Anaesthesia and intensive care
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The use of patient-controlled analgesia is described for forty children who had undergone major orthopaedic or general surgery. Ages ranged from 6 to 18 years (mean 11.4 years) and PCA was used for an average of 46.2 hours postoperatively. Morphine requirements overall averaged 40.5 micrograms/kg/hr (SD 22.6). ⋯ Problems with patient-controlled analgesia have been of a minor nature. We conclude that patient-controlled analgesia is a suitable and safe method of pain relief for paediatric patients and that the lower age limit is that at which a child can understand the concept after suitable explanation. In this study children as young as six years were able to successfully use the method.
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Anaesth Intensive Care · Aug 1989
Comparative Study Clinical Trial Controlled Clinical TrialInterpleural administration of bupivacaine after cholecystectomy: a comparison with intercostal nerve block.
Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. ⋯ Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P less than 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter 'top-ups' between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P less than 0.05).
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Anaesth Intensive Care · May 1989
The oxygen delivery characteristics of the Hudson Oxy-one face mask.
The inspired oxygen fraction (FIO2) delivered by the Hudson Oxy-one face mask was measured under changing conditions of ventilation, oxygen flow rate to mask, and mask fit. A single trained subject sat in a body plethysmograph to measure ventilation and breathed at a constant rate of 15 per minute at three different tidal volumes, of approximately 0.3, 0.6, and 1.2 litres, from the mouthpiece in the plethysmograph. The Oxy-one face mask was fitted to a plaster-of-Paris face model on the outside of the plethysmograph in a loose and then in a tight fashion. ⋯ The loosely fitting mask demonstrated larger SD of measurements and lower mean maximum FIO2 values of 46 to 49% and these fell in an irregular fashion to similar minimum values as ventilation increased and oxygen flow decreased. Although the precise definition of the FIO2 for each breath from the changing concentration during each inspiration was not possible, these results indicate that FIO2 changes in a predictable way as a function of ventilation and oxygen flow, if the mask is close fitting. This method could be conveniently used to study other oxygen delivery systems.