Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Less pain on injection by a new formulation of propofol? A comparison with propofol LCT].
Pain on injection is a major disadvantage of propofol, experienced by the vast majority of patients. Since the traditional formulation has almost normal osmolality and pH, it is hypothesised that the concentration of free propofol in the aqueous phase of the emulsion is responsible for the pain and that reducing the amount of free propofol would also reduce the frequency and intensity of pain on injection. This study was designed to investigate whether pain on injection can be reduced in frequency and intensity by a new formulation of propofol. ⋯ Propofol-MCT/LCT produced significantly less pain on injection when compared to standard propofol in ASA I and II patients undergoing elective surgery. Pain was also significantly less severe, with both effects presumably being due to the lower concentration of free propofol in the MCT/LCT-preparation. With regard to injection pain propofol-MCT/LCT offers significant a advantage over standard propofol.
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Regional analgesia provides effective pain relief during delivery. Postpartal neurological deficits may be due to pressure of the fetal head on nerve structures at the pelvic rim or may be a complication of epidural analgesia. ⋯ This case report describes the differential diagnosis of neurological deficit after spontaneous delivery under epidural analgesia and a discussion of the recent literature. Finally recommendations for the treatment of neurological deficits after delivery under epidural analgesia are presented.
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Just three months after the first application of sulphuric ether to a patient in german-speaking countries the monography Die Wirkung des Schwefeläthers in chemischer und physiologischer Beziehung was published. In this book Ernst von Bibra and Emil Harless presented their experimental research on the effects of ether on humans and compared it to those on animals. ⋯ The authors "Theory on the action of ether" will be discussed in the context of contemporary criticism. Their hypothesis affected the discussion on the mechanisms of anaesthetic action up to the twentieth century.