Anaesthesia
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Randomized Controlled Trial Clinical Trial
The respiratory effects of tramadol in children under halothane an anaesthesia.
In a randomised double-blind, placebo-controlled study, the respiratory effects of intravenous tramadol (1 mg or 2 mg.kg-1) were compared with intravenous pethidine 1 mg.kg-1 under halothane anaesthesia. Children, ASA 1-2 between 2 and 10 years, presenting for inguinal surgery were studied. Once a steady state for halothane was reached, baseline recordings of end-tidal carbon dioxide, oxygen saturation, respiratory rate, tidal volume, minute volume, blood pressure and pulse rate were recorded. ⋯ A lower intensity of pain in the first 2 h was noted in the three opioid groups. During the first 6 h, the proportion of patients requiring a further dose of analgesia was highest in PL and lowest in T2. Tramadol appears safe for use in children.
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Randomized Controlled Trial Clinical Trial
Postoperative intrathecal patient-controlled analgesia with bupivacaine, sufentanil or a mixture of both.
In a randomised double-blind study, 45 patients, scheduled for major orthopaedic surgery under continuous spinal anaesthesia, received for relief of postoperative pain patient-controlled analgesia with either sufentanil 2 micrograms.ml-1, bupivacaine 0.0625% or a mixture of both by the intrathecal route. The mean (SD) consumption of sufentanil and bupivacaine during the first 12 h was 65.5 (27.1) micrograms and 18.2 (4.8) mg, respectively. Combining bupivacaine and sufentanil reduced the consumption of both to approximately 40% as compared to the administration of each component separately. ⋯ Tachyphylaxis did not occur. It was concluded that the groups receiving plain bupivacaine and sufentanil alone experienced pain relief of good quality. The use of a mixture, however, accelerated the onset of analgesia, improved the analgesic quality and reduced the doses for both components by 60% but at the expense of a higher incidence of nausea and vomiting.
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This study measures the anxiety levels in 100 parents of children scheduled for elective surgery at the Royal Aberdeen Children's Hospital. Anxiety levels were quantified using the Leeds scale for self-assessment of anxiety. ⋯ The 'anxious' parents were specifically more anxious about the surgery, anaesthesia, postoperative pain and treatment, and hospitalisation in general. All parents, whether identified as anxious or not, agreed on factors likely to reduce anxiety: pre-operative information from staff, being able to accompany their child to the operating theatre and being present at induction of anaesthesia.
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The Combitube is a twin lumen device designed to establish the airway after blind insertion. Under general anaesthesia a rigid cervical collar was used to immobilise the neck in 15 ASA 1 and 2 patients. Insertion of the Combitude airway was then attempted. ⋯ Ventilation was satisfactory in all patients when insertion was successful. Blood staining of the Combitube was present in 7/15 (47%) patients. The Combitude cannot be recommended for use in patients whose necks are immobilised in rigid cervical collars.