Anaesthesia
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Randomized Controlled Trial Clinical Trial
Continuous blockade of the lumbar plexus after knee surgery--postoperative analgesia and bupivacaine plasma concentrations. A controlled clinical trial.
In a double blind, randomised, controlled investigation the analgesic effect of a continuous block of the lumbar plexus with bupivacaine compared with sodium chloride was examined in 20 patients with postoperative pain after knee-joint surgery. The infusion was given through a catheter inserted in the neurovascular fascial sheath of the femoral nerve, according to the three-in-one block technique. The patients treated with bupivacaine had significantly lower pain scores and a significantly lower demand for morphine. Side effects related to the catheters or the infusions of bupivacaine were not observed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Alkalinized bupivacaine and adrenaline for epidural caesarean section. A comparison with 0.5% bupivacaine.
Twenty-four mothers received either 0.5% bupivacaine (group 1, n = 14), or alkalinized 0.5% bupivacaine and 1 in 200,000 adrenaline (group 2, n = 10), as an epidural local anaesthetic for elective lower segment Caesarean section in a randomised, double blind study. The two groups were prepared for surgery according to an identical technique. Onset of analgesia to pinprick was significantly faster in group 2 (p less than 0.02). ⋯ Onset of motor blockade was significantly faster in group 2 (p = 0.01). There were no significant differences between the two groups with regard to duration of surgery, or Apgar scores at 1 and 5 minutes. Alkalinized 0.5% bupivacaine and adrenaline was superior to 0.5% bupivacaine for epidural Caesarean section.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylaxis against acid aspiration syndrome. Single oral dose of H2-antagonist on the evening before elective surgery.
We have compared famotidine 40 mg, ranitidine 300 mg and placebo given in a single oral dose at 2200 hours as the sole means of prophylaxis in 286 patients who underwent elective surgery the following day. Standardised premedication was administered and anaesthesia induced. ⋯ The proportions of patients considered 'not at risk' (pH greater than 2.5) were 90% after famotidine, 91% after ranitidine and 52% after placebo. We conclude that the administration of a potent H2-antagonist in a single oral dose at night offers a convenient routine means of providing extensive prophylactic cover in patients scheduled to undergo elective surgery the following day.