Anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Non-parenteral postoperative analgesia. A comparison of sublingual buprenorphine and morphine sulphate (slow release) tablets.
Sixty-nine patients undergoing upper and lower abdominal surgery were studied after operation to compare the analgesic effects of sublingual buprenorphine (0.4 mg) and slow release morphine sulphate tablets (MST, 20 mg) given 6 hourly in a double-blind, double-dummy trial. Both MST and buprenorphine produced satisfactory postoperative analgesia but the linear analogue pain scores were significantly lower on the second post operative day with MST.
-
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.
-
The accuracy of the Dinamap 845 automatic blood pressure recorder was assessed by comparing its own indirect determinations of blood pressure with direct intra-arterial recordings. It was found that in the majority of cases it was capable of producing reliable trend information during anaesthesia. The instrument may not be able to interpret pressure signals from a patient with a severe dysrhythmia. It is probably an unsuitable monitor for use with very rapidly acting drugs such as sodium nitroprusside.
-
In investigating the possible causes of an observed complication of intravenous regional anaesthesia, cubital fossa venous pressures were measured distal to an inflated tourniquet as standard 40 ml volumes of normal saline were injected. The maximal pressures obtainable were limited by tourniquet pressure since the veins compressed under the tourniquet acted as 'Starling' spillover resistors. ⋯ The rates of rise and maximum values of venous pressures tended to be increased by increased injection rates, and by failure to exsanguinate the arm, but the choice of injection site was paramount. Compared with more distal injections, cubital fossa venous injections are more likely to lead to leakage under the tourniquet and should never be used for intravenous regional anaesthesia.