British journal of anaesthesia
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Ten obstetric patients received 17-20 ml of autologous blood through an extradural catheter after inadvertent dural puncture. The time interval from dural puncture to prophylactic extradural blood patch ranged from 90 to 660 min. One of the 10 patients developed a mild occipital headache, which required no further intervention.
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Letter Case Reports
Use of naloxone in opioid-induced anaphylactoid reaction.
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Randomized Controlled Trial Comparative Study Clinical Trial
Oral nalbuphine for the treatment of pain after dental extractions.
A randomized, double-blind comparison of nalbuphine 30 mg or 60 mg by mouth and dihydrocodeine 30 mg by mouth was conducted in 75 patients with moderate to severe pain after surgery for dental extractions under general anaesthesia. A significant reduction in pain intensity followed each treatment and persisted throughout the 4-h observation period after nalbuphine, but only for 3 h after dihydrocodeine was given. ⋯ However, the patients who received nalbuphine 30 mg had a significantly higher mean pain intensity before treatment than those in the other groups. The side-effects encountered were those typical of opioid medication; there were no statistically significant differences between the groups.
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Comparative Study
Comparison of neuromuscular blockade in the diaphragm and the hand.
Neuromuscular blockade was recorded in the diaphragm and in the adductor pollicis muscle using unilateral supramaximal stimulation of phrenic and ulnar nerves and measurement of the mechanical effect of each. After administration of atracurium 0.4-0.5 mg kg-1 to 10 patients, both onset and recovery of neuromuscular blockade in the diaphragm occurred before that in adductor pollicis and there was a linear relationship between recovery in diaphragm and adductor pollicis. After administration of vecuronium 0.08-0.1 mg kg-1 to a further 10 patients, paralysis occurred in the diaphragm before adductor pollicis in all except one patient, in whom it occurred simultaneously. Reappearance of adductor pollicis twitch occurred in six patients after all four twitches had returned in the diaphragm, but the rate of recovery of twitch height in the diaphragm was more rapid than in adductor pollicis in every patient.