Anaesthesia
-
Comparative Study
Penile block for circumcision? A comparison with caudal blockade.
A prospective blind trial was conducted comparing the analgesia and adverse effects produced by caudal extradural blockade (caudal block) with blockade of the dorsal nerves of the penis (penile block) in 38 boys undergoing elective circumcision. Analgesia was assessed by senior nurses using a linear analogue scale and by the response to direct questioning over the first 7 hours after surgery. ⋯ One technical failure occurred in the penile block group. It is concluded that a penile block is a satisfactory alternative to caudal blockade with regard to postoperative analgesia and offers several specific advantages.
-
Comparative Study
Anaesthesia in the morbidly obese. A comparison of anaesthetic and analgesic regimens for upper abdominal surgery.
Seventy morbidly obese patients presented for upper abdominal surgery; 17% had pre-existing cardiovascular disease and 23% pre-existing respiratory disease. Twenty-eight patients received general anaesthesia, plus narcotic analgesia postoperatively, and 42 general anaesthesia plus thoracic epidural analgesia intra- and postoperatively. ⋯ Patients who had thoracic epidural analgesia required less volatile anaesthesia than the group who had general anaesthesia and narcotic analgesics. Postoperative respiratory complications were more common in patients with pre-existing cardiovascular and respiratory disease, and occurred less frequently in patients who had thoracic epidural analgesia.
-
Phantom limb pain following amputation is a well known but comparatively rare phenomenon. Spinal anaesthesia in amputees may cause reappearance of phantom pain in previously pain-free patients despite complete sensory analgesia. Two such cases are described.
-
Two cases of profound bradycardia (one progressing to asystole) during orbital surgery where the relevant eye had been removed years earlier are reported. Cessation of stimulation was followed by recovery of heart rate. Intravenous atropine prevented further bradycardia.