British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Clinical studies on Org NC 45: comparison with pancuronium.
Some actions of Org NC 45 have been compared with those of pancuronium in a study on 50 patients anesthetized with nitrous oxide and narcotic supplements. The train-of-four technique was used to assess the recovery of neuromuscular blockade and its antagonism. Org NC 45 was shown to have a duration of action from injection of the intubating dose (0.1 mg kg-1) to the reappearance of the first twitch response of 23.5 +/- 1.1 min; the corresponding time for pancuronium 0.1 mg kg-1 was 50.5 +/- 3.6 min. ⋯ The rate of onset of paralysis of adductor pollicis was faster with Org NC 45 than with pancuronium, but the difference did not reach statistical significance. Satisfactory spontaneous recovery from Org NC 45 blockade could be achieved without undue delay. Org NC 45 was shown to produce significantly less tachycardia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Urinary retention during i.m. and extradural morphine analgesia.
In the postoperative period fifty-six healthy patients undergoing cholecystectomy or operations for duodenal ulcer, received, in a randomized order, i.m., "high-level" or "low-level" extradural morphine. Thirty-five per cent in the i.m. group, 33% in the high-level group and 50% in the low-level group suffered urinary retention, in all cases within the first 24 h. The mean cumulative dose of morphine necessary for pain relief was in the same range (13.4-16.5 mg) during the first 2 h of therapy for all groups, while the amounts after 24 and 48 h were twice to four times with the i.m. route compared with the extradural route. A peripheral effect of morphine on the urinary bladder is possible and the mechanism of action is discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Morbidity in minor gynaecological surgery: a comparison of halothane, enflurane and isoflurane.
A comparison was made between halothane, enflurane and isoflurane with regard to their suitability for minor gynaecological procedures in patients who would be leaving the hospital within 24 h of the anaesthetic. Seventy-five healthy patients were randomly allotted to one of three groups which received one of these anaesthetics. In respect of patient acceptance and postoperative morbidity there were no significant differences between halothane and enflurane, but after isoflurane there was a significantly greater frequency of minor sequelae (headache, nausea, dizziness and coughing) and its pungent odour made it unacceptable to some patients.
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In 30 patients undergoing cardiac surgery, anaesthesia was induced with alfentanil 125 micrograms kg-1 and maintained with an infusion of alfentanil 0.5 mg kg-1 h-1 until the start of cardiopulmonary bypass, and alfentanil 0.25 mg kg-1 h-1 thereafter until the end of surgery. Pancuronium was given and the lungs ventilated with air in oxygen. ⋯ Twenty-six patients required alfentanil supplementation before bypass. These results indicate that anaesthesia with an alfentanil infusion provides satisfactory cardiovascular stability for cardiac surgery.