European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Does epidural injection of physiological saline facilitate the advancement of catheters?
Seventy patients (ASA I, ASA II), scheduled for a surgical intervention under epidural or combined spinal-epidural anaesthesia, were randomly allocated to one of two groups. The epidural space was identified by loss of resistance using air, followed by injection in Group A (35 patients) of 10 ml of physiological saline directed cephallad and in Group B (35 patients) by no injection. ⋯ No significant difference in resistance was found between the groups. The authors conclude that the injection of 10 ml of physiological saline into the epidural space does not facilitate the advancement of an epidural catheter.
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Randomized Controlled Trial Clinical Trial
Effect of nitrous oxide on post-operative nausea and vomiting during propofol anaesthesia for short surgical operations.
One hundred patients of ASA status I or II, undergoing gynaecological or urological surgery were studied. Opioids were omitted from premedication and anaesthesia. Patients were allocated randomly to one of two equal groups and were anaesthetized using a computer controlled infusion system, programmed to achieve theoretically any target blood propofol concentration. ⋯ Theoretical blood propofol concentration shown to produce surgical anaesthesia was maintained in all patients. However 12% of the patients that received nitrous oxide and 40% of the patients that did not, responded to the surgical stimulus by limb movement. Patients in the oxygen group required higher rates of propofol infusion to maintain surgical anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of caudal morphine and buprenorphine for post-operative analgesia in children.
Sixty five children aged from 1-10 years who underwent herniotomy, cystolithotomy or orchidopexy received either buprenorphine 4 micrograms kg-1 (n = 33) or morphine 50 micrograms kg-1 (n = 32) by the caudal epidural route; each thus received 0.5 ml kg-1 body weight. General anaesthesia was given for surgery. Post-operative pain and behaviour were assessed by an independent observer at 1, 4, 8, 16 and 24 h post-operatively. Caudal morphine and buprenorphine were equally effective for post-operative analgesia in children, but buprenorphine was better because of its longer duration of action and lower incidence of side effects.
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Randomized Controlled Trial Comparative Study Clinical Trial
How many interscalenic blocks are there? A comparison between the lateral and posterior approach.
This study compares the areas of analgesia obtained with the lateral and posterior approaches to the interscalene space after injection of equal volumes of anaesthetic solution (40 ml of a mixture of 0.5% bupivacaine with adrenaline 1:200,000 and 2% lignocaine in equal parts). There was a significant difference in the distribution of the areas of analgesia between the two approaches. With the posterior approach, the region supplied by the radial, medial and ulnar nerves and the post-axial border of the upper limb were more frequently involved, whilst with the lateral approach the area of analgesia was usually confined to the regions supplied by the most caudal roots of the cervical plexus and the upper trunk of the brachial plexus (pre-axial border of the upper limb). On these grounds it appears that two different types of interscalene block are possible.
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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.