Anaesthesia and intensive care
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Anaesth Intensive Care · May 1990
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialThe haemodynamic effects of propofol and thiopentone for induction of caesarean section.
Forty Chinese women for elective caesarean section received either propofol 2 mg.kg-1 or thiopentone 4 mg.kg-1 for induction of general anaesthesia. Systolic, mean and diastolic arterial pressures and heart rate were recorded non-invasively every minute for ten minutes. Post-induction arterial pressures were similar to pre-induction values with no differences between thiopentone and propofol. ⋯ At caesarean section, induction with propofol causes less variation in arterial pressure than thiopentone. Hypotension is probably prevented by the coincident stimulus of rapid sequence induction. Neonatal Apgar scores were similar between the two groups.
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Anaesth Intensive Care · May 1990
Comparative Study Clinical Trial Controlled Clinical TrialOral premedication in children: a comparison of chloral hydrate, diazepam, alprazolam, midazolam and placebo for day surgery.
A double-blind study consisting of 339 randomly selected children investigated the effects of several premedicants on the preoperative and postoperative behaviour of children who underwent day-stay surgery. Patients were allocated into two groups. Group 1 consisted of 165 children aged between 6 and 47 months. ⋯ No premedicant reduced anxiety in the older group. The time to awaken postoperatively with diazepam was longer than with placebo. Alprazolam and midazolam were unpalatable for children over four years and conferred no advantage over placebo.
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Anaesth Intensive Care · May 1990
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialComparison of two methods of intravenous administration of morphine for postoperative pain relief.
Morphine sulphate was used for the control of pain following major abdominal surgery for a period of three days either as patient-controlled or continuous infusion. The two groups of patients were comparable with regard to patient and operation details, duration of infusion, pain scores and complications. ⋯ It is suggested that a properly supervised continuous infusion of morphine is as good as patient-controlled administration. There was a negative correlation between the age of the patient and the dose of morphine used.
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Anaesth Intensive Care · May 1990
Carotid endarterectomy under cervical plexus block--a prospective clinical audit.
One hundred and twenty-eight patients having carotid endarterectomy under superficial and deep cervical plexus blocks were prospectively audited. The aim of the audit was to determine the incidence of intra-operative and postoperative neurological and cardiovascular complications and to establish patient acceptance of the technique. Twenty-seven patients who had intra-operative neurological changes following carotid artery clamping responded to shunt insertion. ⋯ Tachycardia (55%) and hypertension (67%) were the most common intra-operative cardiovascular changes and there was one clinical postoperative myocardial infarction. Ninety-two per cent of patients who could be adequately assessed preferred to have the same method of anaesthesia for future carotid endarterectomy. The authors concluded that carotid endarterectomy under superficial and deep cervical plexus blocks was associated with a high patient acceptance, low neurological complication rate and an acceptable rate of cardiovascular complications.
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Anaesth Intensive Care · May 1990
Steroids in croup: do they increase the incidence of successful extubation?
Between January 1983 and July 1988, 2623 patients with croup were admitted to the Royal Children's Hospital, Melbourne. A total of 416 patients (16%) were admitted to the Intensive Care Unit and 176 of these patients required intubation. Of these patients 117 patients were successfully extubated at the first attempt and 59 needed reintubation. ⋯ Only one patient who had received steroids failed extubation. Of those who did not receive steroids 59% required reintubation. In patients with croup who fail the first extubation the results of this study suggest that steroids significantly increase the success of subsequent extubations.