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Biomedical subjects

C Sarantopoulos

Publications and source records attributed to C Sarantopoulos.

30 records · Page 2Linked to original sources
PubMed1995

Performance of the anesthesiologists in 12 Departments of Anesthesia in Greece.

To assess the performance of anesthesiologists in 12 Departments of Anesthesia a questionnaire was completed by 132 anesthesiologists. The questionnaire included preoperative visit, preoxygenation, the anaesthetic record, time of stay in the operating room, management of apnea at the end of surgery and rapid sequence induction. Anesthesiologists were also asked if they keep update and how. Eighty-nine percent of the anesthesiologists visit the patients preoperatively, 77% preoxygenate them routinely, 22% preoxygenate only the emergency patients, 0.8% never preoxygenate, 83% keep an anesthetic record, and the average time they stay in the operating room is 84% of the procedures. If the patient is apneic at the end of surgery, 43% of the anesthesiologists use peripheral nerve stimulator, 41% give atropine/neostigmine, 13% repeat the neostigmine, and 82% continue mechanical ventilation. The 12 Departments of Anesthesia differed significantly between them in all the above variables (P < 0.01-P < 0.0001 for each of the variables between them). To induce anesthesia in patients with full stomach, 89% give thiopentone and succinylcholine, 4% thiopentone and nondepolarizing relaxant, 76% apply cricoid pressure and 5% inflate the lungs via a face mask, (P < 0.0001, P = 0.018 and P < 0.0001 respectively). Eighty-seven percent of the anesthesiologists keep update attending congresses, 76% departmental meetings (P = 0.0015 within the 12 Hospitals), 86% reading journals and 78% reading textbooks. The 12 Departments of Anesthesia presented a uniformity in updating knowledge but not in practicing anesthesia.

Analysis of Variance↗
PubMed1994

Systemic opioids enhance the spread of sensory analgesia produced by intrathecal lidocaine.

The effect of different doses of fentanyl and nalbuphine on the spread of spinal analgesia produced by lidocaine was studied in 68 patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia. Patients were randomly assigned to six groups: fentanyl A, B, or C (FA, FB, FC) or nalbuphine A, B, or C (NA, NB, NC), which received intravenous (i.v.) 50, 100, or 150 micrograms of fentanyl or 10, 15, or 20 mg of nalbuphine, respectively, 20 min after spinal anesthesia with lidocaine. We tested the level of spinal analgesia with pinprick sensation 20 min after spinal anesthesia and 10 min after the opioid administration, when 0.4 mg of naloxone was administered i.v. The levels of sensory analgesia were reassessed 10 min after naloxone. Ten minutes after fentanyl or nalbuphine, the level of analgesia increased (1.8 +/- 1.7, 3.1 +/- 1.2, and 4.1 +/- 1.5 cm, in the FA, FB, and FC groups and 1.9 +/- 0.9, 2.6 +/- 1.4, and 3.7 +/- 2.2 cm in the NA, NB, and NC groups, respectively). The increases in the level of analgesia differed significantly between the fentanyl groups (F = 8.0939; df = 2.35; P < 0.001), the increase produced by 150 micrograms being significantly higher than produced by 50 micrograms of fentanyl (limits of confidence -4.236809 and -0.4431909; P < 0.01). Naloxone reversed the effect of fentanyl and 10 min after its administration the fentanyl groups did not differ with regard to the level of spinal analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Nerve stimulation in patients undergoing hysterectomy under general anaesthesia.

The possible impact of transcutaneous electrical nerve stimulation (TENS) on cardiovascular responses associated with tracheal intubation, surgery and postoperative period was evaluated in patients undergoing hysterectomy. Thirty-eight patients undergoing abdominal hysterectomy were randomly allocated either to the TENS group (n = 19), with electrical stimulation applied preoperatively and continued postoperatively for six hours on the stellate ganglion (SG), or to the control group (n = 19), with the stimulator turned off. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before induction of anaesthesia, after cuff inflation, one minute, three minutes and five minutes later, every 15 minutes intraoperatively and every two hours postoperatively for eight hours. TENS of SG failed to prevent the cardiovascular responses associated with intubation of the trachea and surgery. HR, but not SAP, mean values were significantly lower in the TENS-treated group four and six hours postoperatively (p < 0.02, p < 0.01, respectively) when compared with the control group. These differences disappeared when TENS was discontinued.

Adult↗
PubMed1993

Flumazenil reduces the duration of thiopentone but not of propofol anaesthesia in humans.

The effect of flumazenil (F) on the duration of anaesthesia produced by a single dose of thiopentone (T) and propofol (P) was investigated in a placebo-controlled double-blind trial. Eighty-four patients anaesthetized with N2O in O2 and either thiopentone 7 mg.kg-1 or propofol 3 mg.kg-1 for minor gynaecological procedures were studied. Patients were randomly allocated to pretreatment with either 0.5 mg of flumazenil (F) or 5 ml of normal saline (NS) in one of the following groups: T/NS, T/F, P/NS, or P/F. Anaesthetic requirements were assessed by recording the time between the injection of anaesthetic and the first movement observed during the procedure. The time elapsed from the administration of thiopentone to the first movement was 6.5 +/- 1.6 min for the T/NS group and 5.3 +/- 2.4 min for the T/F group (P < 0.05). The first movement after propofol administration was observed at 7.0 +/- 2.2 min in the P/NS group and at 7.1 +/- 4.5 min in the P/F group (NS). These data suggest that pretreatment with 0.5 mg of flumazenil iv reduces the duration of thiopentone but not of propofol anaesthesia.

