Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the efficacy of paracetamol versus paracetamol, codeine and promethazine (Painstop) for premedication and analgesia for myringotomy in children.
This prospective double-blinded study compared the analgesic effectiveness and incidence of complications of a compound preparation Painstop (Paedpharm Pty Ltd) containing paracetamol 12 mg, codeine 0.5 mg and promethazine 0.65 mg per 1.0 ml, dosage 1.0 ml/kg, with paracetamol 20 mg/kg. Ninety-five children aged 1 to 12 years, ASA 1-2, scheduled for myringotomy and drain tuber insertion as a day procedure were randomized to receive Painstop or paracetamol 30 to 60 minutes prior to surgery. Preoperative drowsiness and complications on induction and postoperative sedation, pain and times to achieve goals were recorded. ⋯ There was, however, no difference in times to discharge. Late sedation was more common in the Painstop group (P = 0.03). Pain scores were low and similar in both groups and the need for additional analgesia was uncommon.
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Anaesth Intensive Care · Feb 1997
Randomized Controlled Trial Comparative Study Clinical TrialThe antinociceptive effect of epidural lignocaine and fentanyl during lithotripsy.
To determine the antinociceptive effect of combining epidural fentanyl with lignocaine during non-immersion lithotripsy, 56 healthy patients were enrolled into a prospective, randomized, double-blind study. Epidural anaesthesia was induced with either lignocaine 300 mg alone, or lignocaine 300 mg, or 200 mg in combination with fentanyl 100 micrograms. Throughout the procedure analgesia was assessed by comparing the incidence of (a) spontaneous complaints of pain, (b) patients' attempts to withdraw from the painful stimulus, (c) supplemental epidural lignocaine requirements, (d) the haemodynamic response to lithotripsy and (e) the time to first postoperative pain. ⋯ No difference was found in the time to the first complaint of postoperative pain. Similarly, discharge times were unaffected by treatment modality. We conclude that despite the addition of fentanyl, adequate analgesia during lithotripsy is dependent upon the dose of local anaesthetic administered.
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Anaesth Intensive Care · Feb 1997
Randomized Controlled Trial Comparative Study Clinical TrialBlood loss during suction termination of pregnancy with two different anaesthetic techniques.
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Anaesth Intensive Care · Feb 1997
Comparative StudyA written guideline implementation can lead to reductions in laboratory testing in an intensive care unit.
The impact of developing guidelines for laboratory testing in an Intensive Care Unit (ICU) was examined. Targeted blood tests were recorded on fifty cardiac surgery and fifty general intensive care patients retrospectively. Following the introduction of guidelines, the study was repeated with prospective data collection. ⋯ The potential cost savings for the annual admissions of 1,200 patients is N. Z.$81,636. This study shows that written guidelines can bring about major cost reduction in the short-term.
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Anaesth Intensive Care · Feb 1997
Comparative StudyAnaesthesia workforce in Australia and New Zealand.
A survey of anaesthetic workforce was undertaken in departments in Australia and New Zealand approved for specialist training by the Australian and New Zealand College of Anaesthetists. When compared to a previous survey 17 years before, the results showed that the number of anaesthetics administered rose, the number of operating theatres (OTs) remained the same, but the surgical beds were reduced. There was a small increase (20%) in full-time specialists with a number of vacancies in establishment. ⋯ The number of trainees required to supply a steady state replacement for this specialist workforce is also derived and the current number of training positions is shown to be in excess of these requirements. When the current shortfall in specialist anaesthetists is corrected there will need to be a gradual reduction (by approximately 40%) in the number of training positions to prevent an oversupply of anaesthetists. The factors which may potentially alter this forecast are addressed and include: change in the general population; ageing of the population; change in the average number of anaesthetics administered per anaesthetist per year; alteration in anaesthetists' working lifespan; change in the age distribution of anaesthetists; increased economic usage of operating theatres and changes in the number of College approved training positions.