Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the vasodilatation produced by two topical anaesthetics.
The vasoactive properties of EMLA (eutectic mixture of local anaesthetic) and amethocaine were compared using Doppler colour ultrasound to measure vein diameter in 20 male volunteers. EMLA or amethocaine cream were applied over veins on the dorsum of the hand and vein diameter was measured prior to application of the preparations and at 1, 1.5 and 2 h after removal. ⋯ The results showed no significant difference in vein diameter between the EMLA and amethocaine groups. However, the amethocaine-treated hands were significantly more erythematous at 1 h (p < 0.00002).
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Randomized Controlled Trial Clinical Trial
Development and evaluation of combined rectus sheath and ilioinguinal blocks for abdominal gynaecological surgery.
We describe the development of a technique of combined rectus sheath and ilioinguinal blocks for patients undergoing abdominal gynaecological surgery, and its use in a series of 37 patients (21 midline and 16 transverse incisions). Up to 60 ml of bupivacaine 0.25% with adrenaline 1:400,000 was used, depending on the patient's weight. ⋯ Six-hourly pain scores within the first 48 h after surgery were < or =1 (mild pain) in 11 out of 21 (52%) and < or =2 (moderate pain) in 18 out of 21 (86%) patients with midline incisions and in 5 out of 16 (31%) and 13 out of 16 (81%) patients with transverse incisions, respectively. No patient had emetic symptoms worse than mild nausea during the 48-h postoperative study period.
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Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown to be important causative factors. ⋯ It would appear, however, that high intracuff pressure is associated with nerve palsies due to neuropraxia and nerve compression. Careful insertion techniques for both the tracheal tube and laryngeal mask are of paramount importance in the prevention of airway trauma and postoperative sore throat.
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Randomized Controlled Trial Clinical Trial
Effects of nitrous oxide on haemodynamic and electroencephalographic responses induced by tetanic electrical stimulation during propofol anaesthesia.
We studied the effect of nitrous oxide on haemodynamic and electroencephalographic responses caused by noxious stimulation during propofol anaesthesia. Thirty-four patients (ASA I-II) were anaesthetised with propofol 3 mg x kg(-1) and were randomly allocated to receive either 60% nitrous oxide in oxygen or 40% oxygen in air. ⋯ Tetanic stimulation significantly increased blood pressure and heart rate in both groups (p < 0.005 or less), but did not induce any arousal pattern on the electroencephalograph. Nitrous oxide significantly attenuated the tetanic stimulation-induced increase in blood pressure (p < 0.05 or less), but not the heart rate.