British journal of anaesthesia
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We have studied prospectively 10 ASA I or II postpartum patients after inadvertent dural puncture during labour. An extradural blood patch (autologous blood 15 ml) was performed within 18 h of delivery, with continuous EEG, upper facial EMG (Datex: Anesthesia and Brain Activity Monitor), pulse oximetry and heart rate measurement before, during and for 30 min after extradural injection. ⋯ Bradycardia was observed for a mean duration of 12.4 (1.1) s. Upper facial EMG, EEG, SpO2 and arterial pressure did not change.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of the laryngeal mask airway on lower oesophageal sphincter pressure in patients during general anaesthesia.
We have studied the tone of the lower oesophageal sphincter (LOS) in 40 adults undergoing routine body surface surgery and allocated randomly to receive anaesthesia either by face mask and Guedel airway or by laryngeal mask airway. In the laryngeal mask group there was a mean (SEM) decrease in barrier pressure (LOS minus gastric pressure) of 3.6 (1.4) cm H2O, compared with a mean increase of 2.2 (1.2) cm H2O in the face mask group (P < 0.005).
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Randomized Controlled Trial Comparative Study Clinical Trial
EEG burst suppression with propofol during cardiopulmonary bypass in children: a study of the haemodynamic, metabolic and endocrine effects.
We have studied the effects of propofol, given to maintain EEG suppression throughout cardiopulmonary bypass (CPB), in 20 children aged 1-15 yr, in a parallel group comparison. Anaesthesia was produced by fentanyl 50 micrograms kg-1, enflurane or halothane and midazolam 0.1 mg kg-1 at the start of CPB. After randomization, 50% of the children also received propofol during CPB. ⋯ Large rates of infusion of propofol were required to maintain EEG suppression, particularly during rewarming. Compared with control, the propofol group showed significant increases in mixed venous oxygen saturation and significant reductions in systemic oxygen uptake and glucose and cortisol concentrations. There were no differences in triiodothyronine and lactate concentrations, mean arterial pressure during CPB and inotrope requirement after CPB, or in recovery times.
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We describe a patient who developed an immobilizing lumbovertebral syndrome after an extradural blood patch and who was hospitalized with a suspected extradural abscess. An infectious aetiology of the persistent backache could be excluded and the patient recovered with analgesics and physiotherapy. The probable aetiology is discussed.