Anaesthesia
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The use of unsheathed non-insulated needles and a nerve stimulator as an aid to peripheral nerve blockade in children has received little attention in the literature. In order to assess the value of such a technique, a study was performed in children presenting for lower limb surgery with no contraindication to femoral and/or sciatic nerve block. Four hundred and eleven children, mean age 4.25 (SD 3.8) years and mean weight 16.8 (SD 9.4) kg, received a total of 883 peripheral nerve blocks: 419 femoral nerve blocks and 464 sciatic nerve blocks. ⋯ The current required to stimulate the more superficial femoral nerve ranged from 0.5-1.0 mA whilst for the deeper sciatic nerve ranged from 1.2-2.0 mA. Staff in training, with little or no experience of the technique, successfully performed 223 nerve blocks in 114 patients under the author's guidance. The overall success rate was 98%, the failures occurring early in the series.
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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 Clinical Trial
The effect of midazolam premedication on implicit memory activation during alfentanil-nitrous oxide anaesthesia.
Eighty-three patients were given midazolam 0.1 mg.kg-1 by intramuscular injection as premedication before general anaesthesia with alfentanil-nitrous oxide. During anaesthesia patients were presented (through headphones) with either statements about common facts of some years ago (group A) (n = 43) or new verbal associations, e.g. names of fictitious, nonfamous people (group B) (n = 40). ⋯ In this study we found no explicit or implicit memory for the auditory information presented during anaesthesia. Midazolam premedication can prevent implicit memory activation during alfentanil-nitrous oxide 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.