British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Neuromuscular blocking effects of vecuronium and pancuronium during halothane anaesthesia.
The neuromuscular blocking properties of vecuronium (Org NC 45) and pancuronium were compared in 40 patients during halothane anaesthesia. Onset time was found to be dose-dependent, but no significant difference was found between the two drugs. ⋯ Recovery indices following both doses of vecuronium (10.0 min and 11.8 min) were significantly shorter than after pancuronium (31.0 min and 46.9 min). The reversal times of vecuronium (times from 10% to 90% twitch height recovery) were significantly shorter than those of pancuronium (7.9 min and 7.3 min, respectively, compared with 17.1 min and 17.7 min).
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Comparative Study
Simultaneous variations of PaCO2 and PACO2 in assisted ventilation.
Thirty-two patients receiving artificial ventilation of the lungs were studied to determine if variations in PACO2 could be reflected in variation in PaCO2. Eleven patients had chronic obstructive lung disease, eight had suffered acute respiratory failure, and 13 had neurological disturbances but normal lungs. ⋯ Change in PaCO2 induced by ventilatory change and by change in inspired carbon dioxide concentration were well described by linear regression of PaCO2 on PaCO2. In patients with chronic lung disease, (PaCO2-PACO2) was the same at all values of PACO2 whereas, in the other patients the ratio PaCO2/PACO2 did not change.
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Continuous intercostal nerve blockade was used to provide analgesia after cholecystectomy. The blockade was maintained by the insertion of a single extradural catheter into an appropriate intercostal space and by "topping-up" with local anaesthetic on demand. ⋯ A mean improvement of 37% on pre- "top-up" peak flows, was found. It is suggested that continuous intercostal analgesia is a a safe, reliable and powerful form of analgesia which may improve respiratory function after cholecystectomy.
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Comparative Study
Comparison of the fresh gas flow requirements and resistance of the Preferential Flow System with those of the Magill system.
The fresh gas flow requirements of the Preferential Flow System have been compared with those of the Magill system in spontaneously breathing volunteers and found to be similar. A lower resistance to expiration was found with the Preferential Flow System and the effectiveness of the valveless method of flow direction was demonstrated.
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The effect of increasing end-tidal enflurane concentration on the auditory evoked response was studied in six patients. After a standard induction, anesthesia was maintained with 70% nitrous oxide in oxygen and the end-tidal enflurane concentration was increased gradually from 0 to 1% over a period of 30 min. ⋯ These results could not be explained by changes in deep body temperature or end-tidal carbon dioxide concentration. The study demonstrated a dose-related direct effect of enflurane on the brainstem and early cortical components of the auditory evoked response.