Anaesthesia
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Randomized Controlled Trial Clinical Trial
Wound infiltration of local anaesthetic after lower segment caesarean section.
The analgesic efficacy of subcutaneous wound infiltration with 20 ml of 0.5% bupivacaine after elective lower segment section Caesarean section was studied in 28 patients in a double-blind randomised controlled manner using a patient-controlled analgesia system. The mean 24-hour morphine consumption of the placebo group and the bupivacaine group was similar (76 mg and 68 mg respectively). ⋯ However, on a weight-adjusted basis statistically significant differences in morphine consumption were demonstrated, although these may not be clinically important. Subjective experiences of pain, nausea and drowsiness assessed by linear analogue scoring were similar in both groups.
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Randomized Controlled Trial Clinical Trial
The effect of prophylactic fentanyl on shivering in elective caesarean section under epidural analgesia.
The aims of this randomised double-blind study were to investigate whether 25 micrograms of fentanyl administered prophylactically by the epidural route would influence the incidence of shivering in parturients who underwent elective Caesarean section under epidural analgesia and whether it would affect the axillary and calf temperatures. There was a 50% reduction (p less than 0.05) in the overall incidence of shivering in patients who received fentanyl and there was some evidence to suggest that low-dose epidural fentanyl might reduce shivering by an influence on thermoregulation.
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Comparative Study
Monitoring of irrigating fluid absorption during transurethral prostatectomy. A study in anaesthetised patients using a 1% ethanol tag solution.
A simple, reliable method to detect absorption of irrigating fluid during transurethral prostatectomy is to tag irrigating fluids with 1% ethanol and monitor expired breath ethanol concentrations. This method correlated well (n = 0.79) with other existing methods of absorption monitoring in 20 anaesthetised patients. ⋯ The technique is non-invasive, repeatable, cheap and gives instant results. It can be used in anaesthetised or awake patients and can detect absorption of as little as 100-150 ml in any 10-minute period.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single operator cardiopulmonary resuscitation in ambulances. Which ventilation device?
Cardiopulmonary resuscitation en route to hospital is performed by a single-handed operator in many British ambulances. In this study, three emergency ventilation devices, and mouth-to-mouth breathing, were compared for effectiveness in unintubated patients. ⋯ There were significant differences in minute volume (p less than 0.01) and number of effective chest compressions (p less than 0.05); mouth-to-mouth breathing produced the best overall results and the simplest device was a close second. The value of automatic ventilators for single-operator cardiopulmonary resuscitation in unintubated patients is questioned.
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Org 9426, a new steroidal non-depolarising muscle relaxant, which is stable in solution, was studied in 30 anaesthetised (thiopentone, fentanyl, nitrous oxide) male patients, ASA 1 or 2. A dose-response curve for Org 9426 was constructed and the ED90, mean (SD), was found to be 0.36 (0.031) mg/kg. ⋯ No signs of histamine release or cardiovascular effects were observed. Org 9426 thus has a faster onset of action than vecuronium bromide or atracurium dibesylate.