Lancet
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Randomized Controlled Trial Clinical Trial
Double-blind controlled trial of indomethacin as an adjunct to narcotic analgesia after major abdominal surgery.
A prospective randomised trial was undertaken to assess the efficacy of indomethacin as an analgesic after abdominal surgery. 44 patients received indomethacin suppositories (100 mg every 8 h for three days postoperatively) and 46 patients received placebo suppositories (every 8 h for the same period), in addition to intramuscular morphine (0.15 mg/kg every 4 h as required). Postoperative subjective pain assessments, analgesic requirements, and respiratory function were recorded. ⋯ The duration of postoperative morphine requirement was shorter for the indomethacin than for the placebo group. pCO2 on the first postoperative day was lower in the indomethacin group than the placebo group (4.82 +/- 0.08 vs 5.18 +/- 0.08 kPa). The administration of indomethacin in addition to morphine after major abdominal surgery provides better pain control than that provided by intramuscular morphine alone.
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Randomized Controlled Trial Clinical Trial
Error in blood-pressure measurement due to incorrect cuff size in obese patients.
Trained nurse-specialists obtained 84 000 blood-pressure measurements in 1240 obese subjects using cuffs of the three standard adult sizes in a randomised order. The differences in readings between the three cuffs were smallest in non-obese subjects and became progressively greater with increasing arm circumference (AC) in the obese population. ⋯ Formulae and a table have been derived to correct the measurement error caused by cuffs of inappropriate size at various ACs. The reported high prevalence of hypertension in obese subjects may be greatly overestimated.
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Comparative Study
Collaborative study of very-low-birthweight infants: Techniques of perinatal care and mortality.
The neonatal units in two large maternity hospitals collaborated in a study of 440 liveborn infants weighting 500-1500 g born in 1977 and 1978: 377 (85.7%) were born in hospital. The overall survival rate was 70.5%, with a range of 67.5% to 71.5% for the inborn and outborn categories of infants in each hospital. In hospital A the survival rate of infants weighing greater than or equal to 1100 g was higher than that in hospital b, whereas the survival rate of infants weighing less than 800 g was higher in hospital B. Obstetric risk factors and obstetric management differed little between the hospitals, but there were several important differences in paediatric management; in particular, hospital B (with a better survival rate of infants weighing under 800 g) used ventilatory support and parenteral feeding much more frequently.