European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Onset time of topical analgesia with EMLA 5%: no reduction with glyceryl trinitrate.
Many adults are distressed by painful investigations or treatment, including venepuncture. The early effects of Eutectic Mixture of Local Anaesthetics (EMLA) 5%, on relief of pinprick pain in the antecubital area was investigated and compared with EMLA plus glyceryl trinitrate and with a placebo cream in 100 patients. Topical analgesia after application of EMLA developed within 5 min in 69% and within 10 min in 83% of those tested, significantly different from placebo, (P = 0.01).
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Comparative Study
Five oxygen-nitrous oxide proportioning systems compared.
The majority of contemporary gas delivery modules, on anaesthetic workstations, are equipped with oxygen-nitrous oxide proportioning systems which should prevent the delivery of hypoxic gas mixtures. We investigated five modules, of two different types, using fresh gas flows ranging from 50 mL min-1 to 20 L min-1 with minimally acceptable proportions of oxygen and maximally acceptable proportions of nitrous oxide set at the flow control valves. ⋯ All systems showed increased O2 concentrations at fresh gas flows below 1 L min-1. The systems can be used with low flow anaesthesia techniques with one exception (Dameca) also with minimal flow techniques.
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Comparative Study
A comparison of mivacurium infusion requirements between young and elderly adult patients.
Forty-one patients of ASA classes I or II, undergoing elective surgery, were divided into two groups: young, 18-41 years (mean 31), and elderly, 64-79 years (mean 71). The integrated evoked compound electromyogram of the adductor pollicis muscle elicited by stimulation of the ulnar nerve was used to monitor the neuromuscular block of the non-depolarizing muscle relaxant mivacurium. An initial dose of mivacurium 0.15 mg kg-1 allowed six excellent, nine good, three adequate and three poor intubations in the young group, and nine excellent, eight good, three adequate and no poor intubations in the elderly group. ⋯ The elderly group's requirements decreased from the start, to 78.5% (0.39 mg kg-1 h-1). The difference between the two groups was significant (P < 0.05). After the first 30 min, both groups requirements decreased, with time, but with no statistically significant differences.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between ketorolac and diclofenac in laparoscopic sterilization.
We compared ketorolac and diclofenac for the prevention and treatment of post-operative pain in patients undergoing laparoscopic sterilization. Fifty ASA I or II women were allocated randomly to receive either diclofenac 75 mg or ketorolac 30 mg intramuscularly 30-90 min before general anaesthesia. Pain scores were assessed half-hourly in the recovery room and then at 2 h and 4 h in the ward. ⋯ Pain at the injection site was more common after diclofenac than ketorolac (12 vs. 3, P < 0.05). In conclusion, both intramuscular diclofenac and ketorolac were relatively ineffective in controlling the pain after laparoscopic sterilization. The drugs were equally well tolerated, but more patients complained of pain at the injection site after diclofenac.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of a radiant heater on post-operative hypothermia: comparison with a reflective blanket.
Thirty patients with post-operative hypothermia following major surgery (thoracic, abdominal, orthopaedic) were allocated randomly to either active warming with a radiant heater (500 W) or passive rewarming with a reflective blanket. Rectal temperature, mean skin temperature (at four measuring sites), continuous haemoglobin saturation and shivering were measured for 2 h post-operatively. Although post-operative heat supply with a radiant heater resulted in faster rewarming, there were no differences between the two groups with respect to haemoglobin saturation and shivering.