British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Accelerated recovery from combined atracurium-vecuronium neuromuscular block.
Patients given combinations of non-depolarizing neuromuscular blocking drugs have been reported to recover from neuromuscular block more rapidly than patients given a single drug. This study was designed to assess if this phenomenon occurred with the combination of atracurium and vecuronium. ⋯ All patients had 100% neuromuscular block, and times to block onset did not differ significantly between the three groups. Recovery to 10, 25, 50 and 90% of control twitch height was significantly faster in the group receiving the combination of drugs.
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A new approach is described to the neurolytic block of the coeliac plexus through the anterior abdominal wall using ultrasonic guidance. In nine patients, ultrasound was used for needle placement and examination of the spread of injection. ⋯ No serious complications were observed. The anterior approach is simple and useful in those patients with chronic pancreatic pain undergoing biopsy of the pancreas, and in those terminally ill or heavily sedated patients who have difficulty in tolerating the prone flexed position.
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Twenty-nine patients (age range 14-81 yr) undergoing orthopaedic surgery received alfentanil 100 micrograms kg-1 given as two i.v. boluses followed by a fixed rate infusion of 1 micrograms kg-1 min-1 for 44-445 min. Additional 1-mg bolus doses of alfentanil were administered as required. Plasma samples were assayed for alfentanil using radioimmunoassay. ⋯ For patients older than 40 yr, T 1/2 beta increased linearly with age. There was no significant decrease in Cl with age, although the lower values for Cl (100-200 ml min-1) were generally found in subjects older than 60 yr. The present study demonstrated that a 100-micrograms kg-1 loading dose and a 1-micrograms kg-1 min-1 infusion may be appropriate for analgesia in general surgical procedures.
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Randomized Controlled Trial Clinical Trial
Awareness following different techniques of general anaesthesia for caesarean section.
Using the isolated arm technique, the frequency of awareness was evaluated in 50 full-term patients undergoing elective Caesarean section under general anaesthesia. In 20 patients, anaesthesia was induced with thiopentone 4 mg kg-1, and in the other 30 patients, induction was with ketamine 1.5 mg kg-1. ⋯ Awareness was significantly greater after induction with thiopentone (14/20) than after ketamine (4/30). There were no significant differences in Apgar scores or umbilical vein blood-gas values in the newborns.