Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Can parturients distinguish between intravenous and epidural fentanyl?
We tested the hypothesis that the sedative, euphoric, and analgesic effects of intravenous fentanyl would distinguish intravenous from epidural administration. One hundred ASA I and II labouring parturients received 100 micrograms fentanyl either iv or via an epidural catheter in a double-blind, randomized, cross-over fashion. ⋯ Most patients experienced prompt, short-lived symptoms with iv fentanyl but no important differences in fetal heart rate pattern or in maternal desaturation were seen between the groups. This study suggests that subjective symptoms will accurately distinguish intravenous from epidural fentanyl administration in labouring parturients (P < 0.001), and should serve as a safe and reliable intravenous test dose for epidural anaesthesia in the obstetric population.
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Letter Case Reports
Postoperative recurrent paralysis in an infant after mivacurium infusion.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lateral popliteal sciatic nerve block compared with subcutaneous infiltration for analgesia following foot surgery.
A new lateral approach to blocking the sciatic nerve in the popliteal fossa is described. In a prospective study, 40 patients scheduled for foot surgery involving osteotomies were allocated randomly into one of two groups following induction of general anaesthesia: group PS (n = 21) received a lateral popliteal sciatic nerve block and group SC (n = 19) received subcutaneous infiltration of the wound. ⋯ Postoperative analgesia in groups PS lasted a median of 18.0 hr and in group SC lasted 6.3 hr (P < 0.05). The lateral popliteal sciatic nerve block provided effective analgesia following foot surgery and had a high level of patient satisfaction.
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Randomized Controlled Trial Comparative Study Clinical Trial
One-lung or two-lung ventilation during transthoracic oesophagectomy?
The purpose of this study was to determine the safety of one-lung ventilation (OLV) during transthoracic oesophagectomy. Changes in circulatory and respiratory variables during and after operation were compared in patients receiving OLV or conventional two-lung ventilation (TLV). Thirty patients undergoing transthoracic oesophagectomy were randomly divided into either the OLV or the TLV group. ⋯ The shunt ratio increased in the OLV group from 20 +/- 7% to 35 +/- 13% during OLV which was greater than the increase in the TLV group (26 +/- 7% from 17 +/- 8%) (P < 0.05). Other variables and the incidence of the complications, however, were little different between the two groups during and after OLV and up to POD 3. It is concluded that OLV is as safe as TLV during oesophagectomy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Rapid tracheal intubation with atracurium: the timing principle.
The "Timing Principle" utilises a single bolus of non-depolarising neuromuscular blocking drug followed by thiopentone given at the onset of clinical weakness. The purpose of this study was to compare the intubating conditions after succinylcholine and after atracurium used according to the "timing principle." Eighty patients were randomly assigned to four groups of 20. Three study groups were given atracurium 0.5, 0.75 or 1 mg.kg-1 (Groups I, II and III respectively) and the control group (Group IV) received succinylcholine 1.5 mg.kg-1. ⋯ All patients, except one were able to cough well after administration of atracurium, before induction of anaesthesia with thiopentone. Patients were generally satisfied with this method of induction. It is concluded that atracurium, when used according to the timing principle, can be an alternative to succinylcholine during rapid-sequence induction.