British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of concentration of local anaesthetic drugs in extradural block.
An increase in the concentration of bupivacaine from 0.5% to 0.75% and etidocaine from 1.0% to 1.5% for extradural block resulted in a more rapid onset of sensory analgesia and motor blockade, a greater frequency of adequate analgesia,a greater depth of motor block and a longer duration of sensory analgesia and motor blockade. An increase in the concentration of prilocaine from 2% to 3% failed to reveal any significant advantage. The use of the more concentrated solutions of bupivacaine and etidocaine would appear to afford significant clinical advantages in extradural anaesthesia for surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficiency of two variable performance techniques of oxygen therapy in relieving postoperative hypoxaemia.
The efficiency of two patient-dependent, variable performance techniques of oxygen therapy in relieving hypoxaemia after upper abdominal surgery was compared. A high-flow system delivered a humidified mixture of oxygen 2 litre min-1 and air 13 litre min-1 through a cannula inserted into the anterior nares. ⋯ With the patients breathing room air, arterial hypoxaemia could be demonstrated with Pao2 inversely related to age. The increase of Pao2 during either oxygen treatment was significantly greater with the low flow system.
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The anaesthetic and surgical problems associated with Caesarean section in eight grossly obese patients (weight 150-204 kg) are described. In addition to an increase in the frequency and severity of the complications of obesity, those weighing more than 150 kg present a panniculus which may weigh 70 kg. ⋯ One fetus died in utero after serious and prolonged arterial hypotension in the mother caused by powerful cephalad retraction of the panniculus (extradural analgesia). General anaesthesia was associated with severe episodes of hypertension in two patients.