Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled epidural analgesia following post-traumatic pelvic reconstruction. A comparison with continuous epidural analgesia.
A randomised, single-blinded study was conducted to compare patient-controlled epidural analgesia with continuous infusion epidural analgesia for the treatment of pain following post-traumatic pelvic reconstruction. The patient-controlled group (n = 11) received a background infusion of 4 ml.h-1 of bupivacaine 0.125% with fentanyl 1 microgram.ml-1, and 3-6 ml bolus doses, self administered, as required (with a 15 min lockout interval). The continuous infusion group (n = 12) received a continuous infusion of the same solution through an identical apparatus, but with the demand button deactivated. ⋯ There was no recorded instance of respiratory depression or hypotension and there was no significant difference between the groups in the volumes of drug solution received. Patient satisfaction was equally very good in both groups. Patient-controlled epidural analgesia is an effective means of providing pain relief after post-traumatic pelvic reconstruction, but did not significantly reduce analgesic requirements in comparison with continuous infusion epidural analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Diclofenac for analgesia after caesarean section.
The analgesic efficacy of a single intramuscular dose of 75 mg diclofenac given after elective Caesarean section was studied in 50 women in a double-blind randomised manner using a patient-controlled analgesia system. The mean 18 h papavaretum consumption of the placebo group was significantly greater (91.4 mg compared to 61.4 mg). Subjective experience of pain and observed sedation were significantly greater in the control group up to 6 h after operation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular effects of fibreoptic oral intubation. A comparison of a total intravenous and a balanced volatile technique.
The cardiovascular response to fiberoptic oral intubation under total intravenous anaesthesia with propofol or a balanced volatile technique with thiopentone/enflurane was compared in 50 patients of physical status ASA 1 and 2 who were scheduled for elective ear, nose and throat surgery. Patients were randomly assigned to receive propofol or enflurane. There was no significant difference between the two anaesthetic techniques in haemodynamic profile either before, during or after fibreoptic intubation (the study design was adequate to detect a 20% difference with > 90% statistical power), in incidence of postoperative sore throat or in time taken for intubation. In no patient did the oxygen saturation decrease to below 95% or the CO2 tension exceed 5.8 kPa.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous extradural infusion of lignocaine 0.75% vs bupivacaine 0.125% in primiparae: quality of analgesia and influence on labour.
We studied 86 primiparous women with uncomplicated pregnancy and labour requesting extradural analgesia in labour. All the women were over 36 weeks of gestation with a cephalic-presenting singleton fetus. The women were allocated randomly to two groups: group A, who received an extradural infusion of lignocaine 0.75%, after an initial dose of 10 ml of lignocaine 1.5%, and group B, who received an infusion of bupivacaine 0.125% after an initial dose of 10 ml of bupivacaine 0.25%. ⋯ However, the requirement for oxytocin augmentation during the first and second stages of labour was significantly less in the lignocaine group (p = 0.004). Similarly, the duration of the second stage was shorter compared with the bupivacaine group. In spite of high plasma concentrations of lignocaine, no side effects were noted in either mothers or babies.
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Comparative Study
A comparison of the performance of two types of infusion device.
The delivery performance of two types of infusion pump, the IVAC 711 series syringe driver and the IVAC 531 series drop-counter, was examined by measuring the output of 16 pumps. We found that despite careful attention to the setting up of all apparatus, the IVAC 711 series syringe drivers had a significant lag phase before output matched the set rate, and that this lag phase was more pronounced at low rates of infusion. This was not the case with the IVAC 531 series which delivered the set rate from the outset. We suggest, that when the timing and rate of an infusion of drug is important from the outset and when these types of pump are being used, that either the syringe driver pump is primed by a brief period of high rate infusion vented by a three-way tap or that a drop-counter pump is used.