Anesthesia and analgesia
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Anesthesia and analgesia · Feb 1982
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine for postoperative pain relief: a comparative study with intramuscular narcotic and intercostal nerve block.
The relatively new technique of epidural morphine analgesia was compared with two well established method of pain relief in 90 patients undergoing gallbladder surgery and divided randomly into three groups of 30 patients each. The first group received intramuscular narcotic analgesic ketobemidone, the second group was given 0.5% bupivacaine-epinephrine intercostal nerve block, and the third group received a single dose of 4 mg of epidural morphine for postoperative pain relief. The mean duration of analgesia after ketobemidone was 5.5 hours, and after intercostal block 11 hours. ⋯ Delayed respiratory depression was not encountered after epidural morphine. It is concluded that a single dose of 4 mg of epidural morphine provides excellent regional analgesia of long duration without drowsiness or circulatory of respiratory depression thus facilitating early ambulation. The technique is superior to more common methods of pain relief after gallbladder surgery, e.g., intercostal nerve block and intramuscular narcotics.
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The effect of the new H2 receptor antagonist ranitidine on gastric pH was studied using a double-blind technique in 36 patients undergoing elective surgery, 18 of whom were given 150 mg of ranitidine orally the night before and on the morning of surgery. The incidence of gastric residue pH higher than 2.5 (p less than 0.01) was significantly greater in patients given ranitidine than in 18 untreated control patients. The mean volume of gastric aspirate in the treated group as 6.7 ml (range 2 to 20 ml) compared with the control group 15.6 ml (range 2 to 44 ml). The higher potency, longer duration of action, and fewer side effects of ranitidine compared with cimetidine suggest that this drug may have clinical advantages over other H2 receptor antagonists.
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Anesthesia and analgesia · Jan 1982
Comparative StudyCuffed tracheal tubes--physical and behavioral characteristics.
This study compares physical and behavioral characteristics of currently used cuffed tracheal tubes. Variability in physical and behavioral characteristics between size 8 tracheal tubes and cuffs exists: radius of tube curvature varies from 12.1 to 15.8 cm, bevel angle 39 to 56 degrees, bevel direction 73 to 107 degrees, distance from proximal end of bevel to cuff 15.4 to 24.4 mm, internal tube diameter 7.5 to 8.8 mm, wall thickness 1.14 to 2.37 mm, force to collapse 1020 to 3103 g, angle to kink 52 to 96 degrees, and indentation hardness 65.4 to 83.1. ⋯ Argyle, National Catheter, Ohio, Portex, Rusch "safety," and Shiley tracheal tubes resist collapse and kinking. Argyle, Lanz, National Catheter "hi-lo," National Catheter "intermediate hi-lo," Ohio, and Portex "profile" cuffs are thin and have diameters larger than the average male tracheal diameter.
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Anesthesia and analgesia · Dec 1981
Delayed onset of epidural anesthesia in patients with back pain.
Onset and completeness of anesthesia were compared in 15 patients with back pain or sciatica and in 10 patients without back pain given lumbar epidural anesthesia with 20 to 25 ml of 1.5% mepivacaine, 80 mg of methylprednisolone, and 1:200,000 epinephrine. Sensory block was complete within 30 minutes in patients without back pain. Eleven of 15 (73%) patients with back pain had delayed onset of anesthesia ranging from 35 to 95 minutes. ⋯ Differences in time of onset between affected nerves and contralateral nerves were also significant (p less than 0.01). The nerve roots involved, as determined from the myelogram or the electromyogram, or those adjacent to them, were the roots with delayed onset of block. Any effect of the steroid on nerve blockade was ruled out as there was solid anesthesia in patients without back pain.