British journal of anaesthesia
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Comparative Study
An investigation in man into the relative potency of lignocaine, bupivacaine and etidocaine.
The relative potency of lignocaine, bupivacaine and etidocaine was estimated by forearm skin weals in four volunteers. Potency was estimated as the time to half-recovery of a sharp sensation in response to a needle-prick. ⋯ At the same concentrations, bupivacaine had a longer duration of action than etidocaine. However, etidocaine 1% had a longer duration of action than bupivacaine 0.5%.
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The effect of tubocurarine on the respiratory function of conscious, non-medicated volunteers was correlated with the degree of neuromuscular blockade measured with the train-of-four technique (the evoked response of the adductor pollicis brevis muscle to trains of four supramaximal ulnar nerve stimuli at 2 Hz, repeated once every 10 sec). Respiratory frequency, tidal volume, vital capacity, inspiratory force and peak expiratory flow rate were measured, (a) before administration of tubocurarine, (b) when the ratio of the amplitude of the fourth response to the amplitude of the first response of the train-of-four reached 60%, and (c) during recovery of the ratio until the control (100%) value was reached. ⋯ Vital capacity and inspiratory force were both reduced significantly at the 60% level and the former also at the 70% level when compared with the control. The magnitude of change in all variables is of minor clinical importance, however, since the lowest measured values are well above acceptable minimum limits required for adequate respiratory function.
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One hundred consecutive reports of reactions to intravenous anaesthetics Althesin, thiopentone and Epontol are reviewed and analysed. Ten reactions are attributed to causes other than the anaesthetic drug, and four are believed to have been caused by the muscle relaxant employed. ⋯ None of the first four reaction types was associated with only one anaesthetic. A knowledge of the sales of Althesin has allowed the incidence of reactions to be estimated as between one in 11,000 and one in 19,000.