Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 1999
Biography Historical ArticleThe Coxeter Boyle Gas Anaesthesia Apparatus.
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Anaesth Intensive Care · Apr 1999
Randomized Controlled Trial Clinical TrialClonidine and cardiac surgery: haemodynamic and metabolic effects, myocardial ischaemia and recovery.
Clonidine may have beneficial effects in patients undergoing major surgery. We enrolled 156 patients having elective CABG surgery in a double-blind, randomized trial. Patients were randomized to receive either two doses of placebo (Group PP) or clonidine 5 micrograms/kg (Group CC). ⋯ Clonidine resulted in a number of significant (P < 0.05) haemodynamic changes, particularly pre-CPB: less tachycardia and hypertension, more bradycardia and hypotension. Clonidine was associated with a significant (P < 0.05) reduction in anaesthetic drug usage, higher creatinine clearance, lower cortisol excretion and improvement in some aspects of quality of life. This study lends support to consideration of clonidine therapy in patients undergoing CABG surgery.
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Anaesth Intensive Care · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialSub-Tenon's block: the effect of hyaluronidase on speed of onset and block quality.
The role of hyaluronidase on the onset time and quality of single quadrant sub-Tenon's block was studied in a prospective, randomized, double-blind controlled manner. One hundred and twenty consecutive patients undergoing cataract surgery under local anaesthesia received a sub-Tenon's block with either of two local anaesthetic solutions. One consisted of 2% plain lignocaine 3 ml with 0.5% plain bupivacaine 2 ml. ⋯ Akinesia scores were lower at all time intervals and were significantly lower (P < 0.05) up to 9 minutes after block in the hyaluronidase group. However, block quality as assessed by the surgeon was not significantly different between the groups. The addition of 150 IU hyaluronidase significantly speeds up the onset of surgical anaesthesia produced by a sub-Tenon's block.
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Anaesth Intensive Care · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialEpidural 0.2% ropivacaine for labour analgesia: parturient-controlled or continuous infusion?
In this randomized, open study, we compared the incidence of lower limb motor block associated with epidural labour analgesia provided by parturient-controlled method (PCEA) with continuous infusion (CIEA) using 0.2% ropivacaine. The PCEA group (n = 20) received a demand-only regimen (bolus 5 ml, lockout 15 minutes). The rate of infusion of the CIEA group (n = 20) was 8 ml/h. ⋯ The total volume of ropivacaine used per hour was also lower in the PCEA group (median 8.75 vs 10.5 ml, P < 0.05). No difference in the maternal or fetal outcome was detected. We conclude that PCEA with ropivacaine is an effective mode of analgesia which is dose-sparing and produces less motor block in comparison with CIEA.
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Prone positioning to improve oxygenation in acute lung injury was first reported over 20 years ago. Although this and several subsequent studies have shown that prone positioning improved oxygenation in the majority of patients, it has failed to become common practice in intensive care units. This paper reviews the mechanism by which prone positioning improves oxygenation and the clinical studies of its use to date.