Anesthesia, Intravenous↗
PubMed1993

Transcutaneous electrical nerve stimulation reduces the incidence of vomiting after hysterectomy.

The possible postoperative antiemetic effect of transcutaneous electrical nerve stimulation (TENS) on the P6 point (on the Pericardium Channel of Hand-Jueyin) was evaluated in 103 women undergoing hysterectomy. TENS on the P6 point was applied 30-45 min before induction of anesthesia in 51 patients and continued for 6 h postoperatively. The control group, 52 patients, was treated exactly in the same way but with the electrical stimulator turned off. Incidence of vomiting was assessed blindly 2 h, 4 h, 6 h, and 8 h postoperatively. The incidence of vomiting postoperatively was significantly less in the TENS-treated group when compared with the control group (between 0 h and 2 h: 23% vs 43%, P < 0.05; between 2 h and 4 h: 27% vs 50%, P < 0.025; and between 4 h and 6 h: 31% vs 67%, P < 0.001, respectively). Six hours postoperatively TENS was discontinued, and 8 h postoperatively the two groups did not differ significantly for incidence of vomiting (between 6 h and 8 h: 51% vs 65%). The authors conclude that TENS reduces the incidence of vomiting after hysterectomy.

Adult↗
PubMed1991

Systemic fentanyl enhances the spread of spinal analgesia produced by lignocaine.

Seventy-one patients undergoing transurethral prostatectomy under spinal anaesthesia were allocated randomly to one of four groups; fentanyl-naloxone (F-Nal), fentanyl-normal saline (F-NS), normal saline-naloxone (NS-Nal), and normal saline-normal saline (NS-NS) group. Twenty minutes after subarachnoid injection of hyperbaric lignocaine 100 mg, we tested the level of spinal analgesia (pinprick sensation) and administered i.v. either fentanyl 100 micrograms (F-Nal and F-NS groups) or normal saline 2 ml (NS-Nal and NS-NS groups). Ten minutes later, we assessed the new levels of analgesia and administered i.v. either naloxone 0.4 mg (F-Nal and NS-Nal groups) or normal saline 1 ml (F-NS and NS-NS groups). The level of sensory block was reassessed 10 min after the naloxone or normal saline treatment. Ten minutes after i.v. administration of fentanyl or normal saline, the level of analgesia increased in the F-Nal and F-NS groups by 3.98 and 3.78 cm, respectively, and differed significantly compared with the NS-Nal and NS-NS groups (both P less than 0.01). Forty minutes after spinal block, the decrease in analgesia in the F-Nal group (3.97 cm) differed significantly from that in the other groups (P less than 0.01). Systemic fentanyl enhanced the spread of analgesia. This enhancement was antagonized by naloxone.

Aged↗
PubMed1991

Minor complications of general anesthesia in a series of 1220 patients: the influence of mode of ventilation.

Postoperative complications due to anesthetic technique were assessed in 1220 patients undergoing abdominal, neurosurgical, breast, head and neck operations or other surgical procedures. All patients were interviewed directly for vomiting, sore throat, headache, suxamethonium myalgias, ocular, vascular, nerve complications and awareness, 24 and 48 hours postoperatively. The incidence of vomiting was significantly higher in abdominal (27.2%) versus the extra-abdominal operations (16.2%), (p less than 0.005), overall incidence 17.6%. Spontaneous breathing was associated with lower incidence of vomiting (p less than 0.001), but a higher incidence of sore throat (p less than 0.001), headache (p less than 0.05) and suxamethonium muscle pains (p less than 0.001), versus controlled ventilation. The incidence of ocular complications was 4.7%, of local vascular complications 15.2%, of peripheral nerve problems 0.33% and of awareness 0.16%.

Anesthesia, General↗
PubMed1991

Is early mobilization associated with lower incidence of postspinal headache? A controlled trial in 69 urologic patients.

Sixty-nine patients who underwent transurethral resection of the prostate under subarachnoid anaesthesia were studied. They were randomly allocated to either an early mobilisation group (group A, 30 patients), or a 24 hour bed rest group (group B, 39 patients). The incidence and severity of postspinal headache were assessed in each patient at 24, 48 and 72 hours. The incidence of headache in group B was significantly higher when compared with group A at 48 and 72 hours postoperatively (p less than 0.025 and p less than 0.01, respectively). The total incidence of headache throughout the 72 hours was also significantly higher in group B (p less than 0.01). Regarding the severity of headache the two groups did not differ significantly. Therefore, bed rest is not recommended as a prophylactic measure for postspinal headache.

Aged↗
PubMedDate not supplied

Sufentanil does not preempt pain after abdominal hysterectomy.

