European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia for labour using a continuous infusion of bupivacaine and alfentanil.
Seventy women who requested epidural pain relief in labour received a continuous epidural infusion at 8 ml h-1, which contained either 0.25% bupivacaine (n = 29), or a mixture of 0.125% bupivacaine and 0.005% alfentanil (n = 31), assigned randomly. Increments of 4 ml 0.25% bupivacaine were given on demand to prevent residual pain from uterine contractions. ⋯ One of the women receiving the mixture and eight of the women receiving bupivacaine alone had almost complete motor block. There were no differences in the mode of delivery or in the neonatal Apgar scores.
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Randomized Controlled Trial Clinical Trial
Central nervous system symptoms after intravenous lignocaine: dose-response during pregnancy.
There is continuing controversy over what dose of what drug should be used to identify an accidental intravascular or subarachnoid catheter placement in obstetric epidural anaesthesia. The purpose of this randomized, double-blind study was to evaluate the dose-effect relationship for the production of central nervous system (CNS) symptoms by intravenous lignocaine. ⋯ An ED95 of 1.12 mg kg-1 was calculated to produce reliable CNS symptoms when injected intravascularly. Lignocaine is an effective and reliable marker for intravenous injection in pregnant women.
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Randomized Controlled Trial Clinical Trial
Effect of intravenous diclofenac on pain and recovery profile after day-case laparoscopy.
Diclofenac sodium, 100 mg, or saline was given intravenously after the induction of anaesthesia to 169 patients undergoing outpatient gynaecological diagnostic laparoscopy or laparoscopic sterilization by tubal ligation. Propofol was used as the main anaesthetic agent and fentanyl and paracetamol were given for post-operative pain relief. In the post-anaesthesia care unit the amount of analgesics given and the incidence of nausea and vomiting were recorded. ⋯ However, patients in the tubal ligation group needed significantly more post-operative analgesia than patients in the laparoscopy group. Diclofenac had no influence on the rapidity of recovery or home readiness in either group. It is concluded that diclofenac has no influence on home readiness, but prevents postoperative pain in patients undergoing diagnostic laparoscopies, whereas it was not a potent enough analgesic to prevent pain after laparoscopic tubal ligation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intubation with propofol: evaluation of pre-treatment with alfentanil or lignocaine.
The effect of lignocaine or alfentanil pre-treatment on conditions at orotracheal intubation following induction with propofol, but without the use of muscle relaxants, were compared in a prospective, controlled, double-blind study. Forty five healthy patients undergoing elective surgery were randomly allocated to receive either 0.9% saline (control), alfentanil 20 micrograms/kg-1, or lignocaine 1.5 mg kg-1 prior to induction with propofol 2.5 mg kg-1. ⋯ Intubation scores of 1 or 2 were obtained in 14 out of 15 patients (93%) in the alfentanil group and this was significantly better than the lignocaine group (33%) or control group (20%). No difference was detected between the scores of the latter two groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
Topical anaesthesia of the larynx: cocaine or lignocaine?
A double-blind, randomized study compared the cardiovascular responses and extubation conditions using lignocaine or cocaine for topical anaesthesia of the larynx. Absorption of both agents from the trachea was quantified by serial venous plasma concentrations. Serial blood pressure, ECG, O2 saturation and end-tidal carbon dioxide measurements were obtained. ⋯ No difference was found in cardiovascular measurements between the two groups. The patterns of absorption of cocaine and lignocaine from the laryngeal mucosa were very similar, with peak absorption occurring at 10-15 min after laryngeal spraying. Although cocaine reduced the incidence of post-operative coughing when compared with lignocaine, this did not reach statistical significance.