British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of meptazinol and pethidine given i.v. on demand in the management of postoperative pain.
Meptazinol and pethidine were compared under double-blind conditions in 20 patients, using an on-demand analgesic system to provide pain relief after upper abdominal surgery. The degree of analgesia, subjectively assessed, was good with both meptazinol and pethidine; although meptazinol produced significantly more nausea than did pethidine (P less than 0.01), there was no statistically significant difference in the frequency of other side-effects. Over 24 h average consumption of meptazinol was 2.4 times that of pethidine, suggesting that, when given by i.v. injection, meptazinol is less potent that pethidine.
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Interstitial fluid pressure (IFP) and plasma colloid osmotic pressure (plasma COP) were measured in dogs following acute haemorrhage and following the infusion of saline, 10% dextra 40 in saline and 3% dextran 40 in lactated Ringer's solution. Exsanguination decreased IFP, plasma COP and total plasma protein and albumin concentrations, and increased plasma glucose concentration and osmotic pressure. A massive infusion of physiological saline increased IFP, and decreased plasma COP and total plasma protein and albumin concentrations. ⋯ When a 10% dextran 40 saline solution was used, there was a marked increase in plasma COP but a decrease in IFP. When 3% dextran 40 in lactated Ringer's solution was infused, IFP was little affected in the early stage, but gradually increased thereafter. Plasma COP increased slightly immediately after infusion, but remained near the pre-exsanguination value for at least 3 h.
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Cyanide antidotes were given to dogs before an infusion of sodium nitroprusside 1.5 mg kg-1 for 1 h. Dogs given thiosulphate 75 mg kg-1 had significantly lower plasma and red cell cyanide concentrations while plasma thiocyanate concentrations were significantly increased in comparison with control. These changes were associated with only minimal disturbance of tissue oxygenation. ⋯ There was no evidence of a synergistic action between thiosulphate and hydroxocobalamin. The vascular response to nitroprusside was unchanged in the thiosulphate-treated dogs, but was significantly greater in those given hydroxocobalamin. The implications for prophylaxis and treatment of cyanide poisoning following nitroprusside overdose are discussed.