Anaesthesia
-
Accidental cannulation of an extradural vein is a troublesome and potentially serious complication of extradural catheter insertion. This study was conducted to assess the influence of posture, catheter size and the injection of saline before catheter insertion, on its occurrence. ⋯ The use of 18-gauge catheters, after injection of 10 ml of 0.9% saline, resulted in a significant (p less than 0.01) reduction in the incidence of extradural vein cannulation. This technique is recommended in obstetric patients as a means of avoiding accidental intravenous injection of local analgesic.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind study of the speed of onset of analgesia following intramuscular administration of ketorolac tromethamine in comparison to intramuscular morphine and placebo.
A double-blind, randomised, parallel group, placebo-controlled study was performed in 85 patients to compare the speed of onset of analgesia following the intramuscular administration of a single dose of 30 mg of ketorolac tromethamine, 10 mg of morphine or placebo. A new, sensitive, method was used to measure the latency of analgesia. The onset of analgesia was defined by the time taken for the pain intensity score to reach a specified percentage of the baseline value. ⋯ Intramuscular ketorolac and intramuscular morphine have comparable analgesic onset times in the postoperative pain context. However, the sensitive method of measuring onset of analgesia described, highlights the slow onset of analgesia when analgesics of known efficacy are given by the intramuscular route in the postoperative period. More attention should be given to the speed of onset of analgesia in future assessments of analgesics.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Nausea and vomiting with use of a patient-controlled analgesia system.
The incidence of nausea and vomiting following patient controlled analgesia and intramuscular morphine injections on demand was compared in a double-blind randomised study of 32 healthy patients undergoing elective cholecystectomy. There were no significant differences between the two groups in mean 24 hour postoperative morphine consumption, subjective experience of pain, nausea and sedation assessed by visual linear analogue scoring, and the postoperative requirements for antiemetic therapy.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural bupivacaine dilution for labour. A comparison of three concentrations infused with a fixed dose of fentanyl.
We have compared the effects of three epidural infusions in a randomised, double-blind study of 56 primigravid mothers in labour. An initial dose of bupivacaine 0.5% 8 ml was followed by infusion of either bupivacaine 0.125%, 0.062% or 0.031%. ⋯ Women receiving the most dilute solution had significantly less analgesia (p less than 0.001) for the first 4 hours of the study, but pain scores were then similar for the three groups. No obvious benefit was gained by using very dilute bupivacaine.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Morphine compared with diamorphine. A comparison of dose requirements and side-effects after hip surgery.
The dose requirements and side effects of morphine were compared with those of diamorphine administered by patient-controlled analgesia in 40 patients following elective total hip replacement. Patients were allocated randomly to receive in a double-blind manner either morphine or diamorphine for postoperative pain relief. There were no significant differences between the two groups with regard to postoperative sedation, nausea, well-being, pain relief and requirements for antiemetic drugs. The dose requirement for diamorphine was approximately 50% of that for morphine.