British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Intra-articular morphine after arthroscopic knee operation.
Reports on pain relief with intra-articular morphine after arthroscopic knee operation are conflicting. To assess the long-term antinociceptive effect of intraarticular morphine, we studied pain at rest, pain on standing and ability to walk for 7 days after intraarticular injection of bupivacaine 100 mg (group 1, n = 11), bupivacaine 100 mg and morphine 1 mg (group 2, n = 10) and bupivacaine 100 mg and morphine 3 mg (group 3, n = 10) at the end of operation. Pain and walking were assessed by visual analogue and walking scales, respectively. ⋯ The scores in group 2 were intermediate between those in groups 1 and 3. The walking scores in group 3 were significantly better than those in group 1 at 12 h. The amount of analgesics received in groups 2 and 3 was significantly less than that in group 1 until day 3 after operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Effects of sub-hypnotic doses of propofol on the side effects of intrathecal morphine.
We have studied the effect of propofol on the side effects associated with intrathecal morphine in 40 patients undergoing major arthroplasty. Patients received spinal anaesthesia with plain 0.5% bupivacaine 20 mg mixed with preservative-free morphine 0.3 mg. Before injection of the local anaesthetic, the patients were allocated randomly to receive either a bolus dose of propofol 10 mg followed by an infusion of 30 mg/24 h or equal volumes of 10% Intralipid (control group). ⋯ The incidence of urinary retention was similar in both groups. There was no additional sedation attributable to propofol. In conclusion, sub-hypnotic doses of propofol protected significantly against itching and had a modest effect on PONV after intrathecal morphine.
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We describe an anaesthesia simulator capable of simulating all possible situations during anaesthesia. The Leiden anaesthesia simulator (LAS) may be used with most commercially available anaesthesia equipment and monitors, which are connected to the simulated patient as they are to a patient. A commercially available intubation manikin attached to an electromechanical lung model represents the patient. ⋯ The task of the trainee is to diagnose and treat the problem as if in real life. The simulator experiences on the LAS were judged as highly realistic by 28 subjects. This simulator is currently being used for teaching and training of anaesthetists, trainees and anaesthesia personnel and for research.