British journal of anaesthesia
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The analgesic effect of i.v. lignocaine was evaluated in five patients with clinical neuralgic pain of varying aetiology. The response was compared with that on concurrently-induced ischaemic pain, initially of the same intensity. ⋯ The results suggest a divergence in the specificity of the analgesic action of lignocaine i.v. according to the nature of the pain-inducing process. Disorders manifesting as deafferentation or central neuralgias appear to be affected favourably by lignocaine i.v. whereas pain of peripheral origin is unaffected by lignocaine, except at blood concentrations which approach toxic values.
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Comparative Study Clinical Trial Controlled Clinical Trial
Plasma concentration and E.E.G. after various regimens of etomidate.
Etomidate was injected i.v. within 10 or 60 s at various doses. After etomidate 0.3 mg kg-1 the plasma concentration was 1.6 micrograms ml-1 at 1 min after the end of injection. For about 7 min a good hypnotic effect (stages C0-D2) was observed on the e.e.g. recording. ⋯ Each additional injection produced a steep increase in concentration of short duration with marked deepening of hypnosis. The infusion induced only a moderate increase in plasma concentration, whereas the depth of sleep during the period of infusion remained nearly the same. E.e.g. changes induced by etomidate are similar to those after barbiturates and other i.v. anaesthetics.
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Some actions of the muscle relaxant drug Org NC 45 on the tibialis anterior muscle of cats under barbiturate-chloralose anaesthesia have been studied. Its effects were characteristic of a neuromuscular blocking agent that acts predominantly, although not necessarily exclusively, by blocking postjunctional cholinoceptors. It was confirmed that one of the important features of the action of Org NC 45 is that, despite its high potency, its offset of action is unusually rapid. ⋯ The results obtained in cats with edrophonium were essentially confirmed in preliminary studies on nine anaesthesized patients. In these studies, a dose of edrophonium 0.5 mg kg-1 i.v. was found to produce adequate and rapid antagonism of Org NC 45, and because of the relatively weak side-effects of edrophonium, it was necessary, about 30 s before edrophonium, to administer only 0.6 mg of atropine (about 9 micrograms kg-1), which is half the dose commonly used when neostigmine is the reversal agent. These preliminary observations in man suggest that edrophonium may be the reversal agent of choice for Org NC 45.
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Comparative Study Clinical Trial Controlled Clinical Trial
Sore throat after operation: influence of tracheal intubation, intracuff pressure and type of cuff.
One hundred and eighty-four patients were studied to elucidate the contribution of intracuff pressure and cuff type to the occurrence of sore throat and hoarseness after operation. The patients were allocated to one of the following groups: A = mask only; B = reusable Rüsch tube with intermittent cuff volume adjustment; C = reusable Rüsch tube without cuff volume adjustment; D = disposable Portex Blue Line tube with intermittent cuff volume adjustment; E = disposable Shiley Low Pressure tube with intermittent cuff volume adjustment. Nitrous oxide was a component of anaesthesia in all patients. ⋯ All sequelae occurred less frequently in group A than in any of the other groups (P less than 0.025). Women were more likely to develop sore throat after intubation than were men (P less than 0.01). A possible relationship between differences in cuff-trachea contact area is postulated.
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Randomized Controlled Trial Clinical Trial
A controlled trial of extradural fentanyl in labour.
In a double-blind trial carried out on patients in the first stage of labour, either fentanyl 80 micrograms (n = 35) or physiological saline (n = 33) was added to the test dose of bupivacaine and administered extradurally. Thereafter analgesia was maintained as necessary with 0.5% bupivacaine alone. ⋯ Analgesia was more rapid in onset and more complete in the fentanyl group, and the duration from first dose to first top-up was 2.36 h, compared with 1.66 h (supplements notwithstanding) in the control group. No serious side-effects were encountered in either group, although eight patients in the fentanyl group experienced mild itching, compared with one in the control group.