British journal of anaesthesia
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We describe the performance of the pneuPAC hyperbaric variant HB, a ventilator designed for use in a one-man hyperbaric chamber. The ventilator delivered minute volumes of 11-23 litre at 1 atm abs to 7.6-16 litre at 2.5 atm abs. The delivered minute volume may be controlled easily from outside the chamber by manipulation of the ventilator rate, 11.5-31 b.p.m.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of pindolol on the cardiovascular response to tracheal intubation.
Laryngoscopy and tracheal intubation often cause hypertension, tachycardia and arrhythmias, which may be exaggerated during rapid-sequence induction of anaesthesia. We have studied the efficacy of pindolol in attenuating the cardiovascular responses to laryngoscopy and intubation in patients receiving pindolol 2 micrograms kg-1 or 4 micrograms kg-1 3 min before induction of anaesthesia in a double-blind design. The data were compared with those in a control group receiving saline. ⋯ These increases after tracheal intubation were reduced in pindolol 4 micrograms kg-1 treated patients compared with those in the control group (P less than 0.05). Pindolol 2 micrograms kg-1 attenuated tachycardia in response to intubation but did not affect hypertension. These data suggest that a bolus injection of pindolol 4 micrograms kg-1 is a simple, practical and effective method for attenuating cardiovascular responses to laryngoscopy and tracheal intubation.
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Randomized Controlled Trial Clinical Trial
Effects of adenosine triphosphate on the cardiovascular response to tracheal intubation.
Laryngoscopy and tracheal intubation often cause hypertension and tachycardia, which may be exaggerated during rapid-sequence induction of anaesthesia. The efficacy of adenosine triphosphate (ATP) in attenuating this response was studied in patients receiving ATP 0.05 mg kg-1 or 0.1 mg kg-1 simultaneously with the start of laryngoscopy. These data were compared with those for a control group receiving saline. ⋯ Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. These increase after tracheal intubation were reduced in ATP-treated patients compared with those of the control group (P less than 0.05). The data suggest that a bolus injection of ATP is a simple, practical and effective method for attenuating the hypertensive response to laryngoscopy and tracheal intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Systemic fentanyl enhances the spread of spinal analgesia produced by lignocaine.
Seventy-one patients undergoing transurethral prostatectomy under spinal anaesthesia were allocated randomly to one of four groups; fentanyl-naloxone (F-Nal), fentanyl-normal saline (F-NS), normal saline-naloxone (NS-Nal), and normal saline-normal saline (NS-NS) group. Twenty minutes after subarachnoid injection of hyperbaric lignocaine 100 mg, we tested the level of spinal analgesia (pinprick sensation) and administered i.v. either fentanyl 100 micrograms (F-Nal and F-NS groups) or normal saline 2 ml (NS-Nal and NS-NS groups). Ten minutes later, we assessed the new levels of analgesia and administered i.v. either naloxone 0.4 mg (F-Nal and NS-Nal groups) or normal saline 1 ml (F-NS and NS-NS groups). ⋯ Forty minutes after spinal block, the decrease in analgesia in the F-Nal group (3.97 cm) differed significantly from that in the other groups (P less than 0.01). Systemic fentanyl enhanced the spread of analgesia. This enhancement was antagonized by naloxone.
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Randomized Controlled Trial Clinical Trial
Clonidine decreases postoperative oxygen consumption in patients recovering from general anaesthesia.
Twenty ASA I patients, undergoing thyroid surgery were allocated randomly to receive at the end of surgery either an isotonic saline solution or clonidine 2 micrograms kg-1 i.v. administered over 20 min. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured during recovery in patients breathing spontaneously with a head canopy system. ⋯ The effect of clonidine was associated with a reduction in shivering. Sedative and analgesic properties of clonidine may also contribute to the reduction in metabolic demand during recovery from anaesthesia.