Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1997
Randomized Controlled Trial Comparative Study Clinical TrialBlood loss during suction termination of pregnancy with two different anaesthetic techniques.
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Anaesth Intensive Care · Dec 1996
Randomized Controlled Trial Clinical TrialAnalgesic efficacy of paracetamol in children using tonsillectomy as a pain model.
The analgesic efficacy of paracetamol was assessed in a prospective, randomized, double-blinded study of 100 children undergoing tonsillectomy with or without adenoidectomy. Fifty children were given paracetamol elixir 40 mg/kg 40 minutes preoperatively (Group A); the remaining 50 children were given an oral placebo 40 minutes preoperatively and paracetamol suppositories 40 mg/kg after induction of anaesthesia (Group B). Paracetamol was the only analgesic given and was given either orally or rectally in order to produce high variations in plasma paracetamol concentrations postoperatively. ⋯ The incidence of nausea and vomiting was the same in both groups (20%) during the 24 hour postoperative period. Plasma paracetamol concentrations of 0.066-0.132 mmol/l are known to reduce temperature; plasma paracetamol concentrations which provide analgesia are unknown. Children with plasma paracetamol concentrations above 0.07 mmol/l had superior analgesia to those with concentrations below this level (P < 0.05).
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Anaesth Intensive Care · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialA prospective clinical comparison of two intravenous polyurethane cannulae.
Tissue irritation, as evidenced by phlebitis, associated with Optiva (Johnson & Johnson Medical) and Insyte (Becton Dickinson) polyurethane cannulae was studied. The integrity of the cannulae on removal, the incidence of infection at the cannula site and the factors which influence phlebitis were also examined. One thousand and eight patients had a polyurethane cannula placed for induction of anaesthesia for cardiac surgery. ⋯ Minor tip distortion or shaft kinking of the cannulae occurred in 16.2% of Optiva and 23.5% of Insyte. This difference is statistically significant and may relate to the slightly more acute taper at the Optiva cannula tip. Both cannulae were similar in clinical performance.
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Anaesth Intensive Care · Oct 1996
Randomized Controlled Trial Clinical TrialProphylactic administration of histamine 1 and/or histamine 2 receptor blockers in the prevention of heparin- and protamine-related haemodynamic effects.
The efficacy of prophylactic administration of H1 and H2 receptor blockers to prevent adverse haemodynamic responses to heparin and protamine was studied. The control group (n = 10) received no histamine receptor blocker, group H1 (n = 10) received oral terfenadine 60 mg, group H2 (n = 10) received oral ranitidine 300 mg, and group H1+H2 (n = 10) received both terfenadine and ranitidine on the night before the operation and on call to the operating room. Heparin sulphate 300 U/kg was injected directly into the right atrium, and protamine hydrochloride was administered at the conclusion of bypass over at least three minutes through a peripheral route. ⋯ Protamine infusion did not lead to an increase in H-LA. Prophylactic administration of histamine receptor blockers (H1 or H2) attenuated the heparin-induced adverse haemodynamic response but did not change the protamine-related haemodynamic effects. Factors other than histamine may play a major role in protamine induced cardiovascular changes.
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Anaesth Intensive Care · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialMorphine for postoperative analgesia. A comparison of intramuscular and subcutaneous routes of administration.
Intermittent parenteral bolus doses of morphine are commonly used for postoperative analgesia. Morphine is typically given by intramuscular or intravenous injection but there are theoretical advantages for the subcutaneous route of administration. Fifty-nine patients entered a prospective randomized double-blind cross-over study comparing intermittent intramuscular and subcutaneous morphine boluses. ⋯ The majority of patients indicated a strong preference for the subcutaneous route. There were no significant differences in pain scores, respiratory rate, arterial oxygen saturation, heart rate, mean arterial pressure, sedation or nausea scores between intramuscular and subcutaneous administration of morphine. Postoperative analgesia by subcutaneous morphine bolus injection is as effective as intramuscular injection with a similar side-effect profile but with greater patient acceptance and less risk.