Anaesthesia and intensive care
-
Anaesth Intensive Care · May 1989
Comparative Study Clinical Trial Controlled Clinical TrialDouble-blind comparison of midazolam and temazepam as oral premedicants for outpatient anaesthesia.
Oral premedication with midazolam 7.5 mg was compared with temazepam 20 mg in a double-blind study of sixty patients undergoing day-stay urological surgery. One hour following ingestion similar degrees of anxiolysis and sedation were reported by patients for both compounds. ⋯ At the time of discharge four hours postoperatively no significant difference could be observed in psychomotor performance or subjective sedation although on the evening of surgery the temazepam group had a greater incidence of sleepiness and an earlier time to retiring. Although the differences were small, the residual post-discharge effects of temazepam lead us to conclude that midazolam 7.5 mg is the more suitable premedicant for outpatient use.
-
Anaesth Intensive Care · May 1989
Randomized Controlled Trial Clinical TrialEpidural morphine by the thoracic or lumbar routes in cholecystectomy. Effect on postoperative pain and respiratory variables.
Thirty-seven women undergoing elective cholecystectomy were randomised into two groups, receiving either lumbar epidural morphine (group L) or epidural morphine via the thoracic route (group T). The effect on pain relief was assessed by a visual analogue scale and included both resting pain and 'provoked' pain. ⋯ No significant difference was observed between the groups concerning pain relief or respiratory performance. We conclude that after cholecystectomy lumbar epidural morphine is as effective as thoracic epidural morphine in relieving postoperative pain.
-
Anaesth Intensive Care · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialEpidural pethidine or fentanyl during caesarean section: a double-blind comparison.
The onset, quality and duration of analgesia and side-effects of a single bolus dose of either epidural pethidine 50 mg or fentanyl 100 mcg, administered immediately post-delivery, were compared in a randomised, double-blind study of fifty-five women undergoing epidural caesarean section. The onset of effect was more rapid with fentanyl, a significantly larger number of women achieving complete pain relief fifteen minutes post-administration (P less than 0.05). ⋯ One patient in the pethidine group experienced early onset respiratory depression; however, she did not require active treatment. Epidural fentanyl 100 mcg appears to offer a small clinical advantage over pethidine 50 mg for intraoperative use during caesarean section.
-
Anaesth Intensive Care · May 1989
Randomized Controlled Trial Clinical TrialMandatory minute volume weaning in patients with pulmonary pathology.
This study evaluates mandatory minute volume (MMV) weaning in patients with pulmonary pathology. When weaning criteria were fulfilled, 22 patients were randomised to MMV and 18 to a control intermittent mandatory ventilation (IMV) group. With IMV weaning the ventilator rate was decreased by two breaths per minute at 3-4 hourly intervals during daylight hours. ⋯ All weans were considered complete four hours after the cessation of mechanical support, and were deemed successful if no further ventilation was required. The success rate was 86% in the IMV and 89% in the MMV group. MMV weaning was rapid (4.75 + 1.5 hrs) and proved less demanding on the ICU staff by providing a safe trial of spontaneous respiration, while retaining the facility for partial ventilation.
-
Anaesth Intensive Care · May 1989
The oxygen delivery characteristics of the Hudson Oxy-one face mask.
The inspired oxygen fraction (FIO2) delivered by the Hudson Oxy-one face mask was measured under changing conditions of ventilation, oxygen flow rate to mask, and mask fit. A single trained subject sat in a body plethysmograph to measure ventilation and breathed at a constant rate of 15 per minute at three different tidal volumes, of approximately 0.3, 0.6, and 1.2 litres, from the mouthpiece in the plethysmograph. The Oxy-one face mask was fitted to a plaster-of-Paris face model on the outside of the plethysmograph in a loose and then in a tight fashion. ⋯ The loosely fitting mask demonstrated larger SD of measurements and lower mean maximum FIO2 values of 46 to 49% and these fell in an irregular fashion to similar minimum values as ventilation increased and oxygen flow decreased. Although the precise definition of the FIO2 for each breath from the changing concentration during each inspiration was not possible, these results indicate that FIO2 changes in a predictable way as a function of ventilation and oxygen flow, if the mask is close fitting. This method could be conveniently used to study other oxygen delivery systems.