Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Suprofen compared to dextropropoxyphene hydrochloride and paracetamol (Cosalgesic) after extraction of wisdom teeth under general anaesthesia.
In a randomised double-blind trial in postoperative ambulant day case dental patients suprofen 200 mg (29 patients) was compared with dextropropoxyphene hydrochloride 65 mg and paracetamol 650 mg (Cosalgesic, 28 patients) both available four times daily for 3 days. Suprofen was better than cosalgesic in the patients' opinion of initial (p = 0.01) and overall pain relief (p = 0.08) compared to Cosalgesic and the second night's sleep was better (p = 0.01). Side effects were reported in six suprofen patients and 10 cosalgesic patients (two suffering from vomiting withdrew). Suprofen, a non-steroidal anti-inflammatory drug is as good as, or better than, a widely used opioid-paracetamol mixture for ambulant patients with postoperative dental pain.
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Randomized Controlled Trial Clinical Trial
Analgesia following femoral neck surgery. Lateral cutaneous nerve block as an alternative to narcotics in the elderly.
In a prospective controlled randomised trial on patients undergoing operative repair of fractured neck of femur via a lateral incision, the postoperative analgesic requirements of one group of patients who received a lateral cutaneous nerve block were compared with a second group who received no block. The former group were found to need significantly less intramuscular pethidine in the first 24 hours, and 44% required no supplementary analgesia whatsoever during this period. The time to first dose of opioid in the remainder was greatly increased. No untoward sequelae associated with the nerve block were seen.
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Randomized Controlled Trial Clinical Trial
Mental function and morbidity after acute hip surgery during spinal and general anaesthesia.
Forty elderly patients (mean age 78.9 years) undergoing acute surgery for hip fracture were given at random either spinal analgesia with bupivacaine 0.75% or general anaesthesia with diazepam, fentanly and N2O/O2. Mental function was studied pre-operatively with an abbreviated mental test and 1 week and 3 months postoperatively in both groups. Mortality and number of complications was similar in the two groups, but a shorter time of ambulation was seen in the spinal group compared to the general anaesthetic group. No persistent impairment in mental function was found after acute hip surgery under spinal or general anaesthesia and the only advantage of regional technique was a shorter time of ambulation.
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A case of an allergic reaction to Syntocinon (synthetic oxytocin) administered during Caesarean section is reported.
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Comparative Study
Volume-controlled high frequency positive pressure ventilation for upper abdominal surgery. A clinical report.
Volume-controlled high-frequency positive pressure ventilation was evaluated and compared to intermittent positive pressure ventilation during anesthesia in 74 patients undergoing biliary tract surgery. There were no statistically significant differences in oxygenation or ventilation. Significantly lower airway pressures and lower tidal volumes were recorded during high frequency positive pressure ventilation. ⋯ Used intra-operatively, it also produced a quiet operative field, which the surgeons appreciated during cannulation of the biliary duct and stapling of the stomach. At the end of the anaesthesia, high frequency positive pressure ventilation was superimposed on spontaneous breathing and operated as a new mode of intermittent mandatory ventilation. This reduced the risk of hypoxia at the time of emergence from anaesthesia and at tracheal suctioning.