Anaesthesia
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Randomized Controlled Trial Clinical Trial
Rectus sheath block for diagnostic laparoscopy.
Sixty adult females of ASA grade 1 or 2 scheduled to undergo diagnostic laparoscopy were allocated randomly to one of two groups. In group A, laparoscopy was performed with a standardised general anaesthetic technique alone. ⋯ Postoperative analgesia was assessed at 1, 6 and 10 hours after operation. Visual analogue pain scores in group B were significantly lower than in group A despite a greater use of intramuscular analgesic injections in group A (p less than 0.005 in each case).
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A 13-year-old female suffered urticaria and severe bronchospasm sufficient to cause hypoxic cardiac arrest after intravenous induction of anaesthesia. Etomidate was strongly implicated in the reaction. The management and mechanism of the reaction are described and discussed, together with consideration of future anaesthesia in the patient.
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A radiological study was performed in 23 patients to look for the position of thoracic epidural catheters and the spread of the contrast medium iohexol 300 mg/ml and 180 mg/ml when used in volumes of 3 and 8 ml. The dye was injected through the epidural catheter just after thoracic surgery. ⋯ In three cases no contrast could be seen on the x-ray, and in two the radiopaque dye was found just outside the epidural space. No relationship between the spread of the dye and the sensory blockade was found, but the position of the epidural catheter should be checked radiographically when the epidural route is to be used for long-term pain relief.
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Biography Historical Article
The Alcock chloroform vaporizer. An early calibrated temperature-compensated plenum apparatus in its historical context.
A long-forgotten chloroform inhaler, probably the first accurately calibrated, temperature compensatable, plenum vaporizer, is described. Its place in the dosimetric movement at the beginning of the 20th century is considered, together with a brief account of the life of its designer.