Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 1985
Comparative StudyCutaneous sensitivity to atracurium and vecuronium in patients suffering anaphylactoid reactions to neuromuscular blockers.
Using an ordinal measure of cutaneous sensitivity to intradermal injections of atracurium and vecuronium, 40 nonreacting subjects were compared with a group of 24 patients previously suffering life-threatening anaphylactoid reactions to other muscle relaxants. Enhanced cutaneous sensitivity to vecuronium was found in three, and to atracurium in two of the previously reacting group. With the exception of those showing abnormal reactivity, no significant difference was found in the distribution of cutaneous sensitivity in the control and reacting group. A concentration of vecuronium 8.75 times that of atracurium was required to produce an equivalent intradermal wheal response.
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Anaesth Intensive Care · May 1985
Evaluation of the technique of central venous catheterisation via the external jugular vein using the J-wire.
This paper reports the results of a prospective study to evaluate the success rate and incidence of complications with the external jugular approach to central venous cannulation using a J-tipped spring guide wire. In a personal series of 100 consecutive patients in whom the technique was attempted, successful placement was achieved in 90, but more importantly there were no immediate technical complications. During the study, internal jugular cannulation was used in fourteen patients because either an external jugular vein was not visible (four patients), could not be cannulated (three patients), or the guide wire could not be manipulated into an intrathoracic position (seven patients). The technique is recommended as the initial method where central venous cannulation must be performed under suboptimal conditions and in very sick patients in whom a serious complication may prove to be fatal.
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Anaesth Intensive Care · May 1985
Comparative Study Clinical Trial Controlled Clinical TrialA comparative study of techniques of postoperative analgesia following caesarean section and lower abdominal surgery.
A double-blind, within-patient trial was carried out to compare intramuscular pethidine 100 mg, epidural pethidine 50 mg and epidural bupivacaine 25 mg for pain relief on the day after caesarean section or lower abdominal gynaecological surgery. Analgesia was assessed on a visual analogue pain scale. Forced expiratory volume in one second (FEV 1.0) and venous plasma catecholamine levels were measured immediately before and approximately thirty minutes after each treatment. ⋯ A mean increase in FEV 1.0 of 18% occurred after both of the epidural treatments, but this did not achieve statistical significance. There was no significant change in catecholamine levels after any of the treatments. Epidural pethidine was preferred by patients over and above intramuscular pethidine and epidural bupivacaine (p less than 0.05).
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Anaesth Intensive Care · May 1985
Review Comparative StudyRecently developed alternatives to conventional mechanical ventilation.