British journal of anaesthesia
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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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Randomized Controlled Trial Multicenter Study Clinical Trial
Spontaneous or neostigmine-induced recovery after maintenance of neuromuscular block with Org 9487 (rapacuronium) or rocuronium following an initial dose of Org 9487.
We have examined spontaneous and neostigmine-induced recovery after an initial dose of Org 9487 1.5 mg kg-1 followed by three repeat doses of Org 9487, a 30-min infusion of Org 9487 or two incremental doses of rocuronium. Mean clinical duration after incremental doses of Org 9487 0.5 mg kg-1 increased from 12.3 (SD 3.4) min to 14.0 (4.0) and 15.9 (5.9) min (P < 0.01), and after rocuronium from 14.4 (5.2) min to 19.2 (5.9) min (P < 0.01). ⋯ These times were significantly reduced to 9.9 (4.5), 8.6 (6.1) and 5.7 (2.5) min, respectively, after neostigmine administration at a T1 of 25% (P < 0.05). We conclude that administration of Org 9487 by repeat bolus doses or infusion was associated with slow spontaneous recovery but neostigmine administration resulted in adequate recovery in less than 10 min.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of rocuronium compared with succinylcholine on intraocular pressure during rapid sequence induction of anaesthesia.
We have compared the effect of rocuronium and succinylcholine on intraocular pressure (IOP) during rapid sequence induction of anaesthesia using propofol and fentanyl, in a randomized double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fentanyl 2 micrograms kg-1 and propofol until loss of verbal response. ⋯ IOP in the succinylcholine group was significantly greater than that in the rocuronium group (mean 21.6 (SEM 1.4) mm Hg vs 13.3 (1.4) mm Hg; P < 0.001). Intubating conditions were equally good in both groups. We conclude that with rapid sequence induction of anaesthesia using propofol and fentanyl, rocuronium did not cause as great an increase in IOP as succinylcholine and may be an alternative in open eye injury cases.
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Randomized Controlled Trial Comparative Study Clinical Trial
Placement of the intubating laryngeal mask is easier than the laryngeal mask during manual in-line neck stabilization.
We have compared in 25 patients ease of placement of the conventional and intubating laryngeal masks while the patient's head and neck were stabilized by a manual in-line method, in a randomized, crossover study. After induction of anaesthesia and neuromuscular block, the masks were placed in turn. ⋯ Adequate ventilation was always obtained after placement of the intubating laryngeal mask, whereas ventilation was adequate in 22 of 25 patients after placement of the conventional laryngeal mask. Placement of the intubating laryngeal mask was significantly easier (P < 0.001; 95% confidence intervals (CI) for median difference 8-31 mm in VAS) and faster (P < 0.001; 95% CI for mean difference 3.2-6.2 s) than that of the conventional mask.
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Randomized Controlled Trial Comparative Study Clinical Trial
Laryngeal mask airway size selection in males and females: ease of insertion, oropharyngeal leak pressure, pharyngeal mucosal pressures and anatomical position.
We have compared ease of insertion, oropharyngeal leak pressure, directly measured pharyngeal mucosal pressure and anatomical position (assessed fibreoptically) for the size 4 and size 5 laryngeal mask airway (LMA) in 20 male and 20 female patients. Microchip pressure sensors were attached to the LMA at locations corresponding to the piriform fossa, hypopharynx, base of the tongue, lateral and posterior pharynx, and the oropharynx. Oropharyngeal leak pressure, mucosal pressure and fibreoptic position were recorded during inflation of the cuff from 0 to 30 ml in 10-ml increments. ⋯ For both males and females, fibreoptic position was similar. We conclude that the size 5 LMA is optimal in males, but either size is suitable for females. The shape of the pharynx may be different between males and females.