Anaesthesia
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Randomized Controlled Trial Clinical Trial
Dermal patch anaesthesia: comparison of 10% lignocaine gel with absorption promoter and EMLA cream.
The analgesic effects of transdermally applied 10% lignocaine aquagel containing 3% glycyrrhetinic acid monohemiphthalate disodium (as an absorption enhancer) and EMLA cream were compared on the forearms of 34 adult volunteers in a double-blind fashion. The mean pinprick pain scores (graded by noting the number of painful pinpricks out of five) at 30, 60 and 90 min after application and 30 min after removal of the anaesthetics were 3.3 (0.3) (mean SE), 1.2 (0.3), 0.3 (0.1) and 0.3 (0.1) respectively, in the lignocaine gel group. ⋯ Insertion of a 26-gauge needle into the treated skin to a depth of 1 mm at 90 min after application was not painful in 91% of the volunteers in the lignocaine gel group and 88% of those in the EMLA group. There was no significant difference in any of the corresponding pain scores between the two groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomised study of local versus general anaesthesia for cataract surgery.
One hundred and sixty-nine patients (aged 65-98 years) were randomised to receive either local or general anaesthesia for cataract surgery. Cognitive function was assessed using a battery of psychometric tests performed pre-operatively, and at 24 h, 2 weeks and 3 months postoperatively. ⋯ Pulse rate and blood pressure were stable in the local anaesthetic group compared with the general anaesthetic group where marked fluctuations were noted; 61% of patients in the general anaesthetic group experienced falls in systolic blood pressure greater than 30% of the pre-induction value. No evidence of long-term postoperative cognitive dysfunction was detected and there was no significant difference between the performances of the two groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anaesthesia for gynaecological laparoscopy--a comparison between the laryngeal mask airway and tracheal intubation.
In a single-blind, randomised, controlled study, we compared two anaesthetic techniques in 60 patients undergoing gynaecological laparoscopy. In the first group, ventilation was controlled, after paralysis and tracheal intubation. ⋯ The only significant difference in morbidity was a greater incidence of nausea and vomiting in the second group in the first 4 h after operation. We conclude that use of the laryngeal mask airway is an acceptable technique for elective gynaecological laparoscopy, in patients who are at low risk of regurgitation.
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Measurements of arterial oxygen saturation were estimated using a pulse oximeter under conditions of reactive hyperaemia in the arms of 10 volunteers. Oxygen saturation measured by pulse oximetry was significantly lower, and venous oxygen saturation measured by co-oximetry was significantly higher, in the hyperaemic arm than in the other arm. ⋯ The pulsatile component is assumed to be purely of arterial origin. However, other vessels may pulsate when vasodilatation occurs and pulse oximeter saturation readings taken under these conditions may not give a true reflection of arterial saturation.
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Randomized Controlled Trial Clinical Trial
Pethidine has a local anaesthetic action on peripheral nerves in vivo. Addition to prilocaine 0.25% for intravenous regional anaesthesia in volunteers.
In a double-blind, randomised study, we have examined the effects of the addition of pethidine 100 mg to 40 ml prilocaine 0.25% for intravenous regional anaesthesia in healthy volunteers. During intravenous regional anaesthesia the hand and forearm are isolated from the rest of the circulation and pethidine interaction with central opiate receptors does not occur. Pethidine increased the speed of onset and extent of sensory and motor block, reduced tourniquet and forearm pain, and subjectively improved the quality of the block. Pethidine has local anaesthetic action on peripheral nerves in vivo.