Anaesthesia
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Randomized Controlled Trial Clinical Trial
Alfentanil used to supplement propofol infusions for oesophagoscopy and bronchoscopy.
This randomised double-blinded study compared the cardiovascular stability and rate of recovery when propofol infusions with or without alfentanil were used to provide anaesthesia for rigid oesophagoscopy and (or) bronchoscopy. Forty-six patients were allocated randomly to receive either alfentanil 10 micrograms/kg or saline just before a rapid sequence induction with propofol. Suxamethonium 1 mg/kg was given and infusions of suxamethonium 10 mg/minute and propofol (10 mg/kg/hour for 10 minutes, 8 mg/kg/hour for 10 minutes and then 6 mg/kg/hour thereafter) were started. ⋯ Recovery from anaesthesia was assessed using the critical flicker fusion threshold. No differences were found between the groups and patients in both groups had returned to baseline values by 60 minutes. No patient had any recall of intra-operative events, and there were no other adverse effects of any significance.
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Randomized Controlled Trial Clinical Trial
Pain relief after tonsillectomy. Effect of benzydamine hydrochloride spray on postoperative pain relief after tonsillectomy.
The efficacy of benzydamine hydrochloride (Difflam) spray to relieve pain from postoperative tonsillectomy was assessed, but it was found that it did not relieve the symptoms after operation when compared to matching placebo.
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Randomized Controlled Trial Clinical Trial
Assessing the position of the tracheal tube. The reliability of different methods.
Various methods have been developed to confirm proper intubation of the trachea. This blind, randomised study evaluates some of these quantitatively and qualitatively. Forty patients had both their trachea and oesophagus intubated. ⋯ Auscultation of the lungs resulted in a wrong conclusion in 15% (6-30, 95% confidence limits) of the cases when the oesophagus was ventilated: the sounds were misinterpretated as normal breath sounds. Suction on the tubes with a 60-ml syringe was also a reliable test. Other methods assessed were observation for condensation of water vapor, and abnormal movements of the upper abdomen; these were unreliable.
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Comparative Study
Postoperative analgesia for haemorrhoidectomy. A comparison between caudal and local infiltration.
This study compared the analgesic effectiveness of local infiltration of bupivacaine with caudal extradural bupivacaine in the first 48 hours after haemorrhoidectomy. Surgical and anaesthetic protocol was rigidly standardised. ⋯ There was no significant difference between the two groups with respect to further analgesic requirements, complications, time to first bowel action, and duration of hospital stay. The definite advantage of caudal extradural bupivacaine for haemorrhoidectomy must be balanced against the rare but potentially serious complications associated with its use.
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Fifty-three patients were admitted in a 5-year period to the intensive care unit as a result of a complication of an anaesthetic technique. These patients represented 1 in 1543 anaesthetics carried out in the District in the period and 2.0% of all admissions to the intensive care unit. ⋯ The complication was considered to be wholly or partially avoidable in 14 instances (26%). Five of these subjects died and two had a residual neurological deficit.