Dilution of Spinal Lidocaine Does Not Alter the Incidence of Transient Neurologic Symptoms 

1999 ◽  
Vol 90 (2) ◽  
pp. 445-450 ◽  
Author(s):  
Julia E. Pollock ◽  
Spencer S. Liu ◽  
Joseph M. Neal ◽  
Carol A. Stephenson
Keyword(s):  
Postoperative Complications ◽  
Knee Arthroscopy ◽  
Physical Status ◽  
Double Blind ◽  
Neurologic Symptoms ◽  
The Third ◽  
Ambulatory Patients ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background Although it has been suggested that the dilution of 5% hyperbaric lidocaine before injection for spinal anesthesia may decrease the incidence of transient neurologic symptoms, previous studies have not noted a decreased incidence between 5% and 2% lidocaine. The aim of the current study was to determine whether the incidence of transient neurologic symptoms could be altered by further diluting spinal lidocaine from 2.0% to 0.5%. Methods One hundred nine patients with American Society of Anesthesiologists physical status 1 or 2 undergoing outpatient knee arthroscopy were randomized in a double-blind fashion to receive 50 mg hyperbaric spinal lidocaine as a 2.0%, 1.0%, or 0.5% concentration. On the third postoperative day, patients were contacted by a blinded investigator and questioned regarding the incidence of postoperative complications, including transient neurologic symptoms, defined as pain or dysthesia in one or both buttocks or legs occurring within 24 h of surgery. Results The incidence of transient neurologic symptoms did not differ among patients receiving 2.0% (incidence of 15.8%), 1.0% (incidence of 22.2%), and 0.5% (incidence of 17.1%) lidocaine (P = 0.756). Conclusions For ambulatory patients undergoing arthroscopy, the incidence of transient neurologic symptoms is not reduced by decreasing spinal lidocaine concentrations from 2.0% to 1.0% or 0.5%. The incidences of transient neurologic symptoms with the 0.5%, 1.0%, and 2.0% solutions are similar to previously reported incidences for 5.0% lidocaine, suggesting that dilution of lidocaine from 5.0% to 0.5% does not change the incidence of these symptoms.

scholarly journals Oxycodone for prevention of etomidate-induced myoclonus: a randomized double-blind controlled trial

2018 ◽  
Vol 46 (5) ◽  
pp. 1839-1845
Author(s):  
Wei Wang ◽  
Jie Lv ◽  
Qi Wang ◽  
Lei Yang ◽  
Wanyou Yu
Keyword(s):  
General Anesthesia ◽  
Intravenous Injection ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physical Status ◽  
Double Blind ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective This study was performed compare the effectiveness of oxycodone and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. Methods In total, 162 patients with an American Society of Anesthesiologists physical status of I or II were assigned at random to three groups. Patients assigned to Group O received 0.1 mg/kg of oxycodone (n = 54), those assigned to Group F were given 1 µg/kg of fentanyl (n = 54), and those assigned to Group S were given an equal volume of saline intravenously 2 minutes prior to administration of 0.3 mg/kg of etomidate (n = 54). The incidence and severity of myoclonus was evaluated 2 minutes after etomidate administration. The patients’ vital signs, coughing, nausea, dizziness, and other related adverse reactions were also recorded. Results The incidence of myoclonus was significantly lower in Group O (0.0%) than in Group F (31.5%) and Group S (72.2%); the intensity was also lowest in Group O. All patients in each group had stable cardiovascular profiles. Conclusions Intravenous injection of 0.1 mg/kg of oxycodone 2 minutes prior to etomidate is more effective in preventing etomidate-induced myoclonus during general anesthesia than is 1 µg/kg of fentanyl.

Comparative Hemodynamic Depression of Sevoflurane versus Halothane in Infants 

1997 ◽  
Vol 87 (4) ◽  
pp. 795-800 ◽  
Author(s):  
Eric Wodey ◽  
Patrick Pladys ◽  
Catherine Copin ◽  
Marie Madeleine Lucas ◽  
Andre Chaumont ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Index ◽  
Elective Surgery ◽  
Physical Status ◽  
Inhalation Induction ◽  
Cardiovascular Side Effects ◽  
American Society ◽  
End Tidal ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background The cardiovascular side effects of volatile anesthetics are one of the chief causes of postoperative complications in children, and infants seem to be at the greatest risk for this. This study compared cardiovascular changes at equipotent concentrations of sevoflurane and halothane in infants. Methods Thirty infants classified as American Society of Anesthesiologists physical status I or II who required elective surgery were randomized to receive either halothane or sevoflurane for inhalation induction. Cardiovascular and echocardiographic data were recorded in both groups at baseline and at end-tidal concentrations of 1 and 1.5 minimum alveolar concentration (MAC). Results Sevoflurane did not alter heart rate or cardiac index at all concentrations compared with awake values. Sevoflurane significantly decreased blood pressure and systemic vascular resistance compared with awake values at all concentrations. Shortening fraction and rate-corrected velocity of circumferential fiber shortening decreased at 1.5 but not at 1 MAC. Myocardial contractility assessed by stress-velocity index and stress-shortening index decreased significantly at all concentrations, but did not fall into the abnormal range at any concentration. Halothane caused a greater decrease in heart rate, shortening fraction, stress-shortening index, velocity of circumferential fiber shortening, stress-velocity index, and cardiac index at all concentrations than did sevoflurane. Conclusion Sevoflurane causes a lesser decrease in cardiac output than does halothane in infants.

