Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
An investigation of the local anaesthetic effects of pethidine in volunteers.
We have investigated the local anaesthetic effects of 0.1% and 0.2% pethidine compared with 0.5% prilocaine using an intravenous regional anaesthetic technique, in a randomised, double-blind study in volunteers. Both pethidine and prilocaine produced a sensory and motor blockade, although the latter had a more profound effect, with a faster onset and slower recovery. Pethidine in low concentration clearly has a local anaesthetic action on peripheral nerves.
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Randomized Controlled Trial Comparative Study Clinical Trial
Recovery of mivacurium and doxacurium versus vecuronium in the isolated forearm.
To assess rate of biophase recovery, the recovery from neuromuscular block with mivacurium in the isolated forearm was compared with that from vecuronium simultaneously administered into the other isolated forearm of six volunteers. In a second series of similar experiments, recovery from doxacurium was compared with that from vecuronium. Neuromuscular block was monitored using the adductor pollicis mechanomyographic response to ulnar nerve stimulation at 0.2 Hz. ⋯ The recovery index of doxacurium in the isolated forearm was significantly greater, and the recovery index of mivacurium significantly less, than the recovery index of simultaneously administered vecuronium. Mivacurium block in the isolated forearm recovers rapidly, although not faster than after systemic injection; this is consistent with a drug that is retained in the biophase despite rapid plasma metabolism. Doxacurium block in the isolated forearm is slow to recover, compared with vecuronium; this suggests that high affinity for the biophase may contribute to its long duration of action.
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Fifty-one patients were referred in one year (1992) for investigation of immediate type anaphylactic/anaphylactoid reactions during anaesthesia. Skin prick tests were made with 23 anaesthetic and associated agents in the concentrations used clinically. ⋯ These comprised mainly the neuromuscular relaxants, chiefly suxamethonium (18); atracurium (6); gallamine (2); one each alcuronium; pancuronium; vecuronium and tubocurarine, as well as alfentanil (1); Gelofusine (2); cefuroxime (1) and latex (2). The materials for performing the skin prick test are readily available and it can be very helpful in making important aetiological diagnoses.
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Randomized Controlled Trial Comparative Study Clinical Trial
Recovery from pre-operative sedation with clonidine--brain stem auditory evoked response.
In a randomised double-blind study, 34 elderly patients (ASA grades 1-2) underwent elective intra-ocular surgery. Patients were allocated randomly to two groups to receive oral clonidine 300 micrograms or oral diazepam 10 mg 2 h before surgery. Facial block and retrobulbar block were given at 2 h after premedication. ⋯ In the diazepam group, there was a significant rise in the interpeak latencies immediately after operation and 120 min after operation and a rise in absolute peak latencies (p < 0.05) immediately after operation. In the clonidine group there was a reduction (p < 0.05) in amplitude of wave V at immediately after operation. We conclude that clonidine 300 micrograms orally before surgery does not delay recovery.