British journal of anaesthesia
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We have studied the automatic administration of alfentanil during alfentanil-nitrous oxide anaesthesia in 11 patients using a closed-loop feedback control system based on EEG analysis. We chose a median EEG frequency of 2-4 Hz as the EEG set point. ⋯ The average effective therapeutic infusion of alfentanil was 0.140 (0.032) mg min-1. We conclude that EEG feedback control may be useful in assessing and defining the dose requirements of alfentanil.
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Randomized Controlled Trial Clinical Trial Retracted Publication
Recoveries of post-tetanic twitch and train-of-four responses after administration of vecuronium with different inhalation anaesthetics and neuroleptanaesthesia.
We have studied recovery of post-tetanic twitch (PTT) and train-of-four (TOF) responses after administration of vecuronium in 100 patients under different inhalation anaesthetics and neuroleptanaesthesia. Patients were allocated randomly to five groups of 20 patients each to receive: neuroleptanaesthesia (droperidol and fentanyl), halothane, isoflurane, enflurane or sevoflurane (1 MAC in nitrous oxide and oxygen). The times from initial administration of vecuronium 0.2 mg kg-1 to the first appearances of T1, T2, T3 and T4 differed significantly between groups. However, the intervals to the first appearance of PTT1, PTT10 and PTT20 did not differ significantly between groups.
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We describe a case of accidental subdural block, after attempted extradural puncture for Caesarean section. Fractionation of the local anaesthetic dose led to avoidance of more serious complications. Subdural fentanyl and a continuous low-dose subdural infusion were used satisfactorily for intraoperative management and postoperative analgesia. As little as 0.5 ml of bupivacaine, hourly, provided satisfactory analgesia over a 15-h period.
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Randomized Controlled Trial Clinical Trial
Comparison of nasal cannulae with face mask for oxygen administration to postoperative patients.
Thirty postoperative patients were allocated randomly to receive oxygen by Hudson face mask at 4 litre min-1 (group I) or 2 litre min-1 (group II) via nasal cannulae. From 22:00 on the first night after operation, the position of the nasal cannula or face mask was observed for 8 h using video and oxyhaemoglobin saturation (SpO2) recorded simultaneously. In group I the mask remained on and positioned correctly in five patients. ⋯ In group II the nasal cannula was removed once in one patient for 16 min 38 s and eight times in another for a total of 1 h 18 min 7 s. Average SpO2 with mask on was 98% (range 96.1-99.9%), with mask off 95% (range 89.8-98.8%) and with cannula 97% (range 90.8-99.3%). We conclude that nasal cannulae are more likely to remain in position than face masks and maintain an adequate saturation in most patients.