Anaesthesia
-
Randomized Controlled Trial Clinical Trial
The effect of glycopyrrolate on postoperative pain and analgesic requirements following laparoscopic sterilisation.
In order to evaluate the contribution of tubal spasm to pelvic pain following laparoscopic sterilisation, we have studied the effect of glycopyrrolate, an anticholinergic agent with antispasmodic properties, on 60 ASA 1 and 2 patients presenting as day-cases for laparoscopic sterilisation using Filshie clips. In a randomised, double-blind, controlled trial, patients received either glycopyrrolate 0.3 mg or saline intravenously prior to induction of anaesthesia. ⋯ Nausea, vomiting and anti-emetic requirements were also reduced though not significantly. We conclude that glycopyrrolate 0.3 mg at induction of anaesthesia is an effective method of improving the quality of recovery after day-case laparoscopic sterilisation using clips.
-
Randomized Controlled Trial Clinical Trial
Respiratory effects of spinal anaesthesia for caesarean section.
We report the changes observed in a number of pulmonary function tests performed on 36 patients undergoing Caesarean section under spinal anaesthesia. The tests comprised peak expiratory flow, forced expiratory volume in one second, forced vital capacity, forced expiratory volume in one second to forced vital capacity ratio and the maximal mid-expiratory flow. ⋯ These changes persisted for four hours after the induction of spinal anaesthesia. Administration of 35% oxygen by facemask failed to change significantly fetal umbilical vein pH or partial pressure of oxygen.
-
Randomized Controlled Trial Clinical Trial
Economics of low-flow anaesthesia in children.
We have measured the consumption of isoflurane and fresh gas flows in 77 infants and children during 20 all-day operating sessions using either the enclosed Mapleson A or the circle absorber mode of the Carden 'Ventmasta' ventilator. The average consumption (SD) of isoflurane in 37 patients anaesthetised using the A mode of the Carden system with a mean fresh gas flow of 2.61 min-1 was 11.1 (4.2) g.h-1, while that in 40 patients anaesthetised using the circle absorber mode with a mean fresh gas flow of 1.21 min-1 was 4.7 (1.0) g.h-1. ⋯ With the addition of small bore breathing hoses the adult circle absorber system was practical to use in both infants and children. These findings should stimulate interest in the use of low-flow techniques in children.
-
Randomized Controlled Trial Clinical Trial
Jaw thrusting as a clinical test to assess the adequate depth of anaesthesia for insertion of the laryngeal mask.
We have studied the efficacy of the loss of response to jaw thrust as a clinical test to assess adequate depth of anaesthesia for insertion of the laryngeal mask in 60 patients. After induction of anaesthesia with propofol (infused using a syringe driver), the patients were randomly allocated to one of two groups. In one group, insertion of the laryngeal mask was attempted immediately after the loss of verbal contact and in the other group, after the loss of motor response to a jaw thrust. ⋯ Conditions were significantly better when jaw thrust was used as a clinical test compared with loss of verbal contact (p < < 0.001). No marked haemodynamic depression occurred in any patient. Thus, jaw thrust is a reliable clinical test to assess the adequate depth of anaesthesia for uncomplicated insertion of the laryngeal mask after induction of anaesthesia with propofol.
-
Clinical Trial Controlled Clinical Trial
Use of a neonatal noninvasive blood pressure module on adult patients.
A clinical and statistical comparison of systolic, mean and diastolic arterial blood pressures was made between a non-invasive technique using a neonatal oscillometric blood pressure monitor attached to the thumb versus an invasive technique using a catheter inserted into the ipsilateral radial artery in 18 patients undergoing general anaesthesia for major surgery. In 1258 readings, the mean differences between the pressures obtained (invasive versus non-invasive) were +9.1, -7.9, and -0.7 mmHg for systolic, diastolic and mean pressures respectively. Oscillometric blood pressure measurement using the thumb appears to be an acceptable method for monitoring blood pressure during anaesthesia and has advantages over conventional cuff placement on the upper arm.