British medical journal
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British medical journal · Jun 1969
Comparative Study Clinical TrialEffect of diazepam on awareness during caesarean section under general anaesthesia.
The use of diazepam for premedication before elective caesarean section increased the incidence of unpleasant recall postoperatively, compared with atropine in a previous study. This finding suggests that diazepam is unsuitable for this type of anaesthesia.
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British medical journal · Jun 1969
Cardiac abnormalities in poisoning with tricyclic antidepressants.
Of 80 consecutive admissions to a general hospital for drug overdose, 10 had taken one or other of the tricyclic antidepressants. All 10 had abnormalities of cardiac conduction as shown by prolonged Q-T(e) intervals, and eight had S-T segment and T-wave changes. Five of the 10 patients had arrhythmias and two of these died. Continuous electrocardiographic monitoring is recommended in patients with overdosage of tricyclic antidepressants.
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A prospective study of 1,000 consecutive primigravid deliveries has shown that active management in labour can ensure that every woman is delivered within 24 hours. Emphasis is laid on the importance of a correct initial diagnosis of labour based on objective criteria. ⋯ Firstly, that prolonged labour is often an expression of cephalo-pelvic disproportion; secondly, that oxytocin may rupture the primigravid uterus; and, thirdly, that there is a valid therapeutic distinction between hypotonic and hypertonic uterine action. Stimulation, properly supervised, is safe to mother and child, it eliminates the problem of occipitoposterior position, results in a sharp decline in forceps delivery, and obviates the need for massive analgesia.