Anaesthesia
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Randomized Controlled Trial Clinical Trial
Premedication for day case surgery. A study of oral midazolam.
A double-blind, between-patient trial was used to assess midazolam 7.5 and 15 mg as oral premedication for day case surgery. Midazolam 7.5 mg did not produce significant anxiolysis or sedation in comparison to placebo as measured by patient self-assessment linear analogue scales and observer scores. ⋯ Psychomotor performance assessed by digital-symbol substitution tests was significantly impaired by midazolam, in both doses, throughout the period of investigation. Midazolam 15 mg orally provides good premedication but the prolonged effects make it unsuitable for short-stay patients.
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Randomized Controlled Trial Clinical Trial
Nausea and vomiting after prostaglandins in day case termination of pregnancy. The efficacy of low dose droperidol.
The antiemetic effects of low dose droperidol (0.25 and 0.5 mg) and a placebo were compared in patients who had received prostaglandin for day case termination of pregnancy. The incidence of nausea and vomiting was high. Low dose droperidol significantly reduced postoperative nausea and vomiting without any delay in immediate recovery or discharge home (p less than 0.05). Droperidol 0.25 mg was equally effective as an antiemetic, as 0.5 mg.
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Randomized Controlled Trial Clinical Trial
Memory of cardiac anaesthesia. Psychological sequelae in cardiac patients of intra-operative suggestion and operating room conversation.
Thirty patients scheduled for elective cardiopulmonary bypass surgery were interviewed pre-operatively and postoperatively to assess changes in their emotional state and recollections, both aware and unaware, of intra-operative events. A random selection of patients heard a prerecorded audio tape towards the end of bypass after they were rewarmed to 37 degrees C. The tape contained suggestions for patients to touch their chin during the postoperative interview, to remember three sentences and to recover quickly. ⋯ Seven patients (23%) recalled intraoperative events, five with the aid of hypnosis. Three reports (10%) were corroborated. Pre-operative medication (p less than 0.01) and postoperative anxiety (p less than 0.05) were significant predictors of those patients who reported recall.
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Case Reports
Cardiovascular collapse following epidural anaesthesia for Caesarean section in a patient with aortic incompetence.
A death following epidural anaesthesia for Caesarean section in a patient with aortic incompetence and pre-eclampsia is described. Possible hazards of epidural anaesthesia in aortic incompetence are described and it is suggested that reduction of total peripheral resistance is contraindicated in such patients.
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Comparative Study
Day-case herniotomy in children. A comparison of ilio-inguinal nerve block and wound infiltration for postoperative analgesia.
Forty-nine boys scheduled for day-case inguinal herniotomy were studied to compare ilio-inguinal nerve block and wound infiltration for postoperative analgesia. Both techniques were simple to perform and produced no complications. ⋯ Some children did appear to have pain following discharge but in all cases this responded well to simple analgesics. We conclude that both techniques provide satisfactory analgesia whilst the complications of narcotics are avoided, and suggest that simple infiltration of the wound with local anaesthetic solution should be encouraged in paediatric anaesthesia.