Anaesthesia
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An obstetric epidural performed for analgesia showed a changing pattern of neurological block. The original features suggestive of a subdural block were complicated when aspiration of cerebrospinal fluid from the catheter became possible. Subsequent management as a continuous subarachnoid catheter allowed delivery.
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Randomized Controlled Trial Clinical Trial
Oral administration of midazolam as a premedicant for paediatric day-case anaesthesia.
Fifty-four children aged 1-10 years, scheduled for day-case anaesthesia were prescribed either oral midazolam 0.5 mg.kg-1 or a placebo preparation 30-60 min pre-operatively on a double-blind basis. On arrival at the induction room, anxiolysis was satisfactory in 23 out of 24 (96%) children who received midazolam compared with 12 out of 27 (44%) of those who received placebo (p < 0.001); at induction of anaesthesia these proportions were 21 out of 24 (88%) and nine out of 27 (33%) respectively (p < 0.001). ⋯ Similarly, the time to hospital discharge was longer in the midazolam group (244 vs 185 min) (p < 0.01). Analysis of behavioural questionnaires completed by parents 2 weeks after hospitalisation indicated that there were fewer postoperative behavioural disturbances in children premedicated with midazolam compared with controls (p < 0.05).
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Randomized Controlled Trial Clinical Trial
Pain during injection of propofol. The effect of prior administration of thiopentone.
A controlled, double-blind study was performed to compare the prior administration of intravenous saline 4 ml (n = 36), lignocaine 20 mg (n = 36) or thiopentone 100 mg (n = 43) on the pain produced by intravenous injection of propofol. One hundred and fifteen ASA 1 or 2 patients scheduled for minor surgery were studied using a randomised, double-blind design. Thiopentone was more effective than lignocaine in reducing the incidence of propofol injection pain (p < 0.03).
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Randomized Controlled Trial Clinical Trial
The addition of triamcinolone acetonide to bupivacaine has no effect on the quality of analgesia produced by ilioinguinal nerve block.
In a study of 30 men undergoing elective inguinal hernia repair under general anaesthesia no difference in postoperative pain, patient rating score or morphine consumption was found between patients who had pre-operative ilioinguinal nerve block with bupivacaine 0.5% plain and those who received a similar block with bupivacaine 0.5% plain and triamcinolone acetonide 40 mg. Mean (SD) morphine requirements using a patient-controlled analgesia system were 37 (22.2) mg and 32 (20.3) mg in the bupivacaine and bupivacaine/triamcinolone groups respectively (p > 0.05). The addition of triamcinolone 40 mg to bupivacaine 0.5% offers no advantages over unsupplemented bupivacaine when used for ilioinguinal block.