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Results for “Anesthesia--administraction and dosage”

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At least 19 recordsLinked to original sources
PubMed1986

Premedication for day-case surgery: double-blind comparison of ketobemidone + dimethylaminodiphenylbuten (A-29) and morphine + scopolamine.

A double-blind comparison of the effect of Ketogan (ketobemidone and A-29, an anticholinergic and spasmolytic agent) and morphine + scopolamine as premedication was performed in 113 women admitted for abortion and in 114 women admitted for gynaecological dilatation and curettage. Anaesthesia was thiopentone and nitrous oxide and oxygen, occasionally supplemented with enflurane. It was found that 1 ml morphine + scopolamine (10 mg + 0.4 mg) was more sedative than 1 ml ketogan (ketobemidone 5 mg + A-29 25 mg). After ketogan there was less nausea and dryness of the mouth before induction of anaesthesia than after morphine + scopolamine. Ketogan had the same tranquillizing effect but less hypnotic effect preoperatively than morphine + scopolamine. During the 3-h postoperative observation period the patients premedicated with ketogan woke up significantly sooner and had more pain than those given morphine + scopolamine. More patients required postoperative antiemetics in the ketogan-premedicated group than in the morphine + scopolamine-premedicated group.

Abortion, Legal↗
PubMed1989

Topical bupivacaine and etidocaine analgesia following fallopian tube banding.

The purpose of this study was to compare the effectiveness and safety of etidocaine and bupivacaine for postoperative analgesia after laparoscope sterilization. The study was performed in 22 healthy patients who received either one per cent etidocaine, 2 mg.kg-1, or bupivacaine 1.5 mg.kg-1 in a double-blind, randomized fashion. The local anaesthetic was dropped onto the fallopian tubes from uterus to fimbriae before tubal occlusion. To establish safety, blood concentrations of the parent drug and its metabolites were measured before application and at 1, 3, 6, 10, 15, 30, 60 and 120 min. The mean peak concentrations were 501.8 +/- 71.3 (SEM) for etidocaine with a range of 225 to 905 ng.ml-1. For bupivacaine, the mean peak concentration was 468 +/- 73.8 SEM with a range from 191 to 1005 ng.ml-1. The mean values are one eighth of the toxic convulsive dose for humans. Etidocaine was metabolized at a faster rate than bupivacaine with a rapid appearance of 2-amino-2'-butyroxylidide (ABX). The bupivacaine metabolite 2,6-pipecoloxylidide (PPX) was detected in low concentrations in the 60-minute samples. We conclude that the topical application of either etidocaine or bupivacaine is a safe procedure in the doses and concentrations used during general anaesthesia for laparoscopic tubal banding.

Abdominal Pain↗
PubMed1987

Bupivacaine infiltration of the mesosalpinx in ambulatory surgical laparoscopic tubal sterilization.

Bupivacaine infiltration of the mesosalpinx was compared to lidocaine, normal saline or no injection for pain relief in women having elective laparoscopic tubal sterilization by Yoon fallopian ring application. One hundred women were assigned randomly to four groups. In a double-blind study, the mesosalpinx was infiltrated in three groups: Group 1 - lidocaine one per cent; Group II - bupivacaine 0.5 per cent; Group III - normal saline. Group IV (control) received no injection. Pain intensity was reported at four study times by the patients on a self-assessment pain intensity scale. Responses were compared using the Kruskall-Wallis H-Test and Wilcoxen's Rank-Sum Test. Both tests indicated significant differences in pain intensity levels at various study times. The amount of supplemental fentanyl given was used as a secondary measure of effectiveness. One-way analysis of variance (ANOVA) and Duncan's Multiple-Range Test showed the bupivacaine group to receive significantly less fentanyl (p less than 0.05) in the postanaesthesia care unit.

Adult↗
PubMed1984

A comparative study of topical anesthesia for laparoscopic sterilization with the use of the tubal ring.

A study of 300 women undergoing sterilization via standard or open laparoscopy was conducted at Siriraj Hospital in Bangkok, Thailand; one aspect of the study was designed to determine whether application of topical anesthesia to the fallopian tubes reduces the degree of pain experienced by the patient. The use or nonuse of topical anesthesia was randomized for all cases. Overall, data from this study indicate that application of topical anesthesia to the fallopian tubes tends to diminish surgical pain of patients sterilized by use of either the standard laparoscopy or the open laparoscopy approach and that pain in the recovery period is also reduced for open laparoscopy patients.

Administration, Topical↗
PubMed1992

Conditions for choosing between drug-induced and surgical abortions.

