Anaesthesia
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Plasma bupivacaine concentrations were measured in 27 children aged 3-7 years who received one of two analgesic regimens for herniotomy or orchidopexy. Analgesia was provided either by caudal epidural bupivacaine 0.2% 2 mg/kg (n = 14) or by ilioinguinal-iliohypogastric nerve block with bupivacaine 0.5% 1.25 mg/kg (n = 13). ⋯ Time to peak plasma concentrations were 29.6 (7.9) and 22.3 (10.9) minutes respectively. These concentrations are well below the potentially toxic level of 4.0 micrograms/ml, but suggest that uptake of bupivacaine is more rapid after ilioinguinal-iliohypogastric nerve block than during caudal analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison between propofol and thiopentone for induction of anaesthesia in children.
Propofol 2.5 mg/kg was compared with thiopentone 5 mg/kg in a randomised open study, as an induction agent in paediatric anaesthesia. One hundred and twenty children who were to undergo elective surgery were included in the study. Both propofol and thiopentone produced a rapid and smooth induction with a low incidence of side effects. ⋯ Respiratory upsets occurred less frequently with propofol than with thiopentone, but propofol frequently induced discomfort on injection. Both agents provided satisfactory and controllable induction of anesthesia and no major adverse reactions occurred during or after anaesthesia. We conclude that propofol is a useful alternative as an induction agent in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Diclofenac sodium for post-tonsillectomy pain in children.
Diclofenac sodium was assessed as an analgesic for postoperative pain following paediatric tonsillectomy in a randomised double blind trial. In a comparison made with both a pethidine and a control group diclofenac was shown to be an effective analgesic. No significant difference in analgesic efficacy was demonstrated between the two drugs, although patients who received diclofenac tended to be less drowsy postoperatively than those who received pethidine. There were no significant differences between the two drugs in respect of time to awaken from anaesthesia or incidence of postoperative vomiting.
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Randomized Controlled Trial Comparative Study Clinical Trial
Heart rate and arterial pressure changes during fibreoptic tracheal intubation under general anaesthesia.
The cardiovascular responses to fibreoptic orotracheal intubation under general anaesthesia were compared with those in a control group in whom tracheal intubation was effected with a Macintosh laryngoscope. The patients received a standard anaesthetic and were allocated randomly to either group immediately before intubation. Fibreoptic intubation took significantly longer to perform. ⋯ The tachycardia in the fibreoptic group was significantly greater than that in the control group during the second minute after intubation, and the increase in systolic pressure was sustained for a longer period in the fibreoptic group. The maximum increases in systolic and diastolic pressures above pre-intubation values were significantly greater in the fibreoptic group. The cardiovascular responses associated with fibreoptic intubation under general anaesthesia appear to be more severe than those which follow intubation effected with a Macintosh laryngoscope.