Anaesthesia
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Randomized Controlled Trial Clinical Trial
Cryoanalgesia for pain after herniorrhaphy.
The effect of freezing the ilioinguinal nerve on postoperative pain relief was examined in a double blind study in 36 patients undergoing herniorrhaphy, randomly allocated into two groups. Patients in the experimental group had their ilioinguinal nerves frozen during surgery and were compared with the patients in the control group who did not have cryoanalgesia. Pain relief was assessed over a 48-hour period in three ways, namely the linear analogue pain scale, peak expiratory flow rates and the amount of analgesic drugs required by patients in the two groups. We conclude that cryoanalgesia of the ilioinguinal nerve alone does not produce significant early post herniorrhaphy pain relief.
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Biography Historical Article
Stanley Rowbotham. Twentieth century pioneer anaesthetist.
Stanley Rowbotham was born in 1890 and spent the first years after qualification in 1915 with the Royal Army Medical Corps (RAMC). His career in anaesthesia began after the Armistice, when he was posted with Ivan Magill to Harold Gillies's plastic surgery unit at Sidcup. ⋯ A versatile and inventive anaesthetist, Stanley Rowbotham later pioneered in the fields of thyroid anaesthesia, basal narcosis, local and intravenous analgesia and in the use of muscle relaxants. He also introduced cyclopropane into this country.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled postoperative analgesia with alfentanil. Adaptive, on-demand intravenous alfentanil or pethidine compared double-blind for postoperative pain.
A double-blind study comparing alfentanil and pethidine given intravenously by an adaptive, patient-controlled on-demand analgesic system is described. It was demonstrated that, despite its well-known rapid onset of effect, alfentanil took several hours to achieve good quality analgesia. ⋯ Alfentanil was associated with significantly less sedation during the postoperative period than pethidine, and was also associated with a significantly greater urine output during the 24-hour period of study. There was no evidence of tolerance or accumulation with either of the two drugs.
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Comparative Study
Induction and recovery characteristics of isoflurane and halothane anaesthesia for short outpatient operations in children.
Induction and recovery characteristics of isoflurane anaesthesia were compared with halothane anaesthesia during outpatient myringotomy and placement of Sheely ventilation tubes in 101 unpremedicated children. Compared with halothane, isoflurane resulted in prolonged induction times and inferior induction scores due to increased salivation, coughing, breathholding and laryngospasm. ⋯ Recovery times from halothane plus isoflurane and pure isoflurane anaesthesia were quicker than pure halothane and thiamylal plus isoflurane, although this was not statistically significant. Compared to halothane, anaesthetic induction using isoflurane is associated with an increased incidence of respiratory problems in unpremedicated children.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between isoflurane and alfentanil supplemented anaesthesia for short procedures.
Sixty unpremedicated patients undergoing short urological and gynaecological procedures were randomly allocated to three groups to receive either methohexitone, alfentanil, nitrous oxide and oxygen, methohexitone, isoflurane and oxygen or methohexitone, isoflurane, nitrous oxide and oxygen. The group receiving methohexitone, isoflurane and oxygen was abandoned after 11 patients had been studied, due to poor conditions during induction of anaesthesia. Therefore, data from only 51 patients are presented. ⋯ The patients in the alfentanil group opened their eyes and gave their names and dates of birth significantly faster postoperatively (p less than 0.01) than those in the isoflurane groups. However, there were no significant differences between the three groups regarding the later tests of recovery. The late recovery after isoflurane was equal to that obtained using an intravenous technique with alfentanil, although the peroperative complication rate was higher.