Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1996
Clinical TrialEvaluation of a disposable device for patient-controlled epidural analgesia after caesarean section.
We evaluated a disposable device (Baxter PCA Infusor) for patient-controlled epidural analgesia (PCEA) using pethidine in twenty women after lower segment caesarean section. Efficacy, as measured by visual analogue pain scores, was comparable with historical controls from PCEA studies using electronic devices. Three patients reported inadequate analgesia, attributable in two cases to problems with epidural catheter. ⋯ Pethidine consumption ranged from 125 to 1500 mg (median 575 mg) in 48 hours. Plasma concentrations of pethidine varied widely. Disposable devices for PCEA after caesarean section provide an alternative to bolus administration or PCEA using more expensive and cumbersome electronic devices, although we suggest currently available apparatus requires modifications to improve clinical performance.
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Anaesth Intensive Care · Feb 1996
Cerebral effects of propofol following bolus administration in sheep.
The effects of bolus administration of propofol (50 mg, 100 mg and 200 mg) on cerebral blood flow and cerebral metabolic rate for oxygen were examined in a chronically catheterized sheep preparation. Depth of anaesthesia was simultaneously measured using a withdrawal response to a noxious electrical stimulus and it was demonstrated that the 100 mg dose induced moderate sedation while the 200 mg dose induced relatively deep anaesthesia. ⋯ These were accompanied by parallel decreases in cerebral metabolic rate but no change in cerebral oxygen extraction. As cerebrovascular responses in the sheep appear similar to those in man, the parallel changes in cerebral blood flow and metabolic rate demonstrated in this study supports the suitability of propofol as a neuroanaesthetic agent.
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Anaesth Intensive Care · Dec 1995
Randomized Controlled Trial Clinical TrialA study of the combined haemodynamic effects of dobutamine and enoximone in patients taking beta adrenoceptor antagonists.
We conducted a randomized, double-blind investigation to determine whether enoximone affects the actions of dobutamine in patients taking beta adrenoceptor antagonists. We studied sixteen patients with good ventricular function after coronary artery bypass operations. All patients were taking a beta adrenoceptor antagonist. ⋯ Dobutamine produced a consistent, significant peripheral vasoconstriction, but no inotropic or chronotropic effect. There was no significant difference in this effect between the two groups, and it was not influenced by concurrent therapy with enoximone. The alpha adrenergic action of dobutamine prevented us from using high enough rates of infusion to explore any interaction between the inotropic actions of dobutamine and enoximone.
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Anaesth Intensive Care · Dec 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of oral cisapride premedication on fasting gastric volumes.
The aim of this study was to determine whether fasting gastric volumes could be reduced by preoperative administration of cisapride. One hundred and twenty-one patients undergoing elective general anaesthesia were randomly allocated to receive either cisapride 20 mg plus diazepam 10 mg or placebo tablets plus diazepam 10 mg, two hours prior to induction. Immediately following induction blind gastric aspiration was performed using a 16Fr multiorificed orogastric tube. ⋯ Gastric volumes were significantly smaller in the cisapride group, 20.5 (SD 22.2) ml compared to placebo 28.2 (SD 26.0) ml but there was no significant difference with respect to pH. Some patients in both groups had large gastric volumes despite fasting. No significant adverse effects were noted with cisapride.