European journal of anaesthesiology
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Historical Article
The effect of the First World War (1914-1918) on the development of British anaesthesia.
One of the greatest but also most unfortunate ironies in life is how modern medicine owes some of its existence to the deadly cancer of war. For those whose image of armed conflict is one of disease, death and destruction, this will no doubt be a surprise. However, these very conditions have allowed military surgeons and physicians unparalleled opportunities to experiment and develop using large and dependent populations of potential patients. ⋯ This work led to the popularity of nitrous oxide, ether and oxygen, which in turn stimulated interest in anaesthesia machines. Finally, the treating of facial wounds in casualties at the Queen's Hospital for facial and jaw injuries at Sidcup, highlighted the possibility of endotracheal intubation, a technique that had a drastic effect on the administration of anaesthetics. Although there were no new wonder anaesthetics, something which would not occur until the neuromuscular blocking drugs of the 1940s, many of these concepts moved into civilian anaesthesia and enabled British anaesthesia to be at the forefront of anaesthesia development for much of the twentieth century.
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Comparative Study
Differential neurotoxicity of tricyclic antidepressants and novel derivatives in vitro in a dorsal root ganglion cell culture model.
Tricyclic antidepressants are commonly employed orally to treat major depressive disorders and have been shown to be of substantial benefit in various chronic pain conditions. Among other properties they are potent Na+ channel blockers in vitro and show local anaesthetic properties in vivo. The present study aimed to determine their differential neurotoxicity, and that of novel derivatives as prerequisite for their potential use in regional anaesthesia. ⋯ Tricyclic antidepressants and novel derivatives thereof show differential neurotoxic potential in vitro. The rank order of toxicity relative to sodium channel blocking potency was desipramine < amitriptyline < N-methyl amitriptyline < doxepin < trimipramine < imipramine < N-methyl doxepin < N-propyl doxepin.
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Randomized Controlled Trial Comparative Study
Comparison of effects of preoperatively administered lornoxicam and tenoxicam on morphine consumption after laparoscopic cholecystectomy.
The efficacy, tolerability and the morphine-sparing effects of lornoxicam were compared with those of tenoxicam when used preoperatively in patients undergoing laparoscopic cholecystectomy. ⋯ Preoperatively administered lornoxicam 16 mg significantly prolonged the first morphine demand time, reduced postoperative morphine consumption during the first 4 h and caused significantly fewer adverse effects when compared with tenoxicam after laparoscopic cholecystectomy.
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Randomized Controlled Trial
Effect of midazolam, dexamethasone and their combination on the prevention of nausea and vomiting following strabismus repair in children.
Postoperative nausea and vomiting is a common complication following strabismus surgery. This randomized and double-blind study was designed to evaluate the efficacy of midazolam alone or in combination with dexamethasone in reducing the incidence of postoperative nausea and vomiting in children undergoing strabismus repair. ⋯ Prophylactic midazolam with or without dexamethasone reduces the incidence of PONV in children undergoing strabismus repair.