British journal of anaesthesia
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There is strong evidence to suggest that anoxic depolarization (AD) is an important factor in hypoxia/ischaemia-induced neural damage. Treatments that prevent the occurrence of AD may be useful in providing neuronal protection against hypoxia. The current study was designed to determine whether general anaesthetics which have been suggested to 'induce prophylaxis' against hypoxia can attenuate the incidence of AD. ⋯ The prophylactic effect of thiopental against hypoxia might be induced, in part, by preventing the generation of AD.
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Randomized Controlled Trial Clinical Trial
Effects of magnesium sulphate and clonidine on propofol consumption, haemodynamics and postoperative recovery.
This placebo-controlled, double-blind study was designed to assess the effects of magnesium sulphate and clonidine on peroperative haemodynamics, propofol consumption and postoperative recovery. ⋯ Clonidine caused bradycardia and hypotension and magnesium sulphate caused delayed recovery, but can be used as adjuvant agents with careful management.
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Randomized Controlled Trial Clinical Trial
Clonidine produces a dose-dependent impairment of baroreflex-mediated thermoregulatory responses to positive end-expiratory pressure in anaesthetized humans.
Perioperative hypothermia is common and results from anaesthesia-induced inhibition of thermoregulatory control. Hypothermia is blunted by baroreceptor unloading caused by positive end-expiratory pressure (PEEP), and is mediated by an increase in the vasoconstriction threshold. Premedication with clonidine impairs normal thermoregulatory control. We therefore determined the effect of clonidine on PEEP-induced hypothermia protection. ⋯ Baroreceptor unloading by PEEP normally moderates perioperative hypothermia. However, clonidine premedication produces a linear, dose-dependent reduction in this benefit.
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Case Reports
Dural ectasia: a likely cause of inadequate spinal anaesthesia in two parturients with Marfan's syndrome.
We report two cases of Caesarean section in patients with Marfan's syndrome where continuous subarachnoid anaesthesia failed to provide an adequate surgical block. This was possibly because of dural ectasia, which was confirmed by a computed tomography scan in both cases.
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There is a paucity of data regarding neurologic function following nerve injury. Our objective was the long-term evaluation of motor function following intraneural injection of ropivacaine in rats using the sciatic function index (SFI), derived from walking track analysis. ⋯ These findings suggest that intraneural injections of ropivacaine at concentrations routinely used in clinical practice appear to have no deleterious effect on sciatic nerve motor function in this experimental rat model.