Anaesthesia and intensive care
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Anaesth Intensive Care · Dec 1997
Randomized Controlled Trial Clinical TrialIntrathecal pethidine: an alternative anaesthetic for transurethral resection of prostate?
We aimed to determine the usefulness of intrathecal pethidine as the sole anaesthetic for transurethral resection of prostate (TURP) while comparing the incidence of hypotension with intrathecal bupivacaine. A double-binded randomized prospective trial was conducted involving 40 patients for TURP. The patients were divided equally into two groups; group A received 2 ml 0.5% bupivacaine intrathecally and group B received 40 mg pethidine intrathecally. ⋯ There was no significant difference in the incidence of hypotension. The pethidine group had significantly greater reduction in heart rate, a lower degree of motor block, shorter period before requests for postoperative analgesia but a higher incidence of sedation, nausea and vomiting. Intrathecal pethidine did not offer any advantage over intrathecal bupivacaine for TURP.
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Anaesth Intensive Care · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of sevoflurane with halothane for paediatric day case surgery.
A phase III, open label randomized study was conducted in 50 patients comparing halothane and sevoflurane for paediatric day case surgery. A graded inhalational induction resulted in only slightly more rapid induction with sevoflurane (3.34 +/- 0.92 versus 3.85 +/- 1.02 minutes; P > 0.05). In children receiving sevoflurane, systolic blood pressure decreased to a lesser extent during induction (143 +/- 19.2 versus 26.9 +/- 10.9 percent decrease from resting values; P < 0.01) and heart rate was maintained. ⋯ Objective pain/discomfort scores were higher in patients receiving sevoflurane at 10, 20, 30 and 40 minutes after arrival in the recovery room, and the incidence of excitement during emergence was higher in this group. It is concluded that sevoflurane is well tolerated for inhalational induction and has an improved cardiovascular profile compared to halothane. Emergence was significantly more rapid following sevoflurane.
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Anaesth Intensive Care · Dec 1997
Letter Randomized Controlled Trial Clinical TrialSpinal morphine for caesarean section.
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Anaesth Intensive Care · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialEpidural infusion of bupivacaine 0.0625% plus fentanyl 3.3 micrograms/ml provides better postoperative analgesia than patient-controlled analgesia with intravenous morphine after gynaecological laparotomy.
One hundred and twenty women undergoing gynaecological abdominal operations were randomized to receive either epidural bupivacaine 0.0625% + fentanyl 3.3 micrograms/ml infusion (Group EPI, n = 57), or patient-controlled intravenous morphine analgesia (Group PCA, n = 54) for postoperative pain relief. The groups were comparable in demographic data, types and duration of operation. Group EPI achieved significantly lower verbal rating scale of pain (VRS) at rest at 0, 4, 12, 16, 20, 28 and 40th postoperative hours. ⋯ Nausea/vomiting occurred in 52.6%/33.3% of patients in Group EPI and 52.7%/37.0% in Group PCA. Most patients (84.2% in Group EPI and 72.2% in Group PCA) rated their pain management as "good". We conclude that epidural infusion of bupivacaine 0.0625% and fentanyl 3.3 micrograms/ml provide better analgesia than patient-controlled intravenous morphine after gynaecological laparotomy.
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Anaesth Intensive Care · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialVentilator-CPAP with the Siemens Servo 900C compared with continuous flow-CPAP in intubated patients: effect on work of breathing.
The effects of continuous positive airway pressure (CPAP) provided by the Siemens Servo 900C ventilator were compared with a continuous flow system (CF-CPAP) in patients weaning from the ventilator. Thirteen patients were studied using both systems at a CPAP level of 0.5 kPa. Additional work of breathing (Wapp) and derived variables were determined in relation to the minute volumes of the patients. ⋯ The EEP increasingly exceeded the preset CPAP level of the ventilator at higher minute volumes. An inspiratory threshold due to a gradient between EEP and preset CPAP greatly increased the Wapp imposed by the ventilator. As this threshold was attributed to the resistance of the PEEP device of the ventilator, it indicates that the additional work related to the expiratory value should be taken into account when the Siemens Servo 900C ventilator is used for weaning purposes.