We compared the effect of intravenous (i.v.) sufentanil on postoperative pain and analgesic requirements, when given before or after abdominal hysterectomy. Patients were assigned in a random blind manner to receive 1 microgram/kg of sufentanil 5 min before induction of anaesthesia (group A, n = 18) or after ligation of the round ligaments of the uterus (group B, n = 21). General anaesthesia was induced with midazolam, thiopental and vecuronium and maintained with isoflurane and N2O in oxygen. Propoxyphene and paracetamol, or pethidine for overnight or if pain was uncontrollable, were prescribed on request. Pain was assessed with VAS and a verbal rating scale (VRS: 1 = no pain and 6 = intolerable pain) immediately before the first analgesic administration and 4, 8, 12, and 24 h postoperatively. VAS or VRS scores did not differ between the two groups at any time: neither did propoxyphene, paracetamol, and pethidine requirements. These results suggest that preinjury i.v. sufentanil is not more beneficial for postoperative pain control than the postinjury administration.

Adult↗
PubMedDate not supplied

EMLA reduces acute and chronic pain after breast surgery for cancer.

BACKGROUND AND OBJECTIVES: A significant percentage of women undergoing breast surgery for cancer may develop neuropathic pain in the chest, and/or ipsilateral axilla and/or upper medial arm, with impairment in performing daily occupational activities. We designed this study to determine if the perioperative application of EMLA (eutectic mixture of local anesthetics; AstraZeneca) cream in the breast and axilla area reduces analgesic requirements, as well as the acute and chronic pain after breast surgery. METHODS: Forty-six female patients scheduled for breast surgery received randomly 5 g of EMLA or placebo on the sternal area 5 minutes before surgery, and 15 g on the supraclavicular area and axilla at the end of the operation. Treatment with EMLA cream (20 g) or placebo was also applied daily on the 4 days after surgery. In the postanesthesia care unit (PACU), 3, 6, 9, and 24 hours after surgery, and on the second to sixth day postoperatively, pain was assessed by visual analogue scale (VAS) at rest and after movement, and postoperative analgesic requirements were recorded. Three months later, patients were asked if they had pain in the chest wall, axilla and/or medial upper arm, decreased sensation, if they required analgesics at home, and for the intensity of pain. RESULTS: Acute pain at rest and with movement did not differ between the EMLA and control groups, and the analgesics consumed during the first 24 hours were the same for the EMLA and control groups. However, time to the first analgesia requirement was longer (P = .04), and codeine and paracetamol consumption during the second to fifth days was less (P = .001, and P = .004, respectively) in the EMLA versus the control group. Three months postoperatively, pain in the chest wall, axilla, and the total incidence and the intensity of chronic pain were significantly less in the EMLA versus the control group (P = .004, P = .025, P = .002 and P = .003, respectively). The use of analgesics at home and abnormal sensations did not differ between the 2 groups. CONCLUSIONS: The application of EMLA to patients undergoing breast surgery for cancer reduced the postoperative analgesic requirements and the incidence and intensity of chronic pain.

Acute Disease↗
PubMedDate not supplied

Regional block and mexiletine: the effect on pain after cancer breast surgery.

BACKGROUND AND OBJECTIVES: Breast surgery for cancer is associated with chronic pain and sensory abnormalities. The present study investigates the effect of regional block, oral mexiletine, and the combination of both, on acute and chronic pain associated with cancer breast surgery. METHODS: One hundred patients scheduled for cancer breast surgery received either regional block with 18 mL of 1% ropivacaine intraoperatively and oral mexiletine for the first 6 postoperative days (R + M group), or regional block and placebo (R + PL), or normal saline instead of ropivacaine and mexiletine (PL + M), or normal saline and placebo (PL + PL). Postoperative analgesic requirements were recorded daily. Pain was assessed 0, 3, 6, 9, and 24 hours in the postanesthesia care unit (PACU) and on the second to sixth day postoperatively, at rest, and after movement using the visual analog scale (VAS). Three months after surgery, patients were interviewed for the presence and intensity of pain, abnormal sensations, and analgesic requirements. RESULTS: Regional block reduced the number of intramuscular (IM) injections required the first 24 hours (P =.05), the R + PL group requiring less injections versus the PL + M group (P =.037). Lonarid tablet (paracetamol and codeine) consumption from the second to the fifth postoperative day differed among the 4 groups (P =.0304), the R + M group requiring fewer tablets than the PL + PL group (P =.009). Three hours postoperatively, the R + PL group had less pain at rest when compared with all other groups (P <.05 for all comparisons). On the second postoperative day, VAS at rest and after movement was less in the R + M versus the R + PL group (P <.01 and P <.05, respectively). Three months after surgery, the 4 groups were similar with regard to incidence or intensity of pain or analgesic requirements. The R + PL group had a lower incidence (77%) of reduced or absent sensation (P =.016). CONCLUSIONS: Regional block reduced the analgesic requirements in the early postoperative period, while mexiletine combined with regional block reduced the total analgesic requirements during the next 5 postoperative days. Although chronic pain was not affected by these treatments late-abnormal sensation may be diminished by combination of these treatments. Reg Anesth Pain Med 2001;26:223-228.

Adult↗