Anaesthesia
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During transcervical endometrial resection the uterine cavity is irrigated under pressure with 1.5% glycine solution. This solution may be absorbed, with consequent fluid and electrolyte shifts. ⋯ In five cases this decrease was > 10 mmol.l-1. Hyponatraemia is a potential risk with this procedure.
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Dr Nathan Cooley Keep (1800-1875) was a Boston dentist and doctor who carried our pioneering work in both dentistry and anaesthesia. He worked with William Morton before the first public demonstration of ether anaesthesia, formed the world's first anaesthetic partnership with Morton but parted company with him and later opposed Morton's claim to be the sole inventor of ether anaesthesia.
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Comment Letter Comparative Study
A comparison of 25G and 27G Whitacre needles for caesarean section.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of pethidine, fentanyl and lignocaine on postanaesthetic shivering.
Pethidine is reported to be more effective than equi-analgesic doses of other opioids as an inhibitor of postanaesthetic shivering. The aim of this study was to verify whether this action resulted from a local anaesthetic effect of pethidine or from inadequate fentanyl dosage in previous studies. We studied 52 ASA 1 or 2 patients. ⋯ The mean (SD) core temperature in the pethidine group was slightly lower than that in the fentanyl group (35.1 (0.6) and 35.9 (0.5)) when the patients stopped shivering. Furthermore, shivering restarted in 6/10 patients in the fentanyl group after 15 min compared with 1/12 in the pethidine group. Our results show that fentanyl (1.7 micrograms.kg-1) can inhibit postanaesthetic shivering but this effect is less pronounced and of shorter duration than with pethidine (0.85 mg.kg-1).
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Randomized Controlled Trial Clinical Trial
Sedation with intravenous infusions of propofol or thiopentone. Effects on pain perception.
The aim of this study was to investigate pain perception during thiopentone or propofol infusions for sedation. Thirty ASA 1 or 2 patients received a two step infusion of either thiopentone (step 1: 1.25 mg.kg-1 followed by 2.5 mg.kg-1.h-1; step 2: 1.25 mg.kg-1 and 12.5 mg.kg-1.h-1; n = 15) or propofol (step 1: 0.5 mg.kg-1, 1 mg.kg-1.h-1; step 2: 0.5 mg.kg-1, 5 mg.kg-1.h-1; n = 15) for sedation. At control and 10 min after the start of each infusion dosage, reaction times and thermal pain detection thresholds were determined. We found no clinically or statistically significant depression of thermal pain detection thresholds during propofol or thiopentone infusions and these are, therefore, unlikely to be associated with clinically relevant hyperalgesia.