British journal of anaesthesia
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Editorial Comment Historical Article
'The only man to have all his work done by Friday was Robinson Crusoe' (anon)
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Randomized Controlled Trial Clinical Trial
Effect of riluzole on acute pain and hyperalgesia in humans.
Riluzole modulates several transmitter systems which may be involved in nociception. Antinociceptive effects have been shown in animal studies, but there are no human data. ⋯ We used a randomized, double-blind, placebo-controlled design, and subjects received riluzole 100 mg or placebo for 2 days with a 14-day interval. The burns produced significant hyperalgesia, but riluzole had no acute analgesic effects in normal or hyperalgesic skin.
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Case Reports
Failure to prevent an anaphylactic reaction to a second neuromuscular blocking drug during anaesthesia.
Skin testing is used widely to determine the drug responsible for an anaphylactic reaction during anaesthesia. When a neuromuscular blocking drug in incriminated as the cause of a reaction, it is usual for neuromuscular blocking drugs which do not produce positive skin tests to be considered safe for subsequent use during anaesthesia. We describe three patients in whom false negative skin tests led to a second severe anaphylactic reaction to another neuromuscular blocking drug.
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An increase in the demand by local surgeons for neuromuscular block during strabismus surgery, and the forced duction test in particular, led us to review the literature and conduct a regional survey of anaesthetic techniques used. A questionnaire was distributed to 379 anaesthetists in the region and 264 responses were received. The results demonstrated that 55% of paediatric patients and 66% of adult patients may have been operated on under suboptimal conditions; residual tone may have been present in the extraocular muscles during forced duction testing and strabismus correction.
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Comment Letter Case Reports
Anaesthesia for caesarean section in severe pulmonary hypertension.