Greater Incidence of Delirium during Recovery from Sevoflurane Anesthesia in Preschool Boys 

1997 ◽  
Vol 87 (6) ◽  
pp. 1298-1300 ◽  
Author(s):  
Jun Aono ◽  
Wasa Ueda ◽  
Kikyo Mamiya ◽  
Eri Takimoto ◽  
Masanobu Manabe
Keyword(s):  
Age Groups ◽  
Older Children ◽  
Caudal Block ◽  
Physical Status ◽  
Early Recovery ◽  
Sevoflurane Group ◽  
Preschool Boys ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background In the authors' clinical experience, preschool children are more likely to show delirium after sevoflurane than are older children. Methods Sixty-three preschool boys aged 3-5 yr (classified as American Society of Anesthesiologists [ASA] physical status I), and 53 school-age boys aged 6-10 yr (ASA physical status I) who underwent minor urologic surgery were randomly assigned to receive either halothane or sevoflurane, thus creating four groups: preschool-halothane (n = 32), preschool-sevoflurane (n = 31), school-halothane (n = 27), and school-sevoflurane (n = 26). Anesthesia was induced by inhalation of halothane or sevoflurane in oxygen and was maintained at 1 minimum alveolar concentration of each agent throughout surgery. For intra- and postoperative analgesia, caudal block with 0.5-1.0 ml/kg 0.25% plain bupivacaine and topical infiltration with 3-5 ml 1% lidocaine were provided for all patients. Recovery characteristics and incidence of delirium on emergence were compared among the four groups. Results Two patients in the preschool-halothane group, one in the preschool-sevoflurane group, and one in the school-halothane group were excluded from the comparison because of insufficient analgesia or agitation before induction. In both age groups, the time to emergence from sevoflurane was significantly faster (about 3 min) than from halothane. The incidence of delirium during recovery in the preschool-sevoflurane group (40%) was significantly greater than that in the other groups (preschool-halothane, 10%; school-halothane, 15.4%; school-sevoflurane, 11.5%). Conclusion Sevoflurane provided quicker emergence and early recovery compared with halothane, but the incidence of delirium was greater in preschool boys after sevoflurane.

scholarly journals Reliable and Rapid Smooth Extubation After "Ketamine-Propfol Mixture" for Induction of General Anesthesia in Laparoscopic Drilling of Polycystic Ovary: A Randomized, Double-Blind, Comparative Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Atef Mohammad Khalil ◽  
Joseph Makram Botros ◽  
Maged Labib Boules ◽  
Safaa Gaber Ragab
Keyword(s):  
Comparative Study ◽  
General Anesthesia ◽  
Polycystic Ovary ◽  
Sedation Score ◽  
Controlled Study ◽  
Physical Status ◽  
Double Blind ◽  
Airway Response ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Ketofol's effect on hemodynamics and the airway response during inducing general anesthesia has been studied previously. However, ketofol's effect on the smoothness of extubation has not been studied yet. Objectives: We aimed to assess ketofol’s effect on the smoothness of extubation and compare it with propofol for inducing general anesthesia. Methods: This double-blind, randomized, and controlled study was conducted on 106 class I and II female patients with the “American Society of Anesthesiologists Physical Status (ASAPS),” aged 18 - 40 years, scheduled for laparoscopic drilling for polycystic ovary disease under general anesthesia. The patients were assigned to two groups of 53 patients each: Group KP = ketofol and Group P = propofol. Results: There was an excellent sedation score during suction and extubation in the ketofol group. The airway response and smoothness of extubation were better in the ketofol group than in the propofol group. Conclusions: Ketofol as an induction anesthetic agent more effectively attenuated the airway response during extubation than only propofol.

