South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Randomized Controlled Trial Comparative Study Clinical Trial
Ciramadol--a new synthetic analgesic. A double-blind comparison with oral codeine for postoperative pain relief.
One hundred and eighty patients (American Society of Anesthesiologists rating 1-2) received one of three oral analgesics--ciramadol (Wy. 15705) 20 mg, ciramadol 60 mg or codeine 60 mg--on a double-blind random basis for the relief of pain 24-48 hours after major general surgical, gynaecological or orthopaedic operations. All three analgesics proved equally effective and caused mild sedation only. No patient showed signs of clinical cardiorespiratory depression, and other side-effects were infrequent. Ciramadol may therefore prove a useful clinical alternative to conventional oral analgesics provided its lack of respiratory depressant properties and addiction potential in monkeys can be substantiated in humans.
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A survey of all paediatricians registered with the South African Medical and Dental Council in July 1981 was conducted and the results were correlated with the child population as determined by the 1980 census. There were 201 active paediatricians, of whom 55% were employed in hospitals and 45% in private practice; 83% were resident in areas in which there were teaching hospitals, while only 23% of the total number of children resided in these areas. ⋯ We are therefore faced with the problem of having a paediatrician corps which although adequate in number is badly distributed, resulting in the rural population being grossly under-serviced. Possible solutions are presented.
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Case Reports
Accidental severe hypercapnia during anaesthesia. Case reports and a review of some physiological effects.
Hypercapnia developed during anaesthesia in 2 patients owing to a nitrous oxide cylinder being filled with carbon dioxide. The aetiology and effects of gross hypercapnia during anaesthesia are reviewed.