[Topical methylprednisolone vs lidocaïne for the prevention of postoperative sore throat]. / Comparaison de l'application locale de corticoïdes et de lidocaïne dans la prévention des douleurs pharyngolaryngées post-intubation.

OBJECTIVE: We assessed the efficacy of topical methylprednisolone or lidocaine for prevention of postoperative sore throat. STUDY DESIGN: Randomised, prospective in single blind study. PATIENTS AND METHODS: Sixty patients ASA 1 or 2 undergoing tracheal intubation for dental surgery received before intubation either topical lidocaine 5% (15 puffs) or aerosolized methylprednisolone (80 mg). Postoperative pain was assessed by the patients using a VAS and a specific scoring system for sore throat, cough and hoarseness. Evaluations were performed immediately after emergence from anaesthesia, 1 h later, at time of the first postoperative drink, at time of the first postoperative meal and 24 h after surgery. RESULTS: Patients receiving methylprednisolone showed slightly better scores for sore throat and cough 1 h after surgery. CONCLUSION: Topical methylprednisolone may therefore be a useful adjuvant in the prevention of sore throat after intubation.

[Continuous administration of mivacurium for short procedures. Delayed onset and recovery from neuromuscular blockade]. / Mivacurium en administration continue pour des actes courts. Délais d'installation et de régression du bloc neuromusculaire.

OBJECTIVE: To assess the delays of onset and spontaneous recovery from neuromuscular block produced by mivacurium administered by continuous infusion for short procedure requiring a deep relaxation. STUDY DESIGN: Prospective open non comparative study. PATIENTS: Twenty-nine class ASA I and II adults undergoing a stomatological procedure of short duration were included in the study. METHOD: General anaesthesia was obtained with a continuous infusion of propofol, supplemented with alfentanil and N2O-O2 mixture. Neuromuscular blockade, assessed with electromyography of the adductor pollicis muscle, was obtained with mivacurium (150 micrograms.kg-1). After restoration of 5% of neuromuscular transmission, mivacurium was administered by continuous infusion in order to maintain a blockade between 91 and 99%. RESULTS: The delay for decreasing twitch height by 95% was 2.9 +/- 1.0 min. The mean dose for maintenance of blockade was 10.9 +/- 1.5 micrograms.kg-1.min-1. The delay of spontaneous recovery from blockade was 10.2 min, 16.6 min and 21.3 min for obtaining 25, 75 and 95% twitchs respectively. The delay for the twitch increase from 25 to 75% was 6.6 min. DISCUSSION: Mivacurium in continuous infusion provides rapidly a deep and stable neuromuscular blockade followed by a rapid spontaneous restoration of neuromuscular transmission in patients with normal pseudocholinesterases.

Propofol as the main anaesthetic agent in dental surgery.

Propofol was used as the main anaesthetic agent for induction and maintenance of anaesthesia in 30 patients undergoing dental surgery requiring tracheal intubation. Anaesthesia was successfully induced and intubation performed in all patients, with a propofol induction dose of 3.5 mg/kg and without muscle relaxants or opioids. Intubating conditions were good for 77% of the patients. No haemodynamic changes occurred. Maintenance with propofol 9 mg/kg/h and 70% nitrous oxide provided suitable conditions for surgery. Awakening and recovery times were short and few side effects were recorded. However, post-operative dental pain was systematically recorded and was present in 60% of the patients.