European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Does epidural injection of physiological saline facilitate the advancement of catheters?
Seventy patients (ASA I, ASA II), scheduled for a surgical intervention under epidural or combined spinal-epidural anaesthesia, were randomly allocated to one of two groups. The epidural space was identified by loss of resistance using air, followed by injection in Group A (35 patients) of 10 ml of physiological saline directed cephallad and in Group B (35 patients) by no injection. ⋯ No significant difference in resistance was found between the groups. The authors conclude that the injection of 10 ml of physiological saline into the epidural space does not facilitate the advancement of an epidural catheter.
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The laryngeal mask airway was used to facilitate fibreoptic bronchoscopy under general anaesthesia in 140 adult patients. Following placement, the position of the mask was observed through the fibreoptic bronchoscope. Three different positions were identified. ⋯ No problems with ventilation or maintenance of an acceptable airway were encountered. In one patient repositioning of the laryngeal mask was necessary to allow the passage of the bronchoscope. One patient developed laryngospasm and required tracheal intubation.
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Clinical Trial Controlled Clinical Trial
Clinical study of interaction between rocuronium and some commonly used antimicrobial agents.
The onset and duration of clinical relaxation and reversibility of rocuronium bromide (ORG 9426) 0.6 mg kg-1 were studied following administration of netilmicin 2 mg kg-1 (n = 10) or cefuroxime 20 mg kg-1 (n = 10) in patients undergoing urological surgery; and cefuroxime 20 mg kg-1 (n = 10) metronidazole 7.5 mg kg-1 (n = 10), metronidazole 7.5 mg kg-1 and cefuroxime 20 mg kg-1 (n = 10), or placebo (n = 10) in patients undergoing abdominal surgery under anaesthesia with thiopentone, nitrous oxide in oxygen, fentanyl and halothane. The antimicrobial agents were administered intravenously 5 min before rocuronium. Neuromuscular function was monitored using mechanomyography and train-of-four (TOF) mode of stimulation. ⋯ There were no statistically significant differences between the groups in either the onset or the duration of clinical relaxation. Reversal of neuromuscular block with neostigmine carried out at spontaneous recovery of T1 (first response in the TOF) of 25% or more was easily achieved in all groups in 2-4 min. It is concluded that there is no significant interaction between rocuronium and single doses of the antimicrobial agents used in the present study.
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Randomized Controlled Trial Clinical Trial
Effect of nitrous oxide on post-operative nausea and vomiting during propofol anaesthesia for short surgical operations.
One hundred patients of ASA status I or II, undergoing gynaecological or urological surgery were studied. Opioids were omitted from premedication and anaesthesia. Patients were allocated randomly to one of two equal groups and were anaesthetized using a computer controlled infusion system, programmed to achieve theoretically any target blood propofol concentration. ⋯ Theoretical blood propofol concentration shown to produce surgical anaesthesia was maintained in all patients. However 12% of the patients that received nitrous oxide and 40% of the patients that did not, responded to the surgical stimulus by limb movement. Patients in the oxygen group required higher rates of propofol infusion to maintain surgical anaesthesia.
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Clinical Trial
Spirometry, blood gas analysis and ultrasonography of the diaphragm after Winnie's interscalene brachial plexus block.
Ten patients with healthy lungs were subjected to radiology, sonography, spirometry and blood gas analysis before and after an interscalene brachial plexus block prior to shoulder surgery. Winnie's interscalene block induced ipsilateral hemidiaphragmatic paresis that was confirmed by radiology and sonography. ⋯ These changes should not cause further clinical symptoms in sitting patients with unaffected lungs. In patients with pulmonary disease, this method of nerve block should be limited to cases for which there is a clear indication.