Anaesthesia
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Thirty-five patients were delivered by electric Caesarean section under general or epidural anaesthesia. For postoperative analgesia they received narcotic analgesics as required and either transcutaneous nerve stimulation or an inactive stimulator. ⋯ The epidural patients did not receive any additional benefit from active stimulation, but had the same amount of pain and the same analgesic requirement as patients receiving active stimulation following general anaesthesia. The possible causes for the failure of transcutaneous nerve stimulation after epidural anaesthesia and their implications are discussed.
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Positive pressure created in the epidural space has been used to confirm correct placement of a lumbar epidural catheter in 125 patients.
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Randomized Controlled Trial Clinical Trial
Laparoscopy--a stressful procedure.
The metabolic and hormonal response to laparoscopy was investigated in 22 patients, in whom nitrous oxide-oxygen anaesthesia was supplemented with either 150 micrograms fentanyl or an Althesin infusion. There were significant increases in plasma cortisol (p less than 0.05) from 303 to 458 mmol/litre and prolactin from 1869 to 3918 mU/litre (p less than 0.01) at the end of laparoscopy in both groups of patients; these were sustained during the first hour of the recovery period. ⋯ The blood glucose concentration increased significantly (p less than 0.05) from 4.43 to 5.36 mmol/litre in the fentanyl patients only during the recovery period. There was no significant difference between the metabolic and hormonal changes observed with the two anaesthetic techniques.