adult↗
PubMedDate not supplied

[Combined premedication at adenectomy in children].

Adenoid vegetation is a frequent pathology in children, and adenotomy (AT) is the only method of its treatment. The problem of anesthesia at AT has always remained an acute one: the risk of general anesthesia exceeds manifold the risk of intervention itself. At the same time, the local anesthesia is not always an method, therefore, the authors put the goal to improve it through potentiating. A total of 180 children, aged 3 to 14, were divided into several groups; anesthesia at AT was implemented according to the below described methods and with regard for the age-related doses of preparations: Group 1--a 2% lydocain solution administered endonasally (e/n); Group 2--lydocain plus diazepam solution administered e/n; Group 3--same preparations and 50% metamizol solution administered e/n; Group 4--lydocain, metamizol e/n, and diazepam administered transbuccally, i.e. chewing gum; Group 5--a 4% articain solution and metamizol e/n plus diazepam administered transbuccally; Group 6--the same technique after a preliminary administration of lydocain; Group 7--clonidine, administered transbuccally, was added. The adequacy of anesthesia was evaluated by using the parameters of the vegetative nervous system and hemodynamics. It was demonstrated that the administration of lydocain alone leads to a sharp activation of the sympathoadrenal system; metamizol and diazepam, especially when administered transbuccally, contribute to an enhanced efficiency of anesthesia, while the endonasal administration of articain and metamizol, after a preliminary introduction of lydocain, combined with the transbuccal administration of diazepam and clonidine is the most optimal variant, however, this method can not be acknowledged as an ideal one and needs further improvement.

Adenoidectomy↗