Propofol versus midazolam antagonized by flumazenil after completion of surgery in day case surgery

In this study, speed of recovery was evaluated by using sedation scores in 45 male patients ASA I or II presented for diagnostic cystoscopy under general anesthesia. Induction of anesthesia was started in groups I and II [15 patients each] with mean [SD] doses of [0.17 + 0.06 mg/kg] or [0.17 + 0.04 mg/kg] midazolam, respectively, group II received i.v. flumazenil [0.54 + 0.17 mg/kg] after completion of surgery. Group III [15 patients] received propofol [1.60 + 0.23 mg/kg]. Anesthesia was maintained with isoflurane in 33% oxygen and nitrous oxide in all patients. Flumazenil showed tendency to improve tests of recovery after midazolam anesthesia, but faster recovery was significant in propofol group. Recovery after propofol anesthesia was associated with better psycomotor test results and less impairment of mental state as judged by sedation and amnesia scores

Anaesthetic technique and laparoscopic cholecystectomy. Effect on arterial to end-tidal carbon dioxide difference

The relationship between arterial carbon dioxide tension and end tidal carbon dioxide tension was studied in 24 patients during laparoscopic cholycystectomy. Thirteen patients received general anesthesia and 11 epidural anesthesia. The overall difference between arterial and end tidal carbon dioxide tension was 0.43 kpa which was significantly less than that reported in studies during other procedures. The possible reasons of this difference are associated with physiological changes induced by CO2 pneumoperitioneum and steep trendlenberg position. The choice of anesthetic technique did not affect the arterial to end tidal carbon dioxide tension difference significantly [P > 0.9]

Comparison between naloxone and nalbuphine for the treatment of side effects of epidural morphine

The aim of this study is to compare naloxone and nalbuphine when needed for treatment of side effects after epidural morphine [5 mg] given for postoperative gall bladder surgery for postoperative analgesia. Patients requesting treatment for pruritus or nusea received either naloxone intravenously [0.2 mg] [group 1, no. 20] or nalbuphine [5 mg] [group 2, no. 20] incidence of vomiting, severity of nusea and pruritus, and the degree of sedation and pain were assessed before and 30 minutes after each dose. The first dose of nalbuphine decreased the incidence of vomiting [P < 0.005] and severity of nusea and pruritus [P < 0.01] whereas naloxone caused no significant changes. Sedation scores increased after nalbuphine [P < 0.05], while they did not change after naloxone, whereas pain scores increased after naloxone [P > 0.01] and unchanged after nalbuphine. Seventeen patients in group 1 and 12 in group 2 received a second dose. After second dose 7 and 4 patients, respectively, received a third dose. After second dose, pruritus decreased with both drugs. It is concluded that nalbuphine is prior to naloxone for treatment of side effects after epidural morphine

Maternal inspired oxygen fraction [F1O2] 0.5 and 1.0 with isoflurane for cesarean section

Thirty mothers ASA1 or 2 undergoing general anesthesia for elective cesarean section not for fetal distress indication, were allocated randomly to receive either FIO 2 0.5 [group 1] or FIO 2 1.0 [group 2] during isoflurane anesthesia 1-1.5 MAC. The mean umbilical venous PO2 was greater in the second group. Babies born to mothers in this group required less resuscitation than those in the first group, and there was a tendency to higher Apgar scores at 1 minute in group 2, though this was not statistically significant. There was no increase in the incidence of awareness in group 2. These results support other studies stating that the use of 100% oxygen can significantly improve fetal oxygenation during cesarean section