Anaesthesia
-
Randomized Controlled Trial Clinical Trial
Low dose amitriptyline in the treatment of chronic pain.
The analgesic efficacy of amitriptyline 25 mg was compared with placebo in 41 patients with chronic (more than 3 months) nonmalignant pain, using a double-blind randomised multiple-dose 3-week treatment period crossover design. Amitriptyline 25 mg provided significantly greater efficacy than placebo, with significant differences evident within the first week. There was no significant difference on mood scores between amitriptyline and placebo. The results suggest that surprisingly low doses of amitriptyline may be effective without substantial adverse effects, that the effect is evident early, and that the effect is distinguishable from any effect of the amitriptyline on mood.
-
The clinical efficacy of transdermal 10% lignocaine gel mixture containing 3% w/w glycyrrhetinic acid monohemiphthalate disodium as an absorption promoter was evaluated at venous cannulation in 17 paediatric (6-11 years) and 17 adult (29-65 years) patients. After about 60 min of occlusive application, the mean (SD) pinprick pain score was 0.7 (0.7) in the paediatric group, compared with 1.4 (1.3) in the adults (p less than 0.05). Twenty-five patients (14 children and 11 adults) who had a pinprick score of 0 or 1 underwent venous cannulation without intradermal local anaesthetic. The mean (SD) pain scores at venepuncture showed no significant differences between children and adults.
-
Comparative Study
A comparison of laryngeal mask airway with tracheal tube for intra-ocular ophthalmic surgery.
The use of the laryngeal mask was compared with tracheal intubation in 30 patients who underwent intra-ocular ophthalmic surgery and who received intravenous anaesthesia with propofol. Changes in intra-ocular pressure, heart rate and mean arterial pressure after the insertion of the laryngeal mask airway or the tracheal tube were not significantly different. ⋯ During intravenous propofol anaesthesia, the laryngeal mask airway does not offer any advantage over tracheal intubation in the control of intra-ocular pressure for intra-ocular ophthalmic surgery. However, there were fewer complications immediately following surgery in the laryngeal mask group.
-
The predicted outcome of anaesthesia and surgery was compared with the immediate outcome in 508 patients by means of two 100 mm linear analogue scales. The results were used to obtain a statistically based rule by which the anaesthetist may consistently select three groups of patients for audit: group 1, patients in whom immediate outcome of anaesthesia and surgery is worse than predicted; group 2, patients whose outcome is better than predicted; and group 3, the remaining patients. The rule, which is simply adapted to departmental audit, does not necessarily need a computer but is suited to the computer as it is numerically based.
-
Anaesthetic techniques and monitoring equipment may interfere with the technical demands of magnetic resonance imaging. The purpose of this study was to evaluate the safety and efficacy of a light anaesthetic technique with intravenous propofol in nonintubated children. In 20 neuropaediatric patients sedation was induced with propofol 1 mg.kg-1, followed by a continuous infusion titrated to produce adequate immobilisation. ⋯ Within 20 min after the end of the procedure all patients were fit for dismissal to the ward. One imaging sequence out of 49 was repeated because of movement artefacts. In conclusion, intravenous propofol sedation appears to be a safe and reliable technique for paediatric sedation during magnetic resonance imaging.