Epidural dexamethasone for postoperative analgesia in patients of carcinoma rectum undergoing lower anterior resection (LAR)

JMS SKIMS ◽  
2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Sheikh Irshad Ahmad ◽  
Gowhar Hameed ◽  
Tanveera Gani ◽  
Tantry Tariq Gani ◽  
Wasim Mohammad Bhat ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Anterior Resection ◽  
Double Blind Study ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Carcinoma Rectum ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
To Receive ◽  
Lower Anterior Resection

Background and Aims: This prospective, randomized, double blind study was undertaken to establish the effect of addition of dexamethasone as an adjunct to epidural ropivacaine in patients of carcinoma rectum undergoing lower anteriorresection. Materials and Methods: Sixty ASA (American Society of Anesthesiologists) class I and II patients undergoing lower anterior resection were enrolled to receive either 6mg or 8mg or 10mg of dexamethasone along with epidural ropivacaine to a total of 10ml test solution in each group for epidural analgesia. Hemodynamic parameters, postoperative analgesia, total requirement of rescue analgesia and adverse events were monitored. Results: Analgesia in the postoperative period was better in Group receiving 10mg of dexamethasone associated with less postoperative rescue analgesic consumption Conclusion: Hence, addition of dexamethasone 10mg to epidural ropivacaine can be advantageous with respect to better postoperative analgesia.

A Double-blind Comparison of 0.125% Ropivacaine with Sufentanil and 0.125% Bupivacaine with Sufentanil for Epidural Labor Analgesia 

1999 ◽  
Vol 90 (3) ◽  
pp. 772-778 ◽  
Author(s):  
Philippe Gautier ◽  
Marc De Kock ◽  
Albert Van Steenberge ◽  
Dominique Miclot ◽  
Luc Fanard ◽  
...  
Keyword(s):  
Motor Impairment ◽  
Epidural Injection ◽  
Motor Blockade ◽  
Double Blind ◽  
Patient Satisfaction Scores ◽  
Severe Motor ◽  
American Society ◽  
Blind Comparison ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background This study intends to evaluate the benefits of the administration of intermittent bolus doses of ropivacaine (0.125%) compared with bupivacaine (0.125%) after addition of sufentanil for analgesia during labor. Methods One hundred thirty American Society of Anesthesiologists physical status 1 or 2 parturients were studied. The 90 initial patients were assigned randomly to receive 10 ml bupivacaine, 0.125%, plus 7.5 microg sufentanil (initial bupivacaine 0.125% group) or ropivacaine, 0.125%, plus 7.5 microg sufentanil (ropivacaine 0.125% group). Forty additional patients were recruited and received 0.125% bupivacaine plus 7.5 microg sufentanil (additional bupivacaine 0.125% group) or 0.100% bupivacaine plus 7.5 microg sufentanil (additional bupivacaine 0.100% group). The duration of analgesia, visual analogue scores for pain, motor blockade (using a six-point modified Bromage scale), patient satisfaction scores, nausea, pruritus, heart rate, and blood pressure were recorded. Results Bupivacaine 0.125% and ropivacaine 0.125% coadministered with sufentanil provided rapid and complete analgesia. Onset of analgesia occurred after +/-15 min and lasted +/-90 min. After the third epidural injection, patients in the ropivacaine group experienced significantly less severe motor blockade than patients in the initial bupivacaine 0.125% group. At this point, 93% of the patients in the ropivacaine group were free from motor impairment versus 66% in the bupivacaine group (P<0.05). Comparable levels of motor blockade were obtained in both additional groups. Patients' evaluation of their analgesia was worst in the bupivacaine 0.100% group. Conclusions Ropivacaine 0.125% with sufentanil affords reliable analgesia with minimal motor blockade.

scholarly journals Reliable and rapid smooth extubation after Ketofol for induction of general anesthesia in Laparoscopic Drilling of polycystic ovary: A randomized controlled trial.

2020 ◽  
Author(s):  
Atef Mohamed Sayed Mahmoud ◽  
Safaa Gaber Ragab ◽  
Joseph Makram Botros
Keyword(s):  
General Anesthesia ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Controlled Study ◽  
Physical Status ◽  
Double Blind ◽  
Randomized Controlled ◽  
Airway Response ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract Background : the outcome of ketofol on the hemodynamics and the airway response during induction of general anesthesia has been studied before. Its effect on the smoothness of extubation has not been studied before. So, we aimed to assess the effect of ketofol on the smoothness of extubation and compare it with propofol only for the induction of general anesthesia. Methods: This double-blind, randomized, and controlled study was conducted on one hundred and six American Society of Anesthesiologists Physical status ''ASA PS'' class I and II female patients aged 18-40 years old and scheduled for laparoscopic drilling for polycystic ovary disease under general anesthesia. The patients were assigned into one of two groups (53) patients each; group KP = ketofol and group P = propofol. Results: There was a good sedation score during suction and extubation in the ketofol group. Airway response and smoothness of extubation were better in the ketofol more than the propofol group. Conclusion: Ketofol as an induction anesthetic agent was effective in attenuating the airway response during extubation more than profofol only. Trial registration: This trial was retrospectively registered at the Clinical Trial.gov with the Identification Number: NCT04365686.

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