Anaesthesia
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Comparative Study
The effects of speed of injection on induction with propofol. A comparison with etomidate.
One hundred and eighty female patients received either propofol 2.5 mg/kg or etomidate 0.3 mg/kg injected over 20, 40 or 80 seconds for induction of anaesthesia after premedication with temazepam 20 mg. The mean induction times for both etomidate and propofol were significantly reduced with increasing speed of injection. The mean induction times for etomidate were significantly less than propofol at the slower rates of injection. ⋯ Apnoea occurred significantly more frequently with propofol than with etomidate at each speed of injection and the incidence of apnoea greater than 60 seconds with propofol was significantly higher when injected over 20 seconds than 80 seconds. The incidence of pain on injection was unaffected by injection speed for either drug. The incidence of myoclonus and (or) hypertonus was significantly higher following etomidate.
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Comparative Study
Fluid flow through dural puncture sites. An in vitro comparison of needle point types.
Leakage of artificial cerebrospinal fluid through human dura was measured in vitro after puncture by spinal needles. Fluid loss tailed off in all cases and ceased within 5 minutes in 10% of punctures made with a 22-gauge needle, 28% made with a 26-gauge and 65% made with a 29-gauge needle (p less than 0.05). ⋯ Leakage rate was related to needle size, but not related to the alignment of a Quincke point. Little or no leakage occurred with 29-gauge needles.
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Spinal anaesthesia was used for 25 infants who were born prematurely and who subsequently required inguinal herniotomy. Hyperbaric bupivacaine 0.5% was administered in a dose of 0.3 mg/kg. ⋯ Spinal anaesthesia is a safe and effective alternative to general anaesthesia in these high-risk infants. However, postoperative apnoea monitoring is still essential for all infants born prematurely.