British journal of anaesthesia
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The dimensions of currently available spinal needles (0.7 mm (22-gauge) to 0.45 mm (26-gauge) external diameter) were measured and compared with the International Standard (ISO 7864-1984 E). The in vitro performance of the needles was assessed by comparing times to appearance of cerebrospinal fluid and flow rates through the needles. There were wide variations in the measurements and performance of the different needles.
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Comparative Study
Pharmacokinetics of alfentanil in children undergoing surgery.
Alfentanil pharmacokinetics and protein binding were determined in 20 children aged 10 months-6.5 yr. The data were compared with those from 10 adult patients. ⋯ The degree of plasma protein binding was also similar in children and adults with mean free fractions of 11.5 +/- 0.9% (+/- SD) and 11.8 +/- 3.9%, respectively. There were marked differences in the elimination half-life of alfentanil (63 +/- 24 min in children; 95 +/- 20 min in adults (P less than 0.001] and plasma clearance of alfentanil (11.1 +/- 3.9 ml min-1 kg-1 in children and 5.9 +/- 1.6 ml min-1 kg-1 in adults (P less than 0.001].
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Randomized Controlled Trial Comparative Study Clinical Trial
Maternal and neonatal responses to alfentanil administered before induction of general anaesthesia for caesarean section.
The cardiovascular response to tracheal intubation was compared in two groups of patients undergoing elective Caesarean section. Both groups received a standard technique of general anaesthesia. ⋯ No adverse effect on the neonate was seen. However, a significant increase in the incidence of postoperative nausea occurred in mothers in the alfentanil group (P less than 0.05).
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This study reports the experience of a department of paediatric anaesthesia with 234 continuous extradural anaesthetics performed in 229 children over a 15-month period. Fifty-nine of the children were aged 0-2 yr, 71 were aged 2-8 yr and 104 were older than 8 yr. The surgical procedures lasted more than 60 min (mean 150 +/- 10.6 min); all were carried out under light general anaesthesia. ⋯ After extradural anaesthesia with 0.25% bupivacaine with adrenaline 1:200000, minimal changes in HR or SAP occurred in children younger than 8 yr; in those older than 8 yr a significant decrease in both HR and SAP was observed. Changes in SAP were at their maximum 25 min after the extradural block and changes in HR were not statistically significant before the 25th min following injection of local anaesthetic. The catheter remained in place in 155 children for postoperative analgesia, mainly for the first 48 h.