British journal of anaesthesia
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Progesterone has long been known to have central effects, by reduced anaesthetic requirements as measured by minimum alveolar concentration (MAC) in various settings. However, other studies have contradicted these findings. Therefore, we compared the effect of progesterone on anaesthetic requirements in a mouse model. ⋯ We conclude that administration of exogenous progesterone injection at higher concentrations decreases anaesthetic requirement as defined by rolling response.
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Hyperbaric prilocaine 2% is a medium long-acting spinal anaesthetic. There are few data on time to recovery and rate of urinary retention after spinal administration of hyperbaric prilocaine 2%. This prospective study was carried out to evaluate the time to spontaneous micturition, quantify the rate of necessary bladder catheterizations, and identify the risk factors for urinary retention after intrathecal prilocaine administration. ⋯ After spinal anaesthesia with hyperbaric prilocaine 2% (60 mg) for ambulatory lower limb surgery, 23% of patients required postoperative urinary catheterization. Postoperative bladder ultrasound and early catheterization are essential to avoid bladder distension and facilitate discharge in patients after intrathecal prilocaine 2% administration in ambulatory surgery.
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The minimum effective volume of local anaesthetic needed to provide effective analgesia of the four main branches of the axillary brachial plexus is unknown. This study was performed to determine the minimum volume of local anaesthetic required to surround the nerves of the axillary brachial plexus and document onset and duration of sensory and motor effects. ⋯ We found that it is possible to surround each nerve of the axillary brachial plexus with 2-4 ml of local anaesthetic. We speculate that increasing this volume would produce blocks of quicker onset and longer duration while still using smaller volumes than previously thought.
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Context-sensitive times to 50%, 80%, and 90% elimination from the brain have been calculated for volatile anaesthetics. This does not represent complete recovery because there are important residual effects even at 90% elimination, and the effect of anaesthetic metabolism on the rate of elimination has not been considered. ⋯ Large amounts of anaesthetics are absorbed during anaesthesia and significant amounts remain in the body for days after apparent recovery.