Anaesthesia
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Randomized Controlled Trial Clinical Trial
Intravenous lignocaine and sympathoadrenal responses to laryngoscopy and intubation. The effect of varying time of injection.
We have studied the effect of varying the timing of a prior dose of intravenous lignocaine 1.5 mg/kg on the cardiovascular and catecholamine responses to tracheal intubation. Forty healthy patients were given an intravenous injection of either placebo or lignocaine 2, 3 or 4 minutes before tracheal intubation. There was a significant increase in heart rate of 21-26% in all groups. There was no significant increase in mean arterial pressure in response to intubation in any group of patients given lignocaine before intubation, but in the placebo group, mean arterial pressure increased by 19.1% compared to baseline values (p less than 0.05).
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural infusion of diamorphine with bupivacaine in labour. A comparison with fentanyl and bupivacaine.
We have compared the analgesic effects of three epidural infusions in a randomised, double-blind study of 61 mothers in labour. An initial dose of bupivacaine 0.5% 8 ml was followed by either bupivacaine 0.125%, bupivacaine 0.125% with diamorphine 0.0025% or bupivacaine 0.125% with fentanyl 0.0002%. ⋯ Diamorphine was shown to be the more effective supplement to bupivacaine. The 5% incidence of pruritus in the opioid groups was less than that reported by earlier authors.
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Randomized Controlled Trial Clinical Trial
The alkalinisation of bupivacaine for intercostal nerve blockade.
A double-blind randomised study was performed to investigate the effect of pH adjustment of bupivacaine, with adrenaline 1:200,000, on the duration of block and pain relief after intercostal nerve blockade following thoracotomy. One group (n = 10) received bupivacaine with adrenaline 1:200,000 (pH = 4.1) and the other (n = 10) received alkalinised bupivacaine with adrenaline 1:200,000 (pH = 6.9). ⋯ A progressive regression of block, not previously described, was observed, explicable by means of spread of local anaesthesia to adjacent intercostal nerves. Alkalinisation of bupivacaine with adrenaline for intercostal nerve blockade has little clinical benefit.