In France, pregnant women with amenorrhoea of no more than 49 days intending to terminate pregnancy can choose between a surgical abortion via vacuum aspiration under local or general anesthesia and a drug method combining Mifepristone orally administered (RU 486 degrees), with a prostaglandin analogue. This prospective survey was conducted to study the conditions under which women choose their abortion method, and to evaluate the acceptability of each method after the abortion. The data gathered from 488 women were analyzed according to their initial decision, and then according to the method actually used. The majority (62%) chose RU 486. The women's choice was found to be linked to sociodemographic characteristics such as age, education, occupation, geographic origin, and certain attitudes towards pregnancy, as well as to the individual criteria of each method. The women who chose the drug protocol had most often already made their decision before going to the family planning center (68%), having been advised by their doctor (20%). They were slightly less satisfied with the abortion experience than they had expected: 12.4% were unsatisfied in the RU group and 3.6% in the aspiration group. They needed more rest and quiet afterwards (50%) than the other women. They were distinguished by their desire to verify the expulsion (63%). The length of pregnancy is therefore not the only criterion to be considered when recommending one or other of these methods: the women concerned have different requirements and should have several possibilities to choose from.

Abortion, Induced↗
PubMed1984

Comparison between midazolam and thiopentone-based balanced anaesthesia for day-case surgery.

In a randomized study of 100 women (ASA 1-2) undergoing termination of pregnancy as outpatients, the combination of midazolam-fentanyl-nitrous oxide was compared with thiopentone-fentanyl-nitrous oxide. The induction time (the time recorded until disappearance of the palpebral reflex) was significantly longer in the midazolam group (40 s) than in the thiopentone group (31 s). There were no significant differences in heart rate or arterial pressure between the two groups. Thirty minutes after the termination of surgery the degree of awareness, estimated by means of Glasgow Coma Scale, was lower in the midazolam group. After 60 and 180 min the scores were equal. During recovery more patients experienced side-effects in the thiopentone group than in the midazolam group, the difference being statistically significant 72 h after discharge when 66% and 34% of the patients complained of side-effects, respectively. Midazolam is as suitable as thiopentone for the induction of anaesthesia in day-case surgery.

Abortion, Induced↗
PubMed1985

Outpatient termination of pregnancy: halothane or alfentanil-supplemented anaesthesia.

Inhalation anaesthesia with halothane was compared with i.v. alfentanil in 66 unpremedicated patients undergoing suction termination of pregnancy as outpatients. Blood loss was significantly greater in the halothane group with a mean loss of 213 ml, compared with a mean loss of 89.8 ml in the alfentanil group. There was a greater frequency of nausea and vomiting in the alfentanil group, but no reduction in abdominal pain or need for analgesia after operation. Positive relationships were found between blood loss and duration of anaesthesia and between blood loss and gestational age in the halothane group, but not in the alfentanil group. We conclude that alfentanil-supplemented anaesthesia is satisfactory for suction termination of pregnancy when rapid recovery is required or the duration of the procedure is likely to be long, but that halothane anaesthesia cannot be recommended, especially if the procedure is long.

Abortion, Induced↗
PubMed1995

Intra-vas deferens bupivacaine for prevention of acute pain and chronic discomfort after vasectomy.

We have studied the use of intra-vas deferens local anaesthesia in 70 patients undergoing vasectomy as day-case patients. Patients were allocated randomly to either a control or treatment group. In the treatment group, 0.5% bupivacaine 1 ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas deferens in a randomized blinded design. The control group did not receive an injection. Patients were discharged with a questionnaire for recording visual analogue scores (VAS) for both the right and left sides to be scored on days 1 and 7 after operation. One year after the procedure a second questionnaire was sent out asking about the presence or absence of chronic testicular discomfort, its duration and any surgical intervention required to relieve it. There were no differences between the control group and the saline side of the treatment group in VAS scores on both day 1 and day 7 after operation or in the incidence and duration of chronic testicular discomfort (mean 30 (SD 53) and 34 (50) days, respectively). The VAS scores were, however, significantly less (P < 0.005) and testicular discomfort was absent on the bupivacaine-treated side.

Adult↗
PubMed1990

Effect of epinephrine on intrathecal fentanyl analgesia in patients undergoing postpartum tubal ligation.

Eighty women receiving spinal anesthesia for postpartum tubal ligation were entered into a double-blind, randomized protocol studying the effects of epinephrine on intrathecal fentanyl-induced postoperative analgesia. All patients received 70 mg hyperbaric lidocaine with either 0.2 mg epinephrine (LE), 10 micrograms fentanyl (LF), epinephrine and fentanyl (LFE), or 0.4 ml saline (L). Onset and regression of anesthesia, degree of intraoperative comfort, incidence of pruritus, and extent of postoperative analgesia were evaluated. The simultaneous administration of epinephrine and fentanyl prolonged the duration of complete analgesia (137 +/- 47 min (LFE); 76 +/- 32 min (LE); 85 +/- 44 min (LF); 65 +/- 36 min (L)) and the duration of effective analgesia (562 +/- 504 min (LFE); 227 +/- 201 min (LE); 203 +/- 178 min (LF); 198 +/- 342 min (L)). Administration of epinephrine decreased the incidence of pruritus associated with intrathecal fentanyl (1/18 (LFE); 1/21 (LE); 8/19 (LF); 2/19 (L)).

Adult↗
PubMed1991

Opioid supplementation to propofol anaesthesia for outpatient abortion: a comparison between alfentanil, fentanyl and placebo.

