British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
P6 acupuncture and postoperative vomiting after tonsillectomy in children.
We have studied the effect of P6 acupuncture on postoperative vomiting in 45 children undergoing tonsillectomy. After induction of anaesthesia and before the start of surgery, 50% of the patients received P6 acupuncture (in the middle of the ventral surface of the wrist) for 5 min. There was no difference in the incidence of vomiting between the acupuncture (39%) and non-acupuncture (36%) groups. We conclude that, when administered after induction of anaesthesia, P6 acupuncture is ineffective in reducing vomiting after tonsillectomy in children.
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Randomized Controlled Trial Clinical Trial
Attenuation of the pressor response to tracheal intubation by magnesium sulphate with and without alfentanil in hypertensive proteinuric patients undergoing caesarean section.
The pressor response to tracheal intubation is known to be exaggerated in patients with gestational proteinuric hypertension (GPH). We have studied the effect of pretreatment with magnesium sulphate 40 mg kg-1 or 30 mg kg-1 with alfentanil 7.5 micrograms kg-1 on this pressor response in 38 patients with moderate to severe GPH. ⋯ There was no significant difference in fetal outcome between groups. Both pretreatment methods produced satisfactory control of catecholamine release.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of plain and alkalinized local anaesthetic mixtures of lignocaine and bupivacaine for elective extradural caesarean section.
We have examined a local anaesthetic mixture of 0.5% bupivacaine 10 ml and 2% lignocaine 10 ml with adrenaline 1 in 200,000, to which 8.4% sodium bicarbonate 2 ml was added, for extradural Caesarean section. The alkalinized mixture of local anaesthetics produced a block of more rapid onset and density than a mixture of bupivacaine and lignocaine alone (P less than 0.001).
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Randomized Controlled Trial Clinical Trial
Pressure support ventilation using a new tracheal gas injection tube.
In order to explore new types of jet ventilation, we tested a tracheal gas injection tube (TGIT) which included six thin capillaries and provided high pressure injection. The driving pressure was chosen to yield a plateau of inspiratory tracheal pressure of 10 cm H2O. An original controller was built to monitor spirometry and trigger injection in order to deliver both pressure controlled ventilation (PCVTGIT) and a new mode of inspiratory pressure support jet ventilation (IPSTGIT). ⋯ IPSTGIT, compared with spontaneous breathing increased minute ventilation (from 5.7 (SD 1.6) to 7.1 (1.7) litre min-1) (P less than 0.001). It reduced the total work of breathing (from 0.625 (0.223) to 0.263 (0.151) J litre-1, respectively) (P less than 0.01) and the occlusion pressure (from 2.62 (1.28) to 1.36 (0.74) cm H2O, respectively) (P less than 0.01). It is concluded that this TGIT used with a specific system for sensing and triggering ventilation allows inspiratory pressure support during low frequency jet ventilation.
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Comparative Study
Comparison of contemporaneous and retrospective assessment of postoperative pain using the visual analogue scale.
We have assessed postoperative pain in 50 patients who had undergone total abdominal hysterectomy, using repeated contemporaneous and single retrospective visual analogue scores. There were significant correlations between the median, mean and greatest contemporaneous scores, and the single retrospective scores, but there was a wide scatter of results among and within individual patients. We conclude that the wide variability between the two methods of assessment suggests that the two techniques should not be used interchangeably.