European journal of anaesthesiology
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The use of suppositories has been examined following a recent case in which an anaesthetist was reported to the United Kingdom General Medical Council. This study examined the preference for routes of administration of post-operative analgesia. ⋯ The i.v. route was most popular with young (98% under 20 years) females (79%) social class I subjects (90%), doctors (96%), nurses (95%), those who had never had a suppository (81%) and those who had ill effects following a previous suppository (95%). This result suggests that patients are more tolerant of suppositories than hospital staff but the majority prefer the i.v. route.
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This study was undertaken to investigate the neuromuscular blocking profile and cardiovascular effects of Org 9487, a new aminosteroidal, non-depolarizing, neuromuscular blocking agent structurally related to vecuronium, in anaesthetized animals and in isolated muscle preparations. In in vitro functional assays of neuromuscular blocking activity, Org 9487 was between eight and 15 times less potent than vecuronium. In cats and monkeys the potency of Org 9487 was approximately one-seventh and one-twentieth, respectively, that of vecuronium. ⋯ The administration of clinically relevant doses of neostigmine or pyridostigmine shortened the time-course profile of Org 9487, even when administered during profound neuromuscular block. In animals, Org 9487 is a low potency, nondepolarizing neuromuscular blocking agent with a time course profile similar to that of suxamethonium. Although Org 9487 is less selective than vecuronium for the neuromuscular junction, it is unlikely to produce prohibitive cardiovascular side effects in man.
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Comparative Study Clinical Trial Controlled Clinical Trial
Adsorption of desflurane from the scavenging system during high-flow and minimal-flow anaesthesia by zeolites.
Application of high-silica zeolites in a special adsorber allows complete selective adsorption of the inhalation anaesthetic desflurane from the outlet port of the scavenging system of the anaesthesia machine. In comparison with charcoal filters, zeolites allow almost complete desorption at moderate temperatures followed by condensation of the desflurane to the liquid phase. The adsorption of scavenged desflurane by zeolites was measured in 13 patients. ⋯ A minimal-flow regime (0.5 L min-1 fresh gas inflow) was used for maintenance in seven patients and a higher-flow regime (3 L min-1 fresh gas flow) was used for maintenance in six patients. In minimal-flow anaesthesia, 62% of the delivered desflurane was adsorbed by the zeolite while 86% of the delivered desflurane was adsorbed in higher-flow anaesthesia. Preliminary results show that about 85% of the adsorbed desflurane could be recovered as liquid with high purity via desorption.
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Randomized Controlled Trial Comparative Study Clinical Trial
Addition of droperidol to morphine administered by the patient-controlled analgesia method: what is the optimal dose?
Eighty patients were recruited into a double-blind, randomized trial to find the optimal dose of droperidol for addition to the patient-controlled analgesia (PCA) morphine infusate for female patients undergoing gynaecological surgery. A standardized anaesthetic technique was employed. Post-operative analgesia was provided by PCA morphine. ⋯ However, after 24 h, patients in group 4 were significantly more sedated than patients in groups 1 and 2 (P < 0.05). There were no significant differences between the groups in terms of the incidence of anxiety or other side effects attributable to droperidol. The present authors suggest that, although the results demonstrate few statistically significant differences between the four groups, a PCA bolus dose of droperidol of 0.10 mg mL-1 appears to provide the optimal balance between anti-emetic efficacy and an acceptable incidence of side effects.