Anaesthesia and intensive care
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Anaesth Intensive Care · May 1983
Comparative StudyA comparison of methods of cardiac output measurement.
Cardiac output measurements determined by dye dilution, iced-injectate thermodilution and room temperature thermodilution were compared in man in order to assess the random error of each method and to examine the systematic error of both thermodilution methods in comparison with dye dilution. Results showed that random error was greatest with room temperature thermodilution and least using iced thermodilution. Iced thermodilution correlated well with dye dilution, tending to overestimate cardiac output only at low flows. Room temperature thermodilution, however, overestimated cardiac output by up to 25% in the clinically important range and more so at low cardiac output.
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Gastric pH values were studied prior to, and up to, ninety minutes after an intravenous injection of cimetidine 200 mg given before general anaesthesia, in twenty surgical patients, all with a gastric pH less than 3.5. At thirty, sixty and ninety minutes, sixteen, eighteen and twenty patients had a gastric pH greater than 3.5 respectively. In conclusion, the results of the present study indicate that cimetidine 200 mg given intravenously 90 minutes before surgery will reduce the hazard of chemical pneumonitis should stomach content be aspirated.
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Anaesth Intensive Care · Feb 1983
Femoral nerve block--the anatomical basis for a single injection technique.
A technique for blocking the femoral nerve using a single needle placement is described. It depends on an appreciation of the anatomy and the need to feel loss of resistance twice as two fascial layers are penetrated during insertion of the needle just lateral to the femoral artery. A single injection of bupivacaine 0.35-0.5 per cent of at least 0.3 ml/kg will produce a satisfactory block.
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Anaesth Intensive Care · Feb 1983
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia for haemorrhoid surgery.
Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p less than 0.05) and morphine-lignocaine (p less than 0.05) groups. ⋯ In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p less than 0.01), morphine-lignocaine (637 min, p less than 0.05) and morphine (665 min, p less than 0.0). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia.