British journal of anaesthesia
-
We describe the anaesthetic management of a parturient with achondroplasia presenting for Caesarean section under epidural anaesthesia. A block extending from T4 to S4 was established over 25 min using a total of 12 ml of 2.0% lidocaine (lignocaine) with epinephrine (adrenaline) 1:200,000 and fentanyl 37.5 micrograms. Apart from mild discomfort during peritoneal incision, her perioperative course was uneventful. Achondroplasia is reviewed and the anaesthetic implications of the condition are discussed.
-
Randomized Controlled Trial Clinical Trial
Remifentanil prevents an increase in intraocular pressure after succinylcholine and tracheal intubation.
We have studied changes in intraocular pressure (IOP) in 30 patients after succinylcholine (suxamethonium) and tracheal intubation following administration of propofol 2 mg kg-1 and either remifentanil 1 microgram kg-1 (group R) or saline (group S). IOP was measured before induction, before administration of succinylcholine and the study drug, before intubation and for every 1 min after intubation for 5 min. There was a significant decrease in IOP in group R compared with group S from the time of administration of the study drugs to the end of the study (P < 0.006).
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of epidural bolus administration of 0.25% bupivacaine and 0.1% bupivacaine with 0.0002% fentanyl for analgesia during labour.
We have compared analgesia during labour provided by two epidural drug regimens, in a double-blind, randomized, controlled study. Group A received 10-ml bolus doses of 0.1% bupivacaine with fentanyl 2 micrograms ml-1 while group B received 0.25% plain bupivacaine 10 ml. ⋯ Duration of labour and time from insertion of the epidural to delivery was similar in both groups, but in group A, duration of the second stage was significantly shorter (P = 0.0003; 95% confidence interval (CI) -1.17, -0.27 h) and the incidence of forceps delivery was lower (P = 0.032). Maternal satisfaction with epidural analgesia, as assessed by VAS, was higher in group A (P = 0.04; 95% CI -0.001, 10.001).
-
Randomized Controlled Trial Clinical Trial
Prophylactic antiemetic therapy with granisetron in women undergoing thyroidectomy.
We have evaluated the efficacy and safety of granisetron, a selective 5-hydroxytryptamine type-3 receptor antagonist, for the prevention of postoperative nausea and vomiting (PONV) in women undergoing thyroidectomy. In a prospective, randomized, placebo-controlled, double-blind study, 100 ASA I patients, aged 30-57 yr, received placebo or granisetron at three different doses (20, 40 or 100 micrograms kg-1) (n = 25 each), i.v., immediately before induction of anaesthesia. A standard general anaesthetic technique was used. ⋯ There were no clinically important adverse events in any group. We conclude that granisetron 40 micrograms kg-1 was an effective antiemetic for the prevention of PONV after thyroidectomy. Increasing the dose to 100 micrograms kg-1 provided no further benefit.