Annals of the Royal College of Surgeons of England
-
Ann R Coll Surg Engl · Mar 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of bupivacaine instillation and inguinal field block for control of pain after herniorrhaphy.
In a single-blind, randomised trial, 50 consecutive adult patients for inguinal herniorrhaphy under general anaesthesia received either an inguinal field block or bupivacaine instilled into the wound to provide postoperative analgesia. Bupivacaine instillation was found to be simple, safe and effective. The method is particularly appropriate for day-case surgery.
-
Ann R Coll Surg Engl · Mar 1992
Comparative StudyA prospective audit of regional anaesthesia for hand surgery.
A prospective audit has been carried out of 153 consecutive regional anaesthetics for hand surgery, using intravenous regional anaesthesia (IVRA), axillary block or multiple peripheral nerve blocks in the upper limb. Surgery was carried out successfully in 147 patients. ⋯ Regional anaesthesia was found to be suitable for use by members of the surgical staff, but success was only assured by meticulous attention to detail and by careful safety precautions. Regional anaesthesia should not be attempted by inexperienced, unsupervised hand surgeons.
-
Ann R Coll Surg Engl · Nov 1991
Randomized Controlled Trial Clinical TrialAntibiotic prophylaxis in penetrating injuries of the chest.
Most prospective studies recommend antibiotic prophylaxis whilst a thoracostomy tube is in place or even longer. We conducted a randomised study of 188 patients with penetrating chest injuries requiring a chest drain. Of these patients, 95 received a single dose of ampicillin before insertion of the chest tube, the remaining 93 patients received additional antibiotic prophylaxis for as long as the drain was in place. ⋯ It is concluded that single-dose prophylaxis in penetrating chest trauma is as effective as prolonged prophylaxis. The importance of chest physiotherapy immediately after the drain insertion and of early removal of the drain is stressed. The role of various possible risk factors in the development of sepsis is discussed.