British journal of anaesthesia
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This study reports the experience of a department of paediatric anaesthesia with 234 continuous extradural anaesthetics performed in 229 children over a 15-month period. Fifty-nine of the children were aged 0-2 yr, 71 were aged 2-8 yr and 104 were older than 8 yr. The surgical procedures lasted more than 60 min (mean 150 +/- 10.6 min); all were carried out under light general anaesthesia. ⋯ After extradural anaesthesia with 0.25% bupivacaine with adrenaline 1:200000, minimal changes in HR or SAP occurred in children younger than 8 yr; in those older than 8 yr a significant decrease in both HR and SAP was observed. Changes in SAP were at their maximum 25 min after the extradural block and changes in HR were not statistically significant before the 25th min following injection of local anaesthetic. The catheter remained in place in 155 children for postoperative analgesia, mainly for the first 48 h.
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The dimensions of currently available spinal needles (0.7 mm (22-gauge) to 0.45 mm (26-gauge) external diameter) were measured and compared with the International Standard (ISO 7864-1984 E). The in vitro performance of the needles was assessed by comparing times to appearance of cerebrospinal fluid and flow rates through the needles. There were wide variations in the measurements and performance of the different needles.
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Randomized Controlled Trial Comparative Study Clinical Trial
Maternal and neonatal responses to alfentanil administered before induction of general anaesthesia for caesarean section.
The cardiovascular response to tracheal intubation was compared in two groups of patients undergoing elective Caesarean section. Both groups received a standard technique of general anaesthesia. ⋯ No adverse effect on the neonate was seen. However, a significant increase in the incidence of postoperative nausea occurred in mothers in the alfentanil group (P less than 0.05).
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Randomized Controlled Trial Clinical Trial
Use of neostigmine in the antagonism of residual neuromuscular blockade produced by vecuronium.
Recovery from neuromuscular block produced by vecuronium was studied in 50 patients using electromyography and the train-of-four technique. Twenty patients received neostigmine 2.5 mg, 10 when the initial response of the train-of-four was 50% of control and 10 when it was 10%. ⋯ Neostigmine significantly reduced the time to 70% recovery of both ratios with both degrees of block, but neostigmine 5.0 mg did not give a substantially more rapid recovery than 2.5 mg. No evidence of a neostigmine-induced block was encountered. neostigmine 2.5 mg was rapidly effective in antagonizing vecuronium-induced block, even when initial recovery was only slight: there was no advantage in using neostigmine 5.0 mg.