Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 2003
Randomized Controlled Trial Clinical TrialCorrelation and linear regression between blood pressure decreases after a test dose injection of propofol and that following anaesthesia induction.
Propofol reduces systemic vascular resistance and suppresses cardiac function when injected rapidly. In this study we investigated whether blood pressure decrease after a minimal dose (test-dose) injection of propofol correlates with that after an induction-dose injection. Patients were randomly divided into two groups; anaesthesia was induced in group A (n = 60) using 1.5 mg/kg propofol and in group B (n = 61) using 2.0 mg/kg. ⋯ In both groups, blood pressure after induction was significantly lower than the control value (P < 0.05). In both groups, a positive correlation was observed between blood pressure reduction after the minimal dose injection and that after the induction-dose injection [P < 0.01, R value for systolic blood pressure correlation in group A 0.712 (P < 0.01) and in group B 0.758 (P < 0.01)]. We concluded there was a positive correlation between blood pressure reduction after a minimal (test-dose) injection and that after an induction-dose injection.
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Anaesth Intensive Care · Oct 2003
Randomized Controlled Trial Comparative Study Clinical TrialEpidural catheter migration: a comparison of tunnelling against a new technique of catheter fixation.
We investigated the efficacy of a new technique of epidural catheter fixation that relies on a strip of adhesive foam transfixed by a securing suture. We compared this technique to a tunnelled technique in a prospective, randomized trial (n = 25 in each group). Epidural catheter depth was recorded at the time of insertion and at the time of removal. ⋯ Clinically significant movement was noted in eight patients (32%) in the tunnelled group and seven patients (28%) in the sutured group (P = 0.75). Movement of the epidural catheter did not correlate with analgesic failure. The sutured technique provided similar protection against migration to tunnelling but any potential advantages were offset by concerns about a significantly higher incidence of erythema around the catheter exist site in the sutured group (1 vs 6 patients, P = 0.04).
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Anaesth Intensive Care · Oct 2003
Randomized Controlled Trial Comparative Study Clinical TrialParaesthesiae during needle-through-needle combined spinal epidural versus single-shot spinal for elective caesarean section.
The aim of this study was to compare the incidence of paraesthesiae during spinal needle insertion in a needle-through-needle combined spinal-epidural (CSE) versus a single-shot spinal (SSS) technique. Eighty-nine women presenting for elective caesarean section at a tertiary referral obstetric unit were randomized to receive either needle-through-needle CSE or SSS. Equipment used was a 16 gauge/26 gauge combined spinal-epidural kit and a 26 gauge pencil-point spinal needle with introducer (both Sims Portex, Australia) The presence and distribution of paraesthesiae was recorded by an observer at spinal needle insertion and again on day one postoperatively. ⋯ Seventeen of forty-six (37%) women in the needle-through-needle CSE group and four of forty-three (9%) in the SSS group had paraesthesiae upon spinal needle insertion (P < 0.05, Chi-squared test). No patient had persistent neurological symptoms at postoperative day one. We postulate that the higher incidence of paraesthesiae with needle-through-needle CSE may be related to deeper penetration of the subarachnoid space with this technique.