Canadian Anaesthetists' Society journal
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Randomized Controlled Trial Clinical Trial
Pre-anaesthetic medication in paediatric day-care surgery.
Pre-anaesthetic medication has the primary aim of making the whole process of anaesthesia smooth and agreeable. This prospective blind study was planned to compare the efficacy of three active drugs and a placebo as premedication in a paediatric population undergoing operation on a day care basis. One hundred and fifty-nine patients between one and 12 years of age were assigned randomly to one of four groups who received either hydroxyzine 0.5 mg . kg-1 (n - 43) promethazine 0.5 mg . kg-1 (n 40) diazepam 0.1 mg . kg (n - 378) or placebo (n - 36) by mouth, 60 minutes before operation. ⋯ The parents were asked for return a questionnaire detailing psychological and physical complications during three postoperative days. There was no difference between the groups in any of the factors examined. From this study we conclude that children undergoing surgical operations and anaesthesia on a day care basis should not receive pharmacological premedication, not because of overwhelming risk from its use, but because of the absence of any benefit.
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We compared a new blood warmer, the Gorman-Rupp DW-1000A Blood Fluid Warmer, with the blood warmer currently being used at our hospital (the Hemokinetitherm). Using dated stored whole blood, we compared the heating capacities of the two blood warmers at varying flow rates. ⋯ The extent of blood warming at the maximum infusion rate was from 10.6 degrees C to 28.5 degrees C for Hemokinetitherm, compared with 10.6 degrees C to 32.5 degrees C for the DW-1000A. We conclude that the DW-1000A is superior to the blood warmer we have been currently using both heating capabilities and maximum possible infusion rate.
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Mice of two strains, Crl:CD-1(1CR)Br and C57BL6, were exposed to nitrous oxide at concentrations of 50, 65 and 80 per cent for 34 or 68 hours. Cessation of nitrous oxide resulted in characteristic convulsions similar to those seen in alcohol withdrawal in all mice. These peaked in severity within 2-3 minutes after removal from nitrous oxide and declined over 6 hours. ⋯ The narcotic antagonists did not precipitate acute weight loss or characteristic jumping behaviour seen in animals dependent on opiates. These results demonstrate that chronic exposure to nitrous oxide results in development of physical dependence which resembles alcohol and not opiate dependence. Analgesia and physical dependence produced by nitrous oxide appear to be mediated through separate mechanisms.
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Comparative Study
Incentive spirometry: its value after cardiac surgery.
Treatment with intermittent positive pressure breathing (IPPB) and incentive spirometry (I. S.) was compared in 109 patients after heart surgery with cardiopulmonary bypass. Assessment was done by measurement of vital capacity, arterial oxygen tension and identification of the radiological signs of atelectasis. ⋯ P. B., in preventing atelectasis after open-heart surgery. Possibly incentive spirometer treatment given more frequently may be more effective.