British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Risk of aspiration with the laryngeal mask.
In order to assess if the use of the laryngeal mask airway is associated with an increased risk of gastric regurgitation during mechanical ventilation, we studied 50 patients allocated randomly to undergo anaesthesia with either artificial ventilation with isoflurane and nitrous oxide in oxygen and atracurium (group A) or spontaneous ventilation with isoflurane and nitrous oxide in oxygen (group B). In both groups a laryngeal mask airway was used. ⋯ In one patient in each group, there was staining of the oropharynx with blue dye at the end of surgery. In the patient in group A, dye was present in the trachea and bronchi.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tracheal intubation without neuromuscular block in children.
We have studied 80 healthy children, aged 2-14 yr, undergoing adenotonsillectomy in a double-blind, randomized design. Tracheal intubation facilitated by either suxamethonium 1.5 mg kg-1 or alfentanil 15 micrograms kg-1 was compared after induction of anaesthesia with propofol 3-4 mg kg-1. ⋯ Fewer patients coughed (P < 0.014) and limb movement was less common (P < 0.007) after tracheal intubation facilitated by suxamethonium. Alfentanil attenuated the haemodynamic responses to tracheal intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of desflurane and fentanyl-based anaesthetic techniques for coronary artery bypass surgery.
We have compared, in 51 ASA II and III patients undergoing coronary artery bypass surgery, an inhaled anaesthetic technique based on desflurane, supplemented with low-dose (10 micrograms kg-1) fentanyl, with an i.v. technique using high-dose (50 micrograms kg-1) fentanyl with midazolam for induction. Satisfactory records were available for analysis in 50 patients. There were no differences between groups in operating time, cardiopulmonary bypass time, aortic cross-clamp time or duration of stay in the intensive care unit after surgery. ⋯ This was always lower than the fentanyl group by 5-15 beat min-1 and the difference was significant at induction, during skin preparation and before aortic cannulation. In comparison with the desflurane group, cardiac index was significantly greater in the fentanyl group at induction, laryngoscopy and during skin preparation, but was significantly less before aortic cannulation. The need for vasodilator intervention was significantly more common in the fentanyl group before, during and after cardiopulmonary bypass and for beta adrenoceptor block before cardiopulmonary bypass.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Topical glucocorticoid has no antinociceptive or anti-inflammatory effect in thermal injury.
We have studied the antinociceptive and anti-inflammatory effects of topical glucocorticoids in human thermal injury. The right and left legs of 12 healthy volunteers were allocated randomly to be treated with either 0.05% clobetasol propionate cream or placebo in a double-blind trial. Thermal injuries were induced with a thermode, which was heated to 49 degrees C for 5 min under standardized pressure. ⋯ Heat pain detection thresholds (HPDT), heat pain tolerance (HPT), mechanical pain detection thresholds (MPDT) and the intensity of burn-induced erythema (erythema index, EI) were assessed inside the thermal injury and areas of hyperalgesia to pinprick outside the injury were determined before and regularly for 72 h after the burn injury. Burn injury caused a decrease in HPDT, HPT and MPDT, an increase in EI and development of mechanical, secondary hyperalgesia. Clobetasol propionate had no effect on any of the nociceptive or inflammatory variables studied.
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Randomized Controlled Trial Clinical Trial
Influence of droperidol on nausea and vomiting during patient-controlled analgesia.
We have studied the addition of droperidol to morphine during patient-controlled analgesia (PCA) in 57 patients using PCA after abdominal hysterectomy. Patients in group 1 (control group) received placebo at induction of anaesthesia and a PCA containing morphine; those in group 2 received droperidol 1.25 mg and a PCA containing morphine and those in group 3 droperidol and a PCA containing droperidol 0.05 mg mg-1 of morphine. ⋯ We did not observe side effects attributable to droperidol. We conclude that droperidol added to morphine in PCA reduces nausea and antiemetic requirements after abdominal hysterectomy.