Anaesthesia
-
This case study emphasises the multiple factors that may be involved in the precipitation of electromechanical dissociation, which are compounded by additional problems that relate to pregnancy. It reinforces the value of the tracheal route for drug administration when a central vein is not cannulated and stresses the importance of posture and early consideration of Caesarean section in the pre-term gravid patient who has sustained a cardiac arrest.
-
Comparative Study
Anaesthetic properties of pregnanolone emulsion. A comparison with alphaxolone/alphadolone, propofol, thiopentone and midazolam in a rat model.
The anaesthetic properties of pregnanolone emulsion, a new steroid preparation for intravenous administration, were evaluated in rats and compared to those of Althesin, propofol, thiopentone and midazolam. The therapeutic index was found to be 50% higher than that of Althesin and 6-8 times higher than those of propofol, thiopentone and midazolam. Induction with pregnanolone emulsion was reliable and fast, with only minor excitatory side effects, although induction time was longer compared to Althesin, propofol and thiopentone. ⋯ Recovery was rapid and smooth, and the proportion of sleeping time to recovery time was higher than found for the other four anaesthetics. No cumulative effects were seen on repeated administration and there were no venous sequelae. The results indicate that pregnanolone emulsion may provide a short-acting, less cumulative and less toxic alternative to existing intravenous anaesthetic agents.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Analgesia from morphine and ketamine. A comparison of infusions of morphine and ketamine for postoperative analgesia.
Ketamine 4 micrograms/kg/minute produced pain relief similar to that from morphine 33 micrograms/minute in a double-blind study that compared analgesia from constant-rate intravenous infusions of the two drugs in 60 patients. The analgesic efficacy of the infusions, as assessed by pain scores and the requirement for supplementary self-administered morphine, was poor. Ventilatory depression, the most significant side effect, occurred only in patients who received morphine infusion. The low dose ketamine infusion did not provide clinically useful analgesia even though adequate plasma concentrations were achieved.
-
Two hundred and forty-two routine surgical patients who had undergone general anaesthesia, were questioned about postoperative sore throat by one of two methods, either direct or indirect questioning. A significantly higher incidence of sore throat was obtained by direct questioning (p less than 0.001).
-
The application of low frequency (10 Hz) electrical current for 5 minutes to an acupuncture needle placed at the P6 (Neiguan) point is as effective as manual needling in the reduction of emetic sequelae in women premedicated with nalbuphine 10 mg for a minor gynaecological operation carried out under a standard anaesthetic. Both were slightly, but not significantly, better than the antiemetic properties of cyclizine 50 mg.