Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Pipecuronium versus high dose vecuronium. II. A comparison of speed of onset and cumulation during propofol anaesthesia.
The onset time and tendency to cumulation of pipecuronium and high-dose vecuronium were compared during nitrous oxide anaesthesia supplemented with a propofol infusion. Pipecuronium 0.06 mg.kg-1 had a similar duration of action to vecuronium 0.2 mg.kg-1 (49 vs 43). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p less than 0.01). Neither pipecuronium nor vecuronium showed marked cumulation.
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Letter Case Reports
Leaking Datex sampling set for the end-tidal CO2 monitor.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pipecuronium versus high dose vecuronium. I. A comparison of speed of onset and cumulation during isoflurane anaesthesia.
The onset time and tendency to cumulation of pipecuronium and high-dose vecuronium were studied during nitrous oxide anaesthesia supplemented with isoflurane. Pipecuronium 0.06 mg.kg-1 had a similar duration of action to vecuronium 0.015 mg.kg-1 (42 vs 49 min). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p less than 0.01). The use of pipecuronium was associated with marked cumulation.
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Upper oesophageal sphincter pressure has been measured in 24 patients with a sleeve device. The median sphincter pressure when awake was 38 mmHg, and when anaesthetized and paralysed was 6 mmHg. ⋯ With the application of cricoid pressure, operating department assistants raised sphincter pressure to above 38 mmHg in only 50% of patients. Laryngoscopy made little difference to the effect of cricoid pressure except in one patient in whom it reduced the sphincter pressure by 27 mmHg.
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A new approach for the management of frozen shoulder associated with reflex sympathetic dystrophy is presented. A suprascapular nerve block was performed by needle insertion behind the lateral end of the clavicle at its junction with the insertion of the trapezius muscle; the needle was directed downwards and backwards. The suprascapular nerve was identified by its response to nerve stimulation. ⋯ The choice of blockade of the suprascapular nerve is a new concept for the management of the frozen shoulder of reflex sympathetic dystrophy. This is based on the fact that the nerve contains a high proportion of sympathetic fibres supplying the shoulder joint. The new approach proved to be simple, highly successful, and reproducible.