Anaesthesia
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Comparative Study
The Finapres 2300e finger cuff. The influence of cuff application on the accuracy of blood pressure measurement.
Blood pressure measurements associated with malapplication of a finger cuff were compared with contemporaneous intra-arterial pressure data in seven volunteers to determine the influence of cuff application on the accuracy of the Finapres 2300e. Systolic readings in all cuff positions differed from arterial line data by more than the recommended standard and tight and loose cuff applications under and over-read respectively, in all subjects. The results show the Finapres to be sensitive to small degrees of finger cuff malapplication which contribute to the bias on direct arterial comparison and limit the reliability of the instrument in clinical practice.
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Anaesthetists require a good knowledge of the excretion of drugs in breast milk and the potential hazards to suckling infants of drug ingestion via breast milk. A brief account of the physiology of lactation is given. The mechanisms of drug passage into breast milk are discussed followed by a review of the excretion in breast milk of drugs used in anaesthetic practice. Suggestions for the management of anaesthesia in breast feeding mothers are offered.
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The regional anaesthesia records of 274 obstetric patients who had inadvertent dural puncture were reviewed to see whether a bloody dural tap resulted in a lower incidence of postdural puncture headache. No such influence was found.
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Randomized Controlled Trial Clinical Trial
A comparison of diclofenac and ketorolac for postoperative analgesia following day-case arthroscopy of the knee joint.
Seventy-one patients presenting for day-case arthroscopy were randomly allocated to receive either intramuscular diclofenac 75 mg or ketorolac 30 mg immediately after induction of anaesthesia. One hour after operation visual analogue pain scores were significantly lower in the ketorolac group compared with those receiving diclofenac. ⋯ Discomfort in the operated knee was similar for both groups on the day following surgery, but pain from the intramuscular injection site was significantly greater in the diclofenac group. Intramuscular ketorolac 30 mg provided better postoperative analgesia and less pain at the injection site than diclofenac 75 mg.
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Case Reports Comparative Study
Vecuronium block in the myasthenic patient. Influence of anticholinesterase therapy.
The neuromuscular block of vecuronium was investigated in two myasthenic patients undergoing thymectomy. The first patient had no pre-operative anticholinesterase therapy, the second patient was given pyridostigmine 60 mg 4 hourly, continued until the morning of surgery. In the two patients, neuromuscular block of vecuronium was monitored by electromyography. The results suggest that the neuromuscular block of vecuronium may be decreased by pre-operative preparation of the myasthenic patient by pyridostigmine.