Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1996
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled epidural analgesia following caesarean delivery: a comparison of pethidine and fentanyl.
Pethidine and fentanyl have both been used to provide patient-controlled epidural analgesia (PCEA) following caesarean delivery. Both have been compared with epidural morphine but these drugs have not been compared with each other. Patient-controlled epidural analgesia was used in a prospective, randomized, double-blind, cross-over trial to compare fentanyl and pethidine for postoperative epidural analgesia in women having elective caesarean deliveries. ⋯ Results from 45 patients showed no difference in pain level outcomes, but pethidine scored better in all side-effects except for drowsiness at 48 hours. Patients were more satisfied with pethidine (P = 0.015) and overall 65% of patients preferred pethidine. We conclude that pethidine is a suitable drug for patient-controlled epidural analgesia and leads to greater patient satisfaction than does fentanyl.
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Anaesth Intensive Care · Feb 1996
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia for acute musculoskeletal trauma: low-dose subcutaneous infusion of ketamine.
Low-dose ketamine by subcutaneous infusion (0.1 mg/kg/h) was compared in double-blind fashion with intermittent morphine (0.1 mg/kg intravenously, four-hourly) as analgesic regimen in 40 ASA-I adults after acute musculoskeletal trauma. Pain was assessed using visual analogue scales and sedation was graded on a four point rank drowsiness score. Objective cardiovascular and respiratory parameters and patient acceptability in terms of supplementary analgesia and early mobilization were also recorded. ⋯ None of the patients in ketamine group required supplementary analgesia (P < 0.001) and the patients could be easily mobilized for traction/splintage as compared with patients in the control group (P < 0.001). The incidence of nausea and vomiting in the morphine group was high (P < 0.01). The study shows that subcutaneous infusion of ketamine provides safe and effective analgesia in acute musculoskeletal trauma.
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Anaesth Intensive Care · Feb 1996
Comparative Study Clinical Trial Controlled Clinical TrialRocuronium bromide in dental day case anaesthesia--a comparison with atracurium and vecuronium.
We have compared intubating conditions at 60 seconds, onset times and reversal characteristics of the new steroidal nondepolarizing muscle relaxant rocuronium with atracurium and vecuronium. A dose of approximately 1.75 X ED90 of each agent was used to assess their relative suitability for brief day case dental procedures requiring intubation. The anaesthetic technique included propofol, fentanyl, nitrous oxide/oxygen and isoflurane. ⋯ The duration of action of rocuronium was shorter than either atracurium or vecuronium, times for spontaneous recovery to 75% block being 22.2 min, 29.6 min and 26.3 min respectively. The neostigmine evoked recovery indices were rocuronium 4.2 min, atracurium 6.6 min and vecuronium 3.7 min. Maximum blockade of greater than 97% was achieved with all three relaxants.