Anaesthesia
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A case of unsuspected acute amphetamine abuse by a 22-year-old girl which led to serious intracranial hypertension during anaesthesia for a neurosurgical procedure is described. It was difficult to maintained anaesthesia with an intermittent positive-pressure ventilation technique using muscle relaxants, N2O and O2 and supplements of fentanyl despite large doses of pancuronium and fentanyl. The differing effects of chronic and acute amphetamine dosage on anaesthetic requirements are reviewed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Extradural analgesia in labour. A comparison of 2-chloroprocaine hydrochloride and bupivacaine hydrochloride.
Chloroprocaine hydrochloride 2% and bupivacaine hydrochloride 0.375% in 10-ml doses of plain solutions were studied in a randomised blind manner as the agents for continuous lumbar extradural analgesia in labour. Twenty-four patients were assessed for the speed of onset, duration of action, degree of motor blockade, dermatomal spread, arterial hypotension, and the incidence of unblocked segments. ⋯ Chloroprocaine exhibited more marked motor blockade and a lower incidence of unblocked segments. The dermatomal spread and effect on arterial pressure were similar in both groups.