Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 1992
Randomized Controlled Trial Comparative Study Clinical TrialTotal intravenous anaesthesia versus inhalational anaesthesia for dental day surgery.
Fifty young healthy and unpremedicated patients scheduled for removal of impacted teeth were randomly allocated to receive either total intravenous anaesthesia with propofol or conventional thiopentone/isoflurane/nitrous oxide anaesthesia. A double-blind postoperative assessment showed the former group to have a shorter reversal time and faster recovery of faculties, i.e. speech, memory as well as ability to sit up and walk without assistance (P < 0.01). There was no incidence of hypotension and of awareness in either group. The incidence of headache, nausea and vomiting was higher in the thiopentone/isoflurane/nitrous oxide group.
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The standard 0.5 to 1.0 mg dose of adrenaline used in cardiac resuscitation may be inadequate on the basis of theoretical and experimental evidence. Well designed clinical trials are indicated to test the hypothesis that higher doses of adrenaline could be more effective in specific subgroups of people experiencing cardiac arrest. ⋯ Other catecholamines such as noradrenaline may be more efficacious, as could be non-adrenergic vasopressors. Clinical studies are required, however, to evaluate these potential alternatives.
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Anaesth Intensive Care · Nov 1992
Randomized Controlled Trial Clinical TrialHigh-volume spinal anaesthesia. A dose-response study of bupivacaine 0.125%.
The clinical effects of high-volume spinal anaesthesia with bupivacaine 0.125% were studied in 30 patients presenting for postpartum sterilisation. Group A, B and C patients received 6, 8 and 10 ml of bupivacaine 0.125% respectively. Onset, duration and regression of sensory block and motor blockade, haemodynamic parameters and postoperative complications were studied. ⋯ Only one patient (Group A) developed a postdural puncture headache. In this study, high-volume spinal anaesthesia with bupivacaine 0.125% was found to be satisfactory for postpartum tubal ligation. The optimal volume of bupivacaine 0.125% was 8 ml.
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Anaesth Intensive Care · Nov 1992
A clinical evaluation of the Hemocue haemoglobinometer using capillary, venous and arterial samples.
The 'Hemocue' device for rapid estimation of haemoglobin concentration was evaluated in a clinical setting. Repeatable accuracy of capillary, venous and arterial samples was examined and then compared with standard laboratory venous haemoglobin estimates using a 'Coulter JT' analyser in 42 patients. The mean values for haemoglobin (g/l) and coefficient of variation were capillary 108.2 (8.0); venous 104.9 (2.2); arterial 105.9 (2.0); and laboratory venous 104.6 (1.3). ⋯ Peripheral skin temperature did not influence the accuracy of capillary samples. Hemocue estimations of venous samples were found to be as accurate as laboratory estimations. The lack of repeatable accuracy of capillary estimations was sufficiently large that their use cannot be recommended in clinical practice.