Ugeskrift for laeger
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Ugeskrift for laeger · Aug 2000
Randomized Controlled Trial Clinical Trial[Neutralization of lidocaine-adrenaline. A simple method for less painful application of local anesthesia].
The amount of sodium bicarbonate necessary to neutralise commercially available lignocaine-epinephrine (pH 4.7) to physiologically neutral pH (7.4) was established. The analysis showed that neutral pH could be accomplished by adding 1.0 ml sodium bicarbonate (8.4 g/l) to 10 ml lignocaine-epinephrine (1%, 5 microgram/ml). Chemical analysis also established that the neutralised lignocaine-epinephrine was stable for 24 hours after adding sodium bicarbonate. A double-blinded randomised clinical trial with crossover design done on volunteers from hospital staff proved that injection of neutralised lignocaine-epinephrine is less painful than commercially available lignocaine-epinephrine (p < 0.001).
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Ugeskrift for laeger · Dec 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Complications after spinal analgesia using three different spinal needles: Sprotee, Spinocan and Atraucan].
In this prospective, randomised study 197 patients aged below 40 years received spinal analgesia using one of the following needles: Sprotte G24, Spinocan G27 or Atraucan G26. The incidence of insufficient or failed analgesia and difficulties handling the needles were noted. Patients were interviewed within three weeks after anaesthesia so as to establish the incidence of postoperative complications including post-dural puncture headache (PDPH). ⋯ Furthermore a significantly lower incidence of insufficient analgesia was observed with the Sprotte needle (0% versus 12.1% with the Spinocan and 11.6% with the Atraucan, p < 0.05). In conclusion, the Sprotte needle had the best profile with respect to PDPH and successful analgesia. This confirms the importance of the needle tip design.
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Ugeskrift for laeger · Mar 1999
Randomized Controlled Trial Clinical Trial[The effect of pedicle screw instrumentation on posterolateral spinal fusion. A prospective, randomized study with a two-year follow-up].
The aim was to evaluate the effect of supplementary pedicle screw fixation (Cotrel-Dubousset [CD]) in posterolateral lumbar spinal fusion. The study comprises 130 patients undergoing lumbar or lumbosacral fusion for spondyloisthesis grades I-II or degenerative segmental instability conditions. The patients were randomly allocated for no instrumentation (n = 66) or CD instrumentation (n = 64) in posterolateral lumbar fusion. ⋯ Instrumentation increased both operation time, blood loss, and early re-operation rates significantly. A high patient satisfaction was found in both groups. However, the results from this study do not justify the general use of pedicle screw fixation alone as an adjunct to posterolateral lumbar fusion.
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Ugeskrift for laeger · Nov 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Prophylactic use of prostaglandin synthesis inhibitors in connection with IUD insertion].
In a double-blind, randomized, placebo-controlled study conducted at a contraception clinic, 55 women (three nulliparous) were given either ibuprofen 600 mg or placebo 1-4 hours prior to insertion of IUD, 4-6 hours after insertion of IUD and the following morning. Pain was assessed by ten point Numerical Rating Scales during insertion, in the first 4-6 hours and in the following three days. ⋯ The patients were further randomized to type of IUD: TCu-380A and Nova T (R.). No difference in pain scores was evaluated between these.
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Ugeskrift for laeger · Aug 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Atraucan, a new needle for spinal analgesia].
One hundred and six consecutive patients, aged below 40 years, scheduled for surgery in the lower part of the body were chosen for this study. Patients were allocated randomly to have spinal analgesia with either a Sprotte 24G or an Atraucan 26G spinal needle. Incidences of insufficient blocks were higher after dural puncture with the Atraucan needle. ⋯ Eight patients (16%), all in the Atraucan group, required an epidural blood patch. Ease of needle insertion and number of puncture attempts were the same for both needles. We conclude that due to the high incidence of PDPH the Atraucan 26G spinal needle cannot be recommended for spinal analgesia in young patients.