British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Biochemical assessment of preoperative stress: a study with diazepam and measurement of monoamine metabolites and catecholamines in cerebrospinal fluid and plasma.
Diazepam 5 mg or an inert placebo tablet was given as preoperative hypnotic on the night before operation to two groups (n = 18 in each) of healthy women having elective Caesarean section under spinal analgesia. A third group (n = 18) received no hypnotic. The quality of the preoperative night's sleep assessed subjectively was significantly better in the diazepam-treated patients compared with those receiving no drug. ⋯ In comparison with the two other patient groups, in the diazepam group there was no correlation between demographic, physiological or subjectively estimated variables and CSF or plasma measurements of monoamine transmitters and their metabolites. Preoperative fear and apprehension correlated most strongly with preoperative heart rate and with the increase in heart rate from the previous day. The monoamine neurotransmitters or their metabolites were of limited use in monitoring the intensity of preoperative fear and anxiety.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of two methods of fibrescope-guided tracheal intubation.
We have compared intubation time and cardiovascular effects of fibrescope-guided orotracheal intubation aided by the Berman 11 Intubating Airway with those of the tongue traction method of fibreoptic intubation and with conventional Macintosh intubation. We studied 75 patients who received a standard general anaesthetic which included non-depolarizing neuromuscular block; they were allocated randomly to one of the three groups immediately before intubation. ⋯ There were no significant differences between the responses to the two fibreoptic techniques. Haemodynamic effects should be considered when performing fibrescope-guided tracheal intubation under general anaesthesia and, when necessary, appropriate measures should be taken to minimize them.
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Randomized Controlled Trial Comparative Study Clinical Trial
Heart rate response to an i.v. test dose of adrenaline and lignocaine with and without atropine pretreatment.
In order to evaluate the sensitivity of an adrenaline test dose for detecting intravascular injection and the effect of atropine pretreatment, 90 ASA physical status I and II patients were allocated randomly to two groups, to receive i.v. saline 1 ml (n = 46) or i.v. atropine 0.5 mg (n = 44). Five minutes later, all patients received an i.v. test dose of 2% lignocaine 3 ml with adrenaline 15 micrograms at a rate of 1 ml s-1. The groups were similar with respect to basal heart rate (HR). ⋯ The maximum increase in HR was greater in the atropine group than in the saline group (31 (4) beat min-1 vs 26 (11) beat min-1 (P less than 0.05). However, when individual maximum HR changes are considered, five patients in the saline group and four in the atropine group had an increase less than or equal to 10 beat min-1, and three patients in the saline group had no change or a decrease in HR. Defining a positive result to a test dose as an increase in HR of greater than 10 beat min-1, the sensitivity of the adrenaline test dose was 83 (5.5)% in the saline group and 91 (3.5)% in the atropine group (ns).(ABSTRACT TRUNCATED AT 250 WORDS)
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We compared measurements obtained with a pulse oximeter (SpO2) against values obtained from a CO-oximeter in a patient with carbon monoxide poisoning. SpO2 was equal to the sum of the oxyhaemoglobin (HbO) and carboxyhaemoglobin (HbCO) values over the range of HbCO from 30 to 1%. ⋯ The patient was treated with oxygen (FlO2 = 50%) and recovered without any sequelae. Under these circumstances, the half-life of HbCO was approximately 2 h.