Anaesthesia
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Comparative Study
Forum. Femoral neck surgery using a local anaesthetic technique.
Thirty cases of femoral sub-capital fractures, Garden grades 1-4, were reduced and internally fixed with crossed Garden screws using femoral nerve block. In addition, sedation and analgesia was provided by low dose ketamine and diazepam. No deaths or other complications occurred in these patients. In a similar group of patients who received spinal analgesia in the same unit under similar conditions there was one death and two cerebrovascular accidents.
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Randomized Controlled Trial Clinical Trial
Second stage of labour with or without extradural analgesia.
Two groups of parturients who had received selective extradural analgesia were studied. In Group A patients the regional block was allowed to wear off for the second stage of labour whereas in Group B patients' analgesia was maintained throughout labour. The maintenance of selective analgesia was of positive benefit to the mothers. They experienced much less pain, labour was not prolonged, dosage of bupivacaine was not increased, the forceps delivery rate was lower and there were fewer persistent malrotations.
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Neurogenic pulmonary oedema is a not uncommon condition with a mortality that may exceed 90%. A fatal case in a 17-month-old child is reported. The literature is reviewed and current theories of the pathogenesis presented. Suggestions are made on how the condition might best be managed.
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Comparative Study
Penile block for circumcision? A comparison with caudal blockade.
A prospective blind trial was conducted comparing the analgesia and adverse effects produced by caudal extradural blockade (caudal block) with blockade of the dorsal nerves of the penis (penile block) in 38 boys undergoing elective circumcision. Analgesia was assessed by senior nurses using a linear analogue scale and by the response to direct questioning over the first 7 hours after surgery. ⋯ One technical failure occurred in the penile block group. It is concluded that a penile block is a satisfactory alternative to caudal blockade with regard to postoperative analgesia and offers several specific advantages.