British journal of anaesthesia
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A questionnaire was mailed to 182 attendees of four practical workshops on fibreoptic endoscopy. After the workshops, 35% of the attendees were able to introduce fibreoptic intubation into their clinical practice or improve their success rate. This suggests that a new psychomotor skill can be disseminated effectively to clinicians by a practical workshop that utilizes inanimate models, and is based on sound educational principles.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effects of extradural clonidine with those of morphine on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block.
We have examined the effects of extradural clonidine 150 micrograms or morphine 4 mg on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block in a double-blind, randomized study in 20 patients undergoing hysterectomy with general anaesthesia. Observations were made for 6 h after each patient's first request for analgesia. Clonidine provided greater pain relief than morphine only for the first 2 h of observation (P less than 0.001). ⋯ After clonidine, mean arterial pressure decreased from 100 (SEM 3) mm Hg to 70 (3) mm Hg (P less than 0.05), but there was no change after morphine. There were no significant changes in heart rate, pulmonary function (FEV1), motor function or sensory analgesia to touch, temperature and pinprick in both groups. Additional systemic opioids were required by five and six patients in the clonidine and morphine groups, respectively.
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Clinical Trial Controlled Clinical Trial
Continuous infusion of mivacurium in children.
Mivacurium is a new short-acting competitive neuromuscular blocking agent. Infusion requirements for the maintenance of a stable 90-99% muscle twitch depression were determined in 28 children anaesthetized with nitrous oxide and 1% halothane (inspired) in oxygen or nitrous oxide in oxygen and opioid. Neuromuscular block was assessed by monitoring the force of contraction of the adductor of the thumb during train-of-four (TOF) stimulation at 0.1 Hz. ⋯ There was no significant correlation between infusion rates required to maintain greater than 90% depression of the first twitch (T1) of the TOF and plasma cholinesterase concentrations. Regardless of the anaesthetic regimen, children recovered rapidly after discontinuing the infusion. The recovery index (25-75% recovery of T1) for all patients was 5.4 (0.57) min with no significant differences between the groups.
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A 55-yr-old man received a left supraclavicular brachial plexus block with 0.42% bupivacaine; he had profound motor and sensory block 26 h after injection; complete recovery occurred at 40 h.