Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Anaesthesia for transurethral prostatectomy. A comparison of spinal intradural analgesia with two methods of general anaesthesia.
One hundred and fifty patients who presented for transurethral prostatectomy were randomly allocated to one of three groups for the purpose of anaesthesia. Group A received spinal intradural analgesia, Group B general anaesthesia with spontaneous ventilation and Group C general anaesthesia with controlled ventilation. The comparability of the three groups was established. ⋯ Dysrhythmias were significantly higher in Group B. The results support the conclusion that the methods of choice for anaesthesia for transurethral prostatectomy are spinal analgesia or general anaesthesia using muscle relaxants and controlled ventilation. The final decision is a matter of personal preference.
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Some of the arguments used to oppose the introduction of inhalation anaesthesia--especially in obstetrics--are considered. These arguments were mainly based upon a desire to retain the sensation of pain, either as a factor necessary for survival or as a diagnostic aid: moral arguments were also adduced but religious opposition is no more than a myth of historiography. The opposition to anaesthesia lasted for less than 15 years and is seen as essentially a reflection of contemporary views on the role of pain.
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Bevelled spinal needles sizes 22 and 25 gauge were passed through tough meat to assess the influence of bevel orientation on the path of the needle. The needle bent away from the bevel surface by about 1 mm for each centimetre of needle travel through the tissue. With an introducer, the deviation was reduced by a reduction of the distance of unsupported travel. Pencil-point needles were less deviated.
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Comparative Study
Reversal of non-depolarising neuromuscular block in children: a comparison of atropine and glycopyrrolate in a mixture with neostigmine.
Atropine and glycopyrrolate were compared when given in a mixture with neostigmine for the reversal of non-depolarising neuromuscular block in children. Glycopyrrolate was an effective antimuscarinic agent and could be safely used as an alternative to atropine, although the advantages in this age group were not as marked as have been observed in adults.