Anaesthesia
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Randomized Controlled Trial Clinical Trial
Continuous blockade of the lumbar plexus after knee surgery--postoperative analgesia and bupivacaine plasma concentrations. A controlled clinical trial.
In a double blind, randomised, controlled investigation the analgesic effect of a continuous block of the lumbar plexus with bupivacaine compared with sodium chloride was examined in 20 patients with postoperative pain after knee-joint surgery. The infusion was given through a catheter inserted in the neurovascular fascial sheath of the femoral nerve, according to the three-in-one block technique. The patients treated with bupivacaine had significantly lower pain scores and a significantly lower demand for morphine. Side effects related to the catheters or the infusions of bupivacaine were not observed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Alkalinized bupivacaine and adrenaline for epidural caesarean section. A comparison with 0.5% bupivacaine.
Twenty-four mothers received either 0.5% bupivacaine (group 1, n = 14), or alkalinized 0.5% bupivacaine and 1 in 200,000 adrenaline (group 2, n = 10), as an epidural local anaesthetic for elective lower segment Caesarean section in a randomised, double blind study. The two groups were prepared for surgery according to an identical technique. Onset of analgesia to pinprick was significantly faster in group 2 (p less than 0.02). ⋯ Onset of motor blockade was significantly faster in group 2 (p = 0.01). There were no significant differences between the two groups with regard to duration of surgery, or Apgar scores at 1 and 5 minutes. Alkalinized 0.5% bupivacaine and adrenaline was superior to 0.5% bupivacaine for epidural Caesarean section.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylaxis against acid aspiration syndrome. Single oral dose of H2-antagonist on the evening before elective surgery.
We have compared famotidine 40 mg, ranitidine 300 mg and placebo given in a single oral dose at 2200 hours as the sole means of prophylaxis in 286 patients who underwent elective surgery the following day. Standardised premedication was administered and anaesthesia induced. ⋯ The proportions of patients considered 'not at risk' (pH greater than 2.5) were 90% after famotidine, 91% after ranitidine and 52% after placebo. We conclude that the administration of a potent H2-antagonist in a single oral dose at night offers a convenient routine means of providing extensive prophylactic cover in patients scheduled to undergo elective surgery the following day.
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Randomized Controlled Trial Clinical Trial
Rectus sheath block for diagnostic laparoscopy.
Sixty adult females of ASA grade 1 or 2 scheduled to undergo diagnostic laparoscopy were allocated randomly to one of two groups. In group A, laparoscopy was performed with a standardised general anaesthetic technique alone. ⋯ Postoperative analgesia was assessed at 1, 6 and 10 hours after operation. Visual analogue pain scores in group B were significantly lower than in group A despite a greater use of intramuscular analgesic injections in group A (p less than 0.005 in each case).
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Randomized Controlled Trial Comparative Study Clinical Trial
Anaesthetic induction with isoflurane or halothane. Oxygen saturation during induction with isoflurane or halothane in unpremedicated children.
The authors performed a randomised, prospective trial in which one junior anaesthetist administered gaseous induction of anaesthesia to 50 unpremedicated children with either isoflurane or halothane in nitrous oxide and oxygen. Arterial oxygen saturation and the electrocardiogram were monitored and the incidence of complications noted. ⋯ Coughing, movement, laryngospasm and sinus tachycardia occurred more frequently with isoflurane. Isoflurane inductions took longer (7.9 as compared with 5.4 minutes, p less than 0.001) and had 4.25 times the number of complications.