Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural buprenorphine for pain relief after major abdominal surgery. A controlled comparison with epidural morphine.
In a controlled trial epidural buprenorphine was compared with epidural morphine as the sole means of analgesia after major abdominal surgery. Bolus injections of buprenorphine 60 micrograms in 10 ml or morphine 2 mg in 10 ml of normal saline were given on demand for the first 48 hours postoperatively. Both drugs produced significant reduction in pain scores as assessed by the linear visual analogue scale and both produced prolonged analgesia at this dosage, which could be extended by further 'top-ups'. The authors conclude that, for postoperative epidural analgesia, buprenorphine may be the opiate of choice and the reasons for this are discussed.
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Oxygen and nitrous oxide pipes were cross-connected during the servicing of an anaesthetic machine. This resulted in the delivery of 100% nitrous oxide instead of 100% oxygen at the end of the operation. The patient fully recovered and was discharged on the 13th day.
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The work of the Parachute Field Surgical Team in the Falkland's campaign is described. Data are provided on the methods of resuscitation and anaesthesia used. Suggestions are made for improving drugs and equipment for use in civil disaster or war.
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The work of nine Naval anaesthetists deployed with the Task Force during the Falklands campaign is described. The anaesthetists worked in a field hospital (Ajax Bay), a hospital ship (SS Uganda), a troop ship (SS Camberra), aircraft carriers (HMS Hermes and HMS Invincible) and a Royal Fleet Auxiliary (Tidespring). The problems of staffing and providing the stores for various teams in different locations at short notice are discussed.
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An etomidate infusion was used in the place of nitrous oxide during one lung anaesthesia for 40 patients undergoing thoracic surgery. Analgesia was provided by fentanyl. ⋯ There was no incidence of awareness or dreams. This technique provides satisfactory anaesthesia and oxygenation during thoracic surgery when one lung only is being ventilated.