British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of atropine and glycopyrrolate on suxamethonium-induced changes in cardiac rate and rhythm.
The effectiveness of atropine and glycopyrrolate in the prophylaxis of suxamethonium-induced bradycardia was evaluated in a double-blind study of 56 patients. Three had clinically demonstrable bradycardia, all having received atropine. We conclude that glycopyrrolate offered adequate protection against cardiac effects of repeated doses of suxamethonium.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind comparison of meptazinol with pethidine in postoperative pain.
Three groups each of 24 patients who had undergone total abdominal hysterectomy were studied on the 1st day after operation. Under double-blind conditions, group 1 compared meptazinol 60 mg with pethidine 100 mg, group 2, meptazinol 75 mg with pethidine 100 mg and group 3, meptazinol 100 mg with pethidine 100 mg. ⋯ From the pain relief score, pethidine was not significantly better than any dose of meptazinol in relieving pain. Patients preferred pethidine 100 mg to meptazinol 60 mg (P less than 0.01, McNemar's test), but there was no significant difference between meptazinol and pethidine for observer or patient preference when the dose of meptazinol was increased to 75 mg or 100 mg.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Ventilatory depression of the newborn of women receiving pethidine or pentazocine. A double-blind comparative trial.
Forty-two women at term received pethidine 100 mg and 43 received pentazocine 45 mg, both given in a double-blind randomized manner. There was no difference in analgesic effect between the groups, but twelve patients were judged to need more than one injection of pentazocine, compared with seven in the pethidine group. The Apgar scores at 1 and 5 min were significantly less in the pethidine group. ⋯ Vigorous ventilation was even more pronounced when naloxone was given indicating an analeptic effect when two drugs with antagonistic activity are combined. At no time was transcutaneous PO2 less than 6.1 kPa. We conclude that both pethidine and pentazocine produce adequate pain relief during labour, but more than one injection of pethidine is associated with greater neonatal depression.
-
We report the extradural administration of low-dose morphine in 10 ml of 10% dextrose (2-3 mg) to 98 adult patients with various types of acute and chronic pain. Extradural morphine injections were given either via a Tuohy needle (single or repeat injection) or via an extradural catheter. Pain relief was evaluated by subjective scoring and by the subsequent need for systemic analgesics. ⋯ The analgesia of each dose of extradural morphine lasted for 8 h (mean range 4-36 h). There was no motor, sensory or sympathetic blockade and no respiratory or haemodynamic complications. Dizziness and vomiting occurred in two patients, and urinary retention for about 12 h in three.
-
The human intercostal space has been studied by excision of the posterior part of the rib cage at autopsy, followed by fixation, decalcification, section and staining. Injection of India ink was used to simulate local anaesthetic. At a point 7 cm from the midline, the distance from the posterior aspect of the rib to the pleura averaged 8 mm. ⋯ An injection of 3 ml will also spread medially to enter the paravertebral space and surround the sympathetic chain. A small clinical study gave excellent analgesia after operation for a mean duration of 12.3 h following unilateral intercostal block with 3 ml of bupivacaine 0.5% (with adrenaline) into each of the intercostal spaces T5-11, before cholecystectomy through a subcostal incision. There were no complications in the series.