Anaesthesia and intensive care
-
Anaesth Intensive Care · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of subcutaneous ring block of the penis with caudal epidural block for post-circumcision analgesia in children.
A randomized, prospective, blind trial was conducted comparing caudal epidural blockade (caudal block) with subcutaneous ring block of the penis (penile ring block) in fifty healthy boys between two and twelve years of age undergoing elective circumcision. Subjects receiving caudal block had a longer duration of analgesia (P = 0.003), and took longer to first micturition (P = 0.04) but there was no difference in time taken to awaken from anaesthesia or spontaneously walk unaided. ⋯ It is concluded that both techniques are effective. Caudal block is more reliable and produces a longer duration of analgesia but penile ring block is inherently safer and has a lower incidence of adverse effects.
-
Anaesth Intensive Care · Jun 1996
Biography Historical ArticleCrawford Williamson Long (1815-1878).
-
Anaesth Intensive Care · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe application of EMLA and glyceryl trinitrate ointment prior to venepuncture.
The efficacy of EMLA cream combined with glyceryl trinitrate (GTN) ointment was assessed by a double-blind prospective study. Adult female patients were randomly allocated to receive either EMLA 1 ml or 2 ml combined with GTN 2 mg, or EMLA 2 ml only. ⋯ There were no significant side-effects. It is concluded that if GTN is used with EMLA, the dose of EMLA can be reduced and intravenous cannulation is technically easier compared with EMLA alone.
-
Anaesth Intensive Care · Jun 1996
Comparative StudyPostoperative nausea and vomiting. Propofol or thiopentone: does choice of induction agent affect outcome?
Postoperative nausea and vomiting (PONV) has many causes, including anaesthetic drugs. Choice of induction agent may affect the incidence of PONV, though the evidence is conflicting. ⋯ Propofol, when compared to thiopentone for induction of anaesthesia, resulted in an 18% reduction in PONV (OR = 0.82, P = 0.03). The likely postoperative benefits of propofol may outweigh concerns about its additional cost.
-
Induced hypothermia as adjunctive therapy has been the subject of considerable research interest and debate for over fifty years. Recently the first prospective randomized controlled trials were undertaken in humans with severe traumatic brain injury, with supportive results. Another prospective controlled study of induced hypothermia in severe septic adult respiratory distress syndrome also suggested improved outcome. ⋯ In addition, hypokalaemia, prolonged clotting times and neutropenia may occur. The evidence that induced hypothermia may be hazardous is mostly drawn from the literature on accidental hypothermia occurring in trauma, or patients with sepsis. It is likely that further trials will be conducted and if benefit is confirmed, induced hypothermia may become more widely used in selected patients in the intensive care unit.