Anaesthesia
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A questionnaire study was undertaken to assess the influence of recently published, simple and conclusive research on the practice of anaesthetists in four centres. The research had clearly demonstrated the benefit of subcutaneous infiltration of local anaesthetic in reducing the pain of intravenous cannulation. Of the 81% who responded, 71% were aware of the research; 43% of these anaesthetists had altered their clinical practice as a result of the research and 73% used local anaesthesia for cannulae of 18 gauge or less, compared with only 46% of those who were unaware of the research. ⋯ Senior house officers were significantly less likely to be aware of the research than other grades. Anomalies were identified between the apparent awareness of the research and routine practice agreeing with the study findings. The value of research and the incorporation of clinical findings into everyday practice is discussed.
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Letter Randomized Controlled Trial Comparative Study Clinical Trial
Fentanyl versus morphine for patient-controlled analgesia.
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Randomized Controlled Trial Clinical Trial
The influence of nitrous oxide on propofol dosage and recovery after total intravenous anaesthesia for day-case surgery.
We studied the influence of nitrous oxide on the maintenance dose of propofol and recovery characteristics in 42 patients, aged 18-62 years, ASA 1 or 2, scheduled for day case inguinal herniotomy. Using a double-blind, randomised design, patients received anaesthesia with propofol-alfentanil-vecuronium-oxygen and either nitrous oxide or room air (FIO2 = 0.30). The rate of propofol infusion was adjusted depending on anaesthetic depth as judged using standard clinical criteria; alfentanil was administered on a weight basis. ⋯ In the nitrous oxide group the mean (SD) interval to spontaneous eye opening was 13.1 (7.3) min compared to 8.1 (4.9) min in the air group (p = 0.01). Similarly, the interval until obtaining a standardised response was 13.5 (5.3) min and 9.8 min (5.4) in the nitrous oxide and air groups, respectively (p = 0.04). The addition of nitrous oxide to propofol-alfentanil-vecuronium anaesthesia does not reduce propofol requirements and prolongs early recovery compared to air.