European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Effect of intravenous diclofenac on pain and recovery profile after day-case laparoscopy.
Diclofenac sodium, 100 mg, or saline was given intravenously after the induction of anaesthesia to 169 patients undergoing outpatient gynaecological diagnostic laparoscopy or laparoscopic sterilization by tubal ligation. Propofol was used as the main anaesthetic agent and fentanyl and paracetamol were given for post-operative pain relief. In the post-anaesthesia care unit the amount of analgesics given and the incidence of nausea and vomiting were recorded. ⋯ However, patients in the tubal ligation group needed significantly more post-operative analgesia than patients in the laparoscopy group. Diclofenac had no influence on the rapidity of recovery or home readiness in either group. It is concluded that diclofenac has no influence on home readiness, but prevents postoperative pain in patients undergoing diagnostic laparoscopies, whereas it was not a potent enough analgesic to prevent pain after laparoscopic tubal ligation.
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Randomized Controlled Trial Clinical Trial
Central nervous system symptoms after intravenous lignocaine: dose-response during pregnancy.
There is continuing controversy over what dose of what drug should be used to identify an accidental intravascular or subarachnoid catheter placement in obstetric epidural anaesthesia. The purpose of this randomized, double-blind study was to evaluate the dose-effect relationship for the production of central nervous system (CNS) symptoms by intravenous lignocaine. ⋯ An ED95 of 1.12 mg kg-1 was calculated to produce reliable CNS symptoms when injected intravascularly. Lignocaine is an effective and reliable marker for intravenous injection in pregnant women.
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Comparative Study
Intra-individual open comparison of burst-suppression-isoflurane-anaesthesia versus electroconvulsive therapy in the treatment of severe depression.
Isoflurane anaesthesia was proposed instead of electro-convulsive therapy (ECT) in patients with treatment-refractory depression. This open study compared burst-suppression-isoflurane-anaesthesia (BSIA) and ECT in 12 severely depressed patients. A series of 6 BSIA was administered in every patient. ⋯ BSIA requires more time and monitoring than ECT. Our exclusions of coronary, cerebral and peripheral vascular disease, untreated hypertension and focal neurological disease are strongly recommended. Due to the ease of application, ECT remains the standard treatment in depressed patients, but we consider BSIA a valuable alternative at least in patients who object to ECT.
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Case Reports
Thoracotomy wound exploration in a single lung transplant recipient under extrapleural paravertebral nerve blockade.
Instillation of bupivacaine through a catheter accurately placed in the extrapleural space prior to closure of a thoracotomy incision provides effective, reliable post-operative analgesia. Its usefulness for further surgery in the post-operative period, in this case wound exploration in a lung transplant recipient, is described.