Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Controlled release morphine tablets: a double-blind trial in patients with advanced cancer.
Eighteen of 27 patients with pain due to advanced cancer, completed a randomised crossover comparison of 4-hourly aqueous morphine sulphate and twice daily controlled release morphine tablets. There was no difference between the two regimens in analgesic efficacy or adverse effects, but there was an apparent improvement in quality of sleep on the controlled release tablets. After completion of the study, 17 patients continued with the latter medication for periods that ranged from 2 days to 94 weeks (median 6.5 weeks). Controlled release morphine tablets given twice daily provide a simpler and more convenient treatment regimen than a 4-hourly opioid for patients with cancer pain, once they have been stabilised.
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Comparative Study
Comparison of two regional techniques for postoperative analgesia in children following herniotomy and orchidopexy.
This study compares the quality and duration of analgesia in two groups of patients aged between 1 and 13 years who received either caudal anaesthesia with plain bupivacaine 0.25% or an iliohypogastric and inguinal nerve block combined with skin infiltration using bupivacaine 0.25% with adrenaline 1:200,000. The results indicate no significant difference in the duration or quality of the analgesia provided by the two techniques. There was no difference in the incidence of vomiting or the time of first micturition between the two groups.
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Comparative Study
Anaesthesia for laparoscopy. A comparison of five techniques including propofol, etomidate, thiopentone and isoflurane.
This is a report about five anaesthetic techniques for laparoscopy. Propofol and etomidate were used for total intravenous anaesthesia. Propofol, etomidate and thiopentone were used as induction agents prior to inhalational anaesthesia with isoflurane and nitrous oxide. ⋯ Recovery was the most rapid following total intravenous anaesthesia with propofol. Postoperative side effects were much lower after propofol. No difference was observed between the groups with regard to changes in arterial blood pressure and heart rate.
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Systemic mastocytosis is a rare disorder characterised by the infiltration of many tissues by abnormal numbers of mast cells. Life-threatening episodes of bronchospasm and hypotension are common in response to a variety of triggers which cause mast cell degranulation. ⋯ Cardiovascular data, together with blood histamine levels and thrombin times, indicated that mast cell degranulation did not occur. A review of the current literature concerning mast cell disease as it relates to anaesthesia is presented and suggestions for the safe management of such cases are given.
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This is a report of a modification to one design of laryngoscope to increase the angle between blade and handle, to facilitate intubation in cases of difficult access, such as in obstetric practice or in patients in whom neck flexion is limited, for example by skull traction. The modification offers the unique advantage of two useful blade angles in one instrument. ⋯ It would also be suitable for inclusion in resuscitation kits for use both within and outside hospital. The second type would be more suitable for the maternity or spinal injuries unit, or the difficult intubation box of a general operating theatre suite.