Anaesthesia
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Randomized Controlled Trial Clinical Trial
The effect of prophylactic clonidine on postoperative shivering. A large prospective double-blind study.
The primary goal of this study was to assess the influence of clonidine administered after induction on postoperative shivering after elective peripheral surgery. The effect of clonidine on intra-operative haemodynamics (blood pressure and heart rate) during the first 30 min after induction and on the postoperative sedation of the patient was also investigated. ⋯ Clonidine did not increase postoperative sedation or diminish overall consciousness. We conclude that administration of clonidine 2 micrograms.kg-1 intravenously after induction of anaesthesia is safe and reduces postoperative shivering in this group of patients.
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Comparative Study
A comparison of retrospective versus contemporaneous nausea scores with patient-controlled analgesia.
In the search for an effective method of reducing the incidence of postoperative nausea, a standardised system of patient assessment is required. We examined 76 patients who had undergone elective total abdominal hysterectomy and were receiving patient-controlled analgesia with morphine. Nausea scores were obtained using an 11-point rating score. ⋯ Maximum contemporaneous score showed greater agreement with the retrospective score than did the median, mean, or minimum contemporaneous score. Collectively, these results suggest that patients tend to remember their episodes of nausea vividly, even if these episodes were punctuated by relatively nausea-free periods. The variability between the two sets of results suggests that contemporaneous and retrospective nausea scores should not be used interchangeably.
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Fifty-four patients, aged 27-90 years, who were given lignocaine 5% in 6.8% glucose solution for spinal anaesthesia were studied. Thirteen of these patients experienced pain in the legs and/or back after recovery from anaesthesia. ⋯ Five of the 13 patients (38%) with pain and seven of the 41 patients (17%) without pain admitted to a high alcohol intake, which might be a contributing factor. Leg and/or back pain is associated with the intrathecal use of hyperbaric 5% lignocaine.
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Forty adult patients had a gum elastic bougie passed blindly through a laryngeal mask on two occasions, after standard insertion, and after the application of cricoid pressure with manual in line stabilisation of the neck. After standard insertion the bougie entered the trachea on 11/40 occasions. ⋯ These results were not statistically significant. Blind passage of a gum elastic bougie through a laryngeal mask does not provide a reliable route into the trachea in either of the circumstances studied.
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A postal survey of 801 members of the Obstetric Anaesthetists Association was carried out in the United Kingdom and Ireland to investigate the use of surgical facemasks whilst performing spinal and epidural blocks. Two hundred and twenty three out of 539 respondents (41.3%) routinely wore masks for both spinals and epidurals; 22 (4.1%) wore masks only for epidurals; 21 (3.9%) wore masks only for spinals and 273 (50.6%) did not wear masks for either spinals or epidurals. Fifty out of 240 (21%) of those who routinely wore masks did not believe that wearing a mask reduced the risk of infection. Only 83 out of 259 (32%) mask wearers changed their masks between cases.