One hundred and sixty-four patients scheduled for elective termination of pregnancy under general anaesthesia were randomly assigned to receive one of three different supplements to propofol and oxygen in nitrous oxide anaesthesia: 0.1 mg fentanyl, 0.5 mg alfentanil or placebo. Postoperative pain and nausea, as well as complications during anaesthesia were studied. There were no differences in complications or complaints by surgeons during anaesthesia, and no patient in any group reacted unsatisfactorily to surgery. The patients in the placebo group consumed significantly more propofol during the procedure (P less than 0.001). No differences were seen in time until hospital discharge between the three groups. Complaints about postoperative pain were significantly less frequent among patients receiving fentanyl (P less than 0.01). The number of patients requesting postoperative analgetics, however, did not differ. There was no difference in the frequency of nausea or vomiting, but postoperative pain was found significantly to increase complaints of nausea (P less than 0.01) and also time until hospital discharge (P less than 0.01). In conclusion, opioid supplementation lowered the amount of propofol needed for anaesthesia. Alfentanil 0.5 mg did not improve the postoperative course. Fentanyl 0.1 mg decreased the frequency of postoperative pain without increasing the time to hospital discharge.

Abortion, Induced↗
PubMed1992

Propofol anaesthesia versus paracervical blockade with alfentanil and midazolam sedation for outpatient abortion.

Propofol anaesthesia was compared with paracervical blockade in a prospective, randomized study of 59 abortion patients. All the patients received alfentanil 0.01 mg/kg i.v. at the start of anaesthesia and were randomized into two groups. Group R (regional, 31 patients): midazolam 0.1 mg/kg i.v. and paracervical blockade with 2 x 10 ml of mepivacaine 20 mg/ml + adrenaline 0.005 mg/ml. Group G (general, 28 patients): propofol 2.0 mg/kg i.v. induction and 75% nitrous oxide in oxygen spontaneous respiration. In 10 patients from the R-group venous blood samples were taken regularly for 30 min for serum concentration measurements (gas chromatography) of mepivacaine. Pain during induction of anaesthesia was remembered by 17% in Group G and 4% in Group R, whereas 8% in Group R remembered pain during the procedure compared with none in Group G. Of the patients in Group G, 25% had apnoea compared with none in Group R. In Group R the patients slept for 2.5 +/- 3.8 min (mean +/- s.d.) after induction compared with 12 +/- 4.0 min in Group G. Except for a better p-deletion score 30 min after the procedure in Group G, there was no difference in recovery function between the groups. Of the patients in Group G, 67% experienced postoperative pain compared with 23% in Group R. Maximum serum mepivacaine concentration (Group R) was reached at 15-30 min, range 1.5-5 micrograms/ml.

Abortion, Induced↗
PubMed1983

Intravenous access: a comparison of two methods.

The reliability in providing a continued venous route to the circulation is compared between a winged needle (Abbott "Butterfly--23 INT") and a plastic catheter (Jelco Teflon "Catheter Placement Unit", 22 gauge). The catheter remained within the vein in all cases and had a much lower incidence of total obstruction during the study period. Where an intravenous infusion is not in place, a plastic catheter provides a more reliable access route to the circulation than does a winged needle.

Abortion, Legal↗
PubMed1989

Pericervical intrafallopian bupivacaine instillation to reduce postoperative pain after laparoscopic tubal sterilisation.

In a double-blind comparative study of 46 women undergoing laparoscopic tubal sterilization under general anesthesia using Falope ring bands, the group of women (study group, n=22) having 0.5% bupivacaine instilled paracervically had less pain than women given normal saline (control group, n=24) at 1 and 2 hours. The trial group also required narcotic analgesia significantly less often (6/22 vs 19.24) than the control group. The reduction in postoperative pain afforded by this method of administration of bupivacaine allows day case laparoscopic sterilization to be performed with greater confidence.

Anesthesia↗
PubMed1983

Jet injection--local anesthesia for fitting and removal of IUDs.

Women with small uterine cavities and narrow cervical canals in particular suffer from symptoms such as discomfort, pain, cramps, bradycardia, syncope, and epileptoid convulsions during IUD insertions. These problems can be avoided by paracervical block (PCB) with syringe and needle, which may, in rare cases, entail hazardous side effects. These can be eliminated by the use of Jet Injection PCB. The Jet Injector deposits a 2% or 3% anesthetic solution paracervically submucously under high carbon dioxide pressure. The patient's fear of injection with a needle is avoided. The method can be applied by paramedics since intravascular application of anesthetic solution is impossible. The use of a more concentrated anesthetic solution allows dose reduction and the method of dispersion of the micro-drops ensures a more rapid onset. Premedication is not required and disposable material is economized on. This study is based on the application of Jet Injection PCB before insertion of medicated IUDs in 447 women; 60% nulligravidae, 14% nulliparous with abortion(s), 13% primiparae, and 13% multiparous. Age ranged from 15-47 years.

Age Distribution↗