British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Pharmacokinetic and clinical study of ropivacaine and bupivacaine in women receiving extradural analgesia in labour.
We have compared, in a randomized, double-blind study, the pharmacokinetics of ropivacaine and bupivacaine during labour. Total and free plasma concentrations of ropivacaine and bupivacaine were measured after the first of two extradural doses. ⋯ At 20 min, Cpmax (free) of ropivacaine (0.04 mg litre-1) was higher than that of bupivacaine (0.02 mg litre-1) (P = 0.0025). The clinical effectiveness of the block was similar in both groups.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of perioperative ketoprofen 2.0 mg kg-1 with 0.5 mg kg-1 i.v. in small children during adenoidectomy.
We have investigated if ketoprofen 0.5 mg kg-1 i.v. provided as good analgesia with less adverse effects compared with ketoprofen 2.0 mg kg-1 i.v. in 107 children, aged 1-7 yr, after adenoidectomy, in a randomized, double-blind, parallel group study design. A standard anaesthetic method was used and all children received fentanyl 1 microgram kg-1 i.v. during induction. Children in group 2.0 received ketoprofen 2.0 mg kg-1 and children in group 0.5, 0.5 mg kg-1 i.v. during induction. ⋯ We found that ketoprofen provided good analgesia and only 49% of children required fentanyl in the post-anaesthesia care unit. There were no differences between the groups in the number of fentanyl doses, pain scores or frequency of adverse reactions. No serious adverse reactions occurred.
-
Randomized Controlled Trial Clinical Trial
Effect of systemic N-methyl-D-aspartate receptor antagonist (dextromethorphan) on primary and secondary hyperalgesia in humans.
Dextromethorphan is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist known to inhibit wind-up and central hyperexcitability of dorsal horn neurones. We studied 24 healthy, unmedicated male volunteers, aged 21-28 yr, in a randomized, double-blind, placebo-controlled, crossover study. Burn injuries were produced on the medial surface of the dominant calf with a 25 x 50 mm rectangular thermode. ⋯ Side effects were frequent but clinically acceptable. The effects of dextromethorphan were in agreement with experimental studies indicating that dextromethorphan is a NMDA receptor antagonist. The effects of dextromethorphan in the burn injury model were similar to those of ketamine and distinct from those of local anaesthetics and opioids.
-
Randomized Controlled Trial Clinical Trial
Emergence times from xenon anaesthesia are independent of the duration of anaesthesia.
Xenon (MAC = 71%) has an extremely low blood:gas partition coefficient (0.14). Therefore, we predicted that the rate of emergence from xenon anaesthesia would not be affected greatly by duration of anaesthesia. We studied 54 ASA I-II patients undergoing lower abdominal surgery who received equal MAC anaesthesia with 60% xenon, 60% nitrous oxide with 0.5% isoflurane or 60% nitrous oxide with 0.7% sevoflurane (n = 18 per group), each supplemented with extradural mepivacaine anaesthesia. ⋯ Mean emergence times from xenon anaesthesia were: T1, 3.3 (SD 1.0) min; T2, 3.6 (1.0) min; T3, 5.0 (1.1) min; and T4, 6.2 (1.7) min. These values were approximately 50% of those after nitrous oxide-sevoflurane anaesthesia (T1, 5.6 (1.4) min; T4, 10.5 (2.0) min). We conclude that xenon provided fast emergence from anaesthesia, regardless of the duration of anaesthesia.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Intra-articular morphine and clonidine produce comparable analgesia but the combination is not more effective.
Both intra-articular morphine and clonidine produce analgesia. This study was designed to compare the analgesic effects of the two drugs, used separately and in combination. We studied 90 patients undergoing arthroscopy of the knee under general anaesthesia. ⋯ There was no difference in VAS scores between the three groups and the time for rescue analgesic was comparable. We conclude that intra-articular morphine and clonidine have comparable analgesic effects in the doses used. The combination of both drugs did not seem to increase analgesia.