European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Oral controlled-release morphine and gut function: a study in volunteers.
The effects of a single 30-mg tablet of oral controlled-release (OCR) morphine (MST) on gastric emptying and small-intestine transit time (SITT) were compared with placebo in a double-blind, cross-over trial, on ten healthy volunteers. Gastric emptying was measured by paracetamol absorption and SITT by the rise in breath hydrogen after a carbohydrate test meal. There was no alteration in the absorption of paracetamol given 90 min after OCR administration but this was well before peak plasma morphine levels occurred. ⋯ Mean SITT in controls was 300 min (range 120-460 min) which was significantly prolonged in eight of the 10 subjects (P less than 0.05) and beyond the study period of 480 min in six subjects. Further study is required to determine how this compares with intramuscular morphine. Peak blood levels of morphine occurred at 3 h with a mean plasma concentration of 12.3 micrograms l-1 (SEM 2.0 micrograms l-1).
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of two sedation techniques for neuroradiology.
Two groups of 25 patients were sedated during neuroradiological investigation. The first group was sedated with fentanyl and midazolam while the other was given fentanyl and a two-stage infusion of propofol in a subanaesthetic dose. Both techniques resulted in satisfactory sedation and recovery, although those who received propofol were more likely to recall their journey from the X-ray department back to the ward. Sedation in both groups resulted in unacceptable PaO2 values in some patients which could subsequently be corrected by administration of supplementary oxygen.
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Comparative Study Clinical Trial Controlled Clinical Trial
A new approach to sciatic nerve block in the gluteal region.
Two personal techniques of sciatic nerve block in the gluteal region were compared in a retrospective study. The study was carried out on 224 patients undergoing elective orthopaedic lower-limb surgery. The block was performed in 107 subjects with a modified Labat's technique, prolonging his line downwards to meet the surface projection of the sciatic nerve, according to Ellis and McLarry. ⋯ A dramatic drop in intra-operative supplemental analgesic and hypnotic needs was observed in these patients. Failure occurred in about 10% with both techniques, whilst side-effects were of minor importance. These results suggest that the new landmarks provide a more precise anatomo-clinical location of the sciatic nerve.