British journal of anaesthesia
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Comparative Study Clinical Trial Controlled Clinical Trial
Control of breathing after fentanyl and Innovar anaesthesia.
Ventilation (VI), end-tidal (PCO2), mixed venous (PvCO2) and the ventilatory response to carbon dioxide were measured before surgery, and during the first 4 h of recovery in 18 adult patients who underwent elective limb surgery under fentanyl or Innovar anaesthesia. End-tidal and mixed venous PCO2 were increased significantly in the first 150 min after the last dose of drug (P less than 0.001, P less than 0.01), but had returned to control values by 4 h. ⋯ This suggests that patients with a low value of VI/PCO2 are not more susceptible to the ventilatory depressed action of narcotic anaesthetics. Recovery of ventilatory responsiveness towards normal during the 4 h after anaesthesia, occurred in a graded and progressive manner, there was no evidence of a biphasic pattern of recovery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Dose-response relation for atracurium, ORG NC 45 and pancuronium.
The potencies of atracurium, Org NC 45 and pancuronium were determined using cumulative dose-response curves. The effective doses producing 95% twitch depression were 279 microgram kg-1, 56 microgram kg-1 and 64 microgram kg-1 respectively, the relative potency being 1:5.0:4.3. ⋯ The three drugs provided equal and generally good intubating conditions at approximately 95% twitch depression. Greater arterial pressure and heart rate were seen with pancuronium than with atracurium and Org NC 45.
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Randomized Controlled Trial Clinical Trial
Changes in fetal TCPO2 values occurring during labour in association with lumbar extradural analgesia.
Forty-six of 64 high risk labours were managed with continuous lumbar extradural analgesia. Fetal heart rate (FHR) and continuous transcutaneous PO2 (tcPO2) measurements were made in the 64 patients. ⋯ These effects and the changes in FHR were not seen in the 18 mothers not receiving extradural analgesia. The supine position was associated with slightly smaller fetal tcPO2 values than the preferred lateral positions, with a significant worsening of the fetal tcPO2 values after induction of the extradural block although, overall, extradural analgesia neither improved nor impaired the fetal tcPO2.
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Randomized Controlled Trial Clinical Trial
Effect of the trendelenberg position on spinal anaesthesia with hyperbaric bupivacaine.
In a double-blind study, the effect of the Trendelenberg position was compared with the supine, in 20 patients following intrathecal injection of 3 ml of 0.5% bupivacaine in 8% glucose. All patients had blocks suitable for abdominal surgery. ⋯ There were no differences in motor block, duration or cardiovascular changes between the groups. It is concluded that the trendelenberg position is not necessary to ensure spread of local anaesthetic solution into the mid thoracic region for abdominal surgery.