British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Preoperative starvation and blood glucose concentrations in children undergoing inpatient and outpatient anaesthesia.
Blood glucose concentrations were measured in 82 children undergoing inpatient anaesthesia and in 46 children undergoing anaesthesia as outpatients. The children were aged between 6 months and 9 yr. Outpatients were fasted from bedtime, while inpatients were randomly allocated to two groups. ⋯ A blood glucose concentration of less than 40 mg dl-1 was found in only one of the fasted children (1%). The mean blood glucose concentration was greater in group B than A, but only significantly so for children older than 4 yr. It is concluded that to minimize the risks of hypoglycaemia and inhalation of vomit on induction of anaesthesia children older than 6 months should be fasted overnight and operated on in the morning.
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The effects of methohexitone, Althesin, ketamine and etomidate on single fibre discharge of cardiac vagal efferents and on heart rate were studied in cats. Cardiac vagal efferents were inhibited markedly and regularly for equihypnotic doses of methohexitone (2.0 mg kg-1), Althesin (0.1 ml kg-1) and ketamine (5.0 mg kg-1), but not of etomidate (0.8 mg kg-1). These inhibitory effects were independent of arterial pressure and mirrored the increases of heart rate elicited by the first three agents. ⋯ Thus methohexitone. Althesin and ketamine inhibit efferent cardiac vagal drive by their central action independently of baroreflex function. This central vagolysis is probably the cause of their positive chronotropic effects.
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Comparative Study
Status of neonates delivered by elective Caesarean section.
A series of 144 elective Caesarean sections is reported. One hundred and five patients had no evidence of placental dysfunction (group A), of whom 57 (40 with vertex presentation) received extradural analgesia. The remaining 39 patients comprised group B. ⋯ The contrast was marked when the U-D interval was relatively prolonged. When the U-D interval was less than 90 s the infants born under extradural analgesia were marginally more acidotic than those born under general anaesthesia; in the latter there was a correlation between the duration of the U-D interval and neonatal acidosis, a feature which was not evident in the extradural series. The small numbers of group B cases precluded statistical evaluation, but the results reflected contrasts similar to those found among group A patients.
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Adult male or female rats were exposed either to enflurane 200 p.p.m. or to air for up to 63 days before mating and subsequently throughout the pregnancy of the females. The treated animals were exposed for 8 h per day, 5 days per week for a maximum total of 100 days. The parents and progeny-were studied. ⋯ Skeletal examination of the fetuses failed to reveal any major teratogenic effect. The parents remained healthy clinically, whilst autopsy and histopathological examination failed to reveal any consistent organ injuries which could be blamed on exposure to enflurane. In rats at least, environmental pollution with enflurane appears not to be associated with significant toxicity or teratogenicity.
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Randomized Controlled Trial Comparative Study Clinical Trial
Zomepirac, placebo and paracetamol/dextropropoxyphene combination compared in orthopaedic postoperative pain.