British journal of anaesthesia
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The problem of ventilating small animals during nuclear magnetic resonance studies has been solved by using a T-piece system with a remotely controlled non-magnetic expiratory valve. This system does not affect the NMR signal, has minimal internal compliance and expiratory resistance, permits accurate control of peak airway pressure, and may be of use when animals have to be ventilated in hazardous surroundings.
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Forty-five patients in four groups undergoing orthopaedic, upper abdominal, prolonged or cardiac surgery received a constant rate i.v. infusion of fentanyl 100 micrograms h-1, for 24 h starting 2 h before surgery. A single bolus dose was given i.v. at the induction of anaesthesia. ⋯ The elimination half-life was 7.3-9.7 h. This simple regimen produced effective analgesia.
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The effect of changing the composition of the carrier gas from 66% nitrous oxide in oxygen to 100% oxygen was examined in three halothane vaporizers (Fluotec Mk 3, Drager Vapor 19 and Abingdon halothane vaporizer). All showed a transient increase in output following the discontinuation of the nitrous oxide. ⋯ The steady-state output of the vaporizers, once the transient response was over, was found to be lower with 100% oxygen as carrier gas than it had been with 66% nitrous oxide in oxygen. The difference was minor in the case of the Drager Vapor 19 (1% of indicated output) and Fluotec Mk 3 (5% of indicated output), but greater in the case of the Abingdon (15% of indicated output).
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of wakefulness with two anaesthetic regimens. Total i.v. v. balanced anaesthesia.
Fifty-five patients were assigned randomly to receive either a total i.v. anaesthetic based on a two-stage infusion of etomidate plus increments of fentanyl or a regimen based on inhaled nitrous oxide with i.v. fentanyl increments. Using the isolated forearm technique, 44% of the nitrous oxide group were found to be wakeful at some time during surgery, whereas only 7% of the etomidate group were wakeful. There was one case of awareness in the nitrous oxide group.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following major gynaecological surgery.
Domperidone 20 mg, droperidol 2.5 mg, metoclopramide 10 mg and placebo (saline) were given i.v. 10 min before the end of anaesthesia, to 200 women undergoing major gynaecological surgery, and the incidence of postoperative nausea and vomiting following a standard anaesthetic technique was assessed. Droperidol was significantly more effective than domperidone, metoclopramide or placebo in reducing emetic sequelae. ⋯ Patients given droperidol required less postoperative analgesia than those given domperidone or metoclopramide. It was concluded that, of the drugs studied, droperidol alone was effective in protecting against nausea and vomiting after major gynaecological surgery.