British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural versus intrathecal morphine for postoperative analgesia after Caesarean section.
Perispinal anaesthesia for Caesarean section allows injection of epidural (ED) or intrathecal (i.t.) morphine to provide long-lasting postoperative analgesia. To compare these two routes, a prospective, randomized, double-blinded study of 53 patients undergoing elective Caesarean section was performed. ⋯ The ED protocol was more effective than the i.t. protocol, whilst side-effects were similar.
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Randomized Controlled Trial Comparative Study Clinical Trial
Optimization of desflurane administration in morbidly obese patients: a comparison with sevoflurane using an 'inhalation bolus' technique.
The concept of an 'inhalation bolus' can be used to optimize inhaled drug administration. We investigated the depth of anaesthesia, haemodynamic stability, and recovery time in morbidly obese patients resulting from bispectral index (BIS)-guided sevoflurane or desflurane administration and BIS-triggered inhalation boluses of sevoflurane or desflurane combined with titration of remifentanil. ⋯ Immediate recovery was significantly faster in the desflurane group. Overall hypnotic controllability measured by BIS was less accurate with desflurane. Overall haemodynamic controllability was better when using desflurane. Fewer episodes of hypotension were found in the desflurane group. The use of the inhalation bolus was found to be appropriate in both groups without causing severe haemodynamic side effects. Minimal BIS values were significantly lower after a desflurane bolus.