British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Effects of intrathecal morphine, injected with bupivacaine, on pain after orthopaedic surgery.
Morphine hydrochloride 0.4 mg was administered with isobaric 0.5% bupivacaine intrathecally for orthopaedic surgery and produced good analgesia for about 24 h after operation in both elderly (60-80 yr) and middle-aged patients (30-50 yr). Morphine 0.2 mg (older patients only) was not as effective in preventing pain after operation, but even this dose postponed the requirement for analgesia. Morphine did not change the quality of spinal anaesthesia. ⋯ Severe delayed respiratory depression was not noted. Urinary retention and minor voiding difficulties were the most disturbing side-effects. This complication did not appear to be dose-dependent, and also occurred in patients not receiving morphine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single injection spinal anaesthesia with amethocaine and morphine for transurethral prostatectomy.
The intrathecal administration of amethocaine plus morphine as an anaesthetic technique for providing surgical anaesthesia and postoperative analgesia was evaluated in 24 patients undergoing transurethral resection of the prostate. The efficacy of the technique was compared with that observed following spinal anaesthesia with amethocaine alone. ⋯ In group II the addition of morphine 1 mg to the amethocaine produced excellent surgical anaesthesia and postoperative analgesia and these patients had significantly less postoperative pain than the patients who received amethocaine alone. There was a high frequency of side-effects associated with intrathecal morphine in group II, for example, subtle respiratory depression, nausea, vomiting and pruritus.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiac arrhythmias during outpatient dental anaesthesia: comparison of halothane with enflurane.
In 75 young female patients undergoing extraction of 3rd molar teeth during halothane or enflurane anaesthesia, the electrocardiogram was recorded on magnetic tape and analysed subsequently for arrhythmias, using a high-speed analyser. Enflurane induced a much lower frequency of arrhythmia during surgery than halothane, but there was otherwise little difference between the two drugs in the quality of anaesthesia or recovery. Many arrhythmias occurred before exposure of the patient to enflurane or halothane; the significance of this is discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of flupirtine maleate and dihydrocodeine in patients following surgery.
Flupirtine maleate 100 mg was compared with dihydrocodeine 60 mg when given by mouth to 50 women on the first 3 days following abdominal hysterectomy in a double-blind parallel-group trial. The analgesia produced was similar for both preparations, and the consumption of active drug was the same in both groups. The only significant differences in side-effects were an increased frequency of depression in patients receiving flupirtine and of sleepiness in those receiving dihydrocodeine.
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Clinical Trial Controlled Clinical Trial
Metoprolol, fentanyl and stress responses to microlaryngoscopy. Effects on arterial pressure, heart rate and plasma concentrations of catecholamines, ACTH and cortisol.
Forty patients undergoing microlaryngoscopy were anaesthetized with thiopentone and nitrous oxide. Twenty patients received metoprolol 200 mg in a slow-release tablet once daily for 4 days up to, and including, the morning of operation, and 10 mg i.v. shortly before induction of anaesthesia. The other patients received placebo tablets and physiological saline i.v., instead. ⋯ Arterial plasma noradrenaline concentrations during microlaryngoscopy were enhanced by metoprolol, in comparison with placebo, the reverse being the case for cortisol concentrations. Fentanyl decreased arterial pressure and plasma ACTH and cortisol concentrations regardless of whether the patient had received metoprolol. Plasma adrenaline and noradrenaline concentrations were decreased by fentanyl in the patients receiving metoprolol.