Anaesthesia
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Randomized Controlled Trial Clinical Trial
Protection against pulmonary acid aspiration with ranitidine. A new histamine H2-receptor antagonist.
Ninety patients presenting for elective surgery were randomly divided into three groups A, B and C and studied on a double-blind basis to assess the effects of ranitidine, a new histamine H2 -receptor antagonist and placebo on gastric secretion. Group A received 150 mg ranitidine orally at 2200 hours on the evening before surgery and a further 150 mg 1-2 hours before operation. Group B received 150 mg ranitidine with premedication only, while Group C received a placebo at 2200 hours and again with premedication on the day of surgery. ⋯ The proportion of patients with pH greater than 2.5 at induction of anaesthesia was 100, 82.3 and 67.9% in Groups A, B and C, respectively. The percentage of patients who had measured gastric volume less than 25 ml or pH greater than 2.5 were Group A--90%, Group B--75.9% and Group C--57%. Thus ranitidine 150 mg orally on the evening before surgery and on the morning prior to anaesthetic induction lowered the mean volume and raised the average pH of gastric content to safe levels in all cases.
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Comparative Study
Hypotension during epidural anaesthesia for Caesarean section. A comparison of intravenous loading with crystalloid and colloid solutions.
The incidence of hypotension occurring in women undergoing elective Caesarean section with epidural anaesthesia was investigated in 20 patients receiving an intravenous preload of 1 litre of Hartmann's solution and in 20 patients receiving 0.5 litre of polygelatin (Haemaccel) and 0.5 litre of Hartmann's solution. Hypotension occurred in 45% of the Hartmann's group but in only 5% of the polygelatin and Hartmann's group. An argument for the use of a 2-litre intravenous preload of crystalloid solution is offered to provide prophylaxis against hypotension occurring during Caesarean section under epidural anaesthesia.
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Day care patients at Law Hospital, who had received either a general or a local anaesthetic in conjunction with minor surgery, were assessed by five tests of mental function before surgery and before discharge from hospital some hours after surgery. These patients did not perform differently from control patients, who were subjected to the same two testing sessions, without intervening surgery or anaesthesia. It was concluded that the day cases were quite capable of normal cognitive functioning at the time of their discharge and that the procedures followed by the hospital for the discharge of day cases are generally adequate.