Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 1993
Vecuronium-thiopentone induction for emergency caesarean section under general anaesthesia.
Induction of general anaesthesia for emergency caesarean section has always been hazardous. Acid aspiration syndrome and adverse reactions to suxamethonium are well recognised problems, in spite of which "crash" induction using thiopentone and suxamethonium remains a common induction technique. Recent case reports suggest that the use of medium duration nondepolarising relaxants in place of suxamethonium achieves satisfactory intubating conditions in the emergency caesarean section patient. ⋯ To detect instances of acid regurgitation or aspiration. 5. To confirm that relaxant reversal is clinically effective at the completion of surgery. In this series of thirty cases, vecuronium 8 mg preceding thiopentone 250 mg and atropine 0.6 mg by 20 seconds provided effective induction and easy intubating conditions without clinical effects on the newborn, maternal acid aspiration, or clinical signs of persistent paralysis after reversal.
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Anaesth Intensive Care · Jun 1993
Randomized Controlled Trial Clinical TrialEpidural catheter insertion: the effect of saline prior to threading in non-obstetric patients.
The effects of injecting normal saline 4 ml through the epidural needle before catheter passage on ease of catheterisation and incidence of certain complications were investigated in 189 non-obstetric patients. The use of saline had no effect on ease of catheterisation, with 84.2% of Group S patients (saline, n = 95) and 88.3% of Group C patients (control, n = 94) having the difficulty of passing the catheter rated as "easy" (P = 0.31). ⋯ Epidural venous cannulation occurred in 6.3% of Group S patients versus 11.7% of Group C patients (P = 0.30). We conclude that the use of 5 ml of normal saline prior to catheter threading provides no significant benefit in improving the ease of catheterisation or decreasing the incidence of catheter complications.