British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Unconscious learning during surgery with propofol anaesthesia.
Learning during anaesthesia has been demonstrated, but little is known about the circumstances under which it may occur. This study investigated the hypothesis that learning during anaesthesia occurs during, but not before, surgical stimulation. ⋯ Learning during anaesthesia seems more likely to occur during rather than before surgical stimulation at comparable anaesthetic depth. We hypothesize that surgical stimulation facilitates learning during anaesthesia, independently of its effects on anaesthetic depth.
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Randomized Controlled Trial Comparative Study Clinical Trial
Articaine versus lidocaine plus bupivacaine for peribulbar anaesthesia in cataract surgery.
We compared the efficacy and safety of articaine 2% with a mixture of lidocaine 2% and bupivacaine 0.5% without hyaluronidase for peribulbar anaesthesia in cataract surgery. ⋯ Articaine 2% without hyaluronidase is more advantageous than a mixture of lidocaine 2% and bupivacaine 0.5% without hyaluronidase for peribulbar anaesthesia in cataract surgery.
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Randomized Controlled Trial Clinical Trial
Effect of remifentanil infusion rate on stress response to the pre-bypass phase of paediatric cardiac surgery.
Opioids are used routinely to eliminate the stress response in the pre-bypass phase of paediatric cardiac surgery. Remifentanil is a unique opioid allowing a rapidly titratable effect. No data are available regarding a suitable remifentanil dose regimen for obtunding stress and cardiovascular responses to such surgery. ⋯ In infants and children under 5 yr, remifentanil infusions of 1.0 micro g kg(-1) min(-1) and greater can suppress the glucose increase and tachycardia associated with the pre-bypass phase of cardiac surgery, while 0.25 micro g kg(-1) min(-1) does not. Remifentanil should be used with caution in neonates with complex congenital heart disease.
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Randomized Controlled Trial Clinical Trial
Developmental pharmacokinetics of morphine and its metabolites in neonates, infants and young children.
Descriptions of the pharmacokinetics and metabolism of morphine and its metabolites in young children are scant. Previous studies have not differentiated the effects of size from those related to age during infancy. ⋯ M3G is the predominant metabolite of morphine in young children and total body morphine clearance is 80% that of adult values by 6 months. A mean steady-state serum concentration of 10 ng ml(-1) can be achieved in children after non-cardiac surgery in an intensive care unit with a morphine hydrochloride infusion of 5 micro g h(-1) kg(-1) at birth (term neonates), 8.5 micro g h(-1) kg(-1) at 1 month, 13.5 micro g h(-1) kg(-1) at 3 months and 18 micro g h(-1) kg(-1) at 1 year and 16 micro g h(-1) kg(-1) for 1- to 3-yr-old children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Entropy of EEG during anaesthetic induction: a comparative study with propofol or nitrous oxide as sole agent.
The search continues for an anaesthetic monitor that can define the level of anaesthesia in an individual patient irrespective of anaesthetic agent(s) used. Studies of available monitors based on bispectral analysis or evoked auditory potentials show the complexity of the problem. We assessed a new monitor, based on the entropy of the EEG, during induction of anaesthesia with either propofol or nitrous oxide. ⋯ The entropy monitor of anaesthetic depth shows a successive decrease with propofol but loss of consciousness with nitrous oxide is not associated with change in entropy indices.