Journal of the Royal Society of Medicine
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Historical Article
Colonic trauma: modern civilian management and military surgical doctrine.
Colonic trauma, traditionally the domain of the military surgeon, has become commonplace in many parts of the world, where civilian surgeons have developed considerable experience with this complex type of injury. The author highlights the differences between military and civilian management concluding with an overview of current military research into battlefield colonic trauma. ⋯ Colonic trauma has been the subject of a military surgical research project, since 1992, with preliminary studies establishing an anastomotic technique suitable for use in the field. This work is summarized with an outline of the research programme.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesia for venous cannulation: a comparison of EMLA (5 minutes application), lignocaine, ethyl chloride, and nothing.
Three commonly available local anaesthetics were compared, in a controlled trial, for use before venous cannulation. The pain of application of the local anaesthetic, the pain of cannulation, and the rate of successful cannulations were compared. The value of EMLA cream applied for 5 min was questioned. ⋯ Lignocaine 1%, injected subcutaneously, and ethyl chloride spray significantly reduced the pain of venous cannulation (P < 0.01). The use of lignocaine did not result in significantly more failed cannulations than the control group. It was concluded that local anaesthesia should be used before venous cannulation, even for 20G cannulae.