European journal of anaesthesiology
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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.
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Randomized Controlled Trial Clinical Trial
Inspired oxygen concentration during general anaesthesia for caesarean section.
The effects on maternal oxygen saturation, foetal wellbeing and umbilical blood gases were compared when parturients received either 30 or 50% oxygen prior to delivery by Caesarean section under general anaesthesia. Maternal arterial oxygen saturation was significantly increased in the group receiving 50% oxygen. There was no difference between the two groups in terms of Apgar score minus colour, time to sustained respiration or umbilical cord blood gas estimations. The use of 30% inspired oxygen during uncomplicated Caesarean section is advocated.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of different glucose concentrations on spinal anaesthesia with bupivacaine and tetracaine.
The effects of 5% and 8% glucose in 0.5% tetracaine or bupivacaine on the anaesthetic spread were investigated in 80 urological patients requiring spinal anaesthesia for trans-urethral resection of the prostate. The local anaesthetic solutions were randomly administered, the patients being divided into four groups of 20, and the anaesthetic profile was then evaluated in a double-blind fashion by an independent observer. Maximum cephalad spread of analgesia was significantly greater with tetracaine in 8% glucose compared to the other three groups (tetracaine/5% glucose, bupivacaine/5 or 8% glucose) (P less than 0.05). ⋯ Both the 5% and 8% solutions of tetracaine achieved a 3+ motor blockade significantly faster than either bupivacaine solution. Regression of motor blockade from tetracaine was not influenced by the glucose concentration, but the 8% solution of bupivacaine had a delayed 2+ and 3+ blockade, although the ultimate decay for both solutions was similar. The results of our study suggest that 0.5% bupivacaine 4 ml in 5% glucose provides a rapid and controllable spread of sensory analgesia for transurethral surgery, of optimal duration associated with a complete motor blockade of moderate duration.
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This study compares some physical characteristics of a selection of cuffed endotracheal tubes with large-volume, low-pressure cuffs currently used in the United Kingdom. Six types of endotracheal tubes of Sizes 7, 8 and 9 were studied. There was considerable variation in physical characteristics of endotracheal tubes and cuffs from different manufacturers and even from the same manufacturer.
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A new way of saving anaesthetic vapours is described. The method is analogous to the heat-moisture exchanger principle: the vapour is trapped in a filter during expiration and is returned to the patient during the subsequent inspiration. ⋯ In model lung tests, this reduced the isoflurane consumption by 51% at a tidal volume of 300 ml, by 57% at 600 ml and by 51% at 930 ml. Neither isoflurane nor halothane yielded any degradation products when brought in contact with the zeolite.