Anaesthesia
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Clinical Trial Controlled Clinical Trial
Mandatory sublingual buprenorphine for postoperative pain.
This study examined the analgesic effect, vital signs and side effects when 0.4 mg doses of buprenorphine were given pre-emptively for the treatment of postoperative pain after elective total hip replacement. Pain intensity, pain relief, retrospective peak pain intensity and pain relief, sedation, vital signs and side effects were measured 1 hour after surgery and then in the morning and evening of the first 2 postoperative days. ⋯ However, there was a significant increase in the number of patients with a pulse rate greater than 100 beats per minute. No particular benefit for postoperative pain relief was observed in patients receiving buprenorphine premedication in comparison with those who had received morphine or placebo.
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Case Reports
Extensive spread of local anaesthetic solution following subdural insertion of an epidural catheter during labour.
A case is described where a small dose of bupivacaine was accidentally injected into the subdural, extra-arachnoid space resulting in extensive unilateral block and hypotension. The spread of solution was confirmed radiologically.
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Comparative Study
Continuous monitoring of blood PO2 in extracorporeal systems. An in vitro evaluation of a re-usable oxygen electrode.
The technique of intermittent sampling of blood during extracorporeal circulation and in vitro analysis to establish that the blood-gas status of the patient is within acceptable limits has drawbacks which may be overcome by continuous monitoring. An evaluation of an oxygen monitoring system and a comparison with a blood gas analyser have been performed. ⋯ There was no significant difference between the calculated value and the monitor readings but the blood gas analyser results were significantly lower (p less than 0.01) than the calculated values of the tonometered blood. The reasons for this difference and the potential clinical advantages of continuous monitoring are discussed.
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Comparative Study
Midazolam versus atropine plus pethidine as premedication in children.
The effects of oral midazolam or intramuscular atropine and pethidine used as premedication in two groups of 35 children over 5 years of age were studied. There was some evidence that the anxiolytic effect of midazolam was rather better than that of atropine plus pethidine, but, in other respects, subjective assessments in the two patient groups were similar. ⋯ Oral midazolam is a new anxiolytic drug which can be used as an alternative to existing premedicant drugs, but, in children, it should still be combined with an anticholinergic agent. No correlation between serum levels of midazolam or atropine and their clinical effects was found.