Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 1993
Randomized Controlled Trial Clinical TrialEpidural catheter insertion: the effect of saline prior to threading in non-obstetric patients.
The effects of injecting normal saline 4 ml through the epidural needle before catheter passage on ease of catheterisation and incidence of certain complications were investigated in 189 non-obstetric patients. The use of saline had no effect on ease of catheterisation, with 84.2% of Group S patients (saline, n = 95) and 88.3% of Group C patients (control, n = 94) having the difficulty of passing the catheter rated as "easy" (P = 0.31). ⋯ Epidural venous cannulation occurred in 6.3% of Group S patients versus 11.7% of Group C patients (P = 0.30). We conclude that the use of 5 ml of normal saline prior to catheter threading provides no significant benefit in improving the ease of catheterisation or decreasing the incidence of catheter complications.
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Anaesth Intensive Care · Apr 1993
Randomized Controlled Trial Clinical TrialBackground infusion with patient-controlled analgesia: effect on postoperative oxyhaemoglobin saturation and pain control.
The aim of this study was to determine whether the addition of a background infusion (BI) to patient-controlled analgesia (PCA) would lead to significantly improved pain control or poorer oxyhaemoglobin saturation (SpO2) after gynaecological surgery. Sixty-two patients were studied for 24 hours postoperatively; pain scores and morphine dose were recorded hourly, SpO2 was recorded every 10 seconds. ⋯ Despite the increased morphine dose pain scores also were similar in the two groups. Addition of a BI at 1 mg/hr did not confer any advantage over PCA alone and is not recommended when PCA is used in this patient group.
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Anaesth Intensive Care · Apr 1993
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia following arthroscopic knee surgery. A controlled study of intra-articular morphine, bupivacaine or both combined.
In a double-blind, randomised controlled trial, we studied 40 patients who received one of four intra-articular injections at the end of arthroscopic surgery. Each group contained ten patients. The patients in Group 1 received normal saline 25 ml; those in Group 2 received bupivacaine 0.25% 25 ml; those in Group 3 received morphine 5 mg in normal saline 25 ml; and those in Group 4 received a combination of bupivacaine 0.5% 12.5 ml and 5 mg of morphine made up to 25 ml with normal saline to produce the same bupivacaine concentration as Group 2. ⋯ Group 4 had the lowest pain scores over the recorded period compared with the other groups. The need for supplemental analgesia was significantly lower (P < 0.05) in the treatment Groups 2, 3 and 4 compared to the control Group 1. There was no significant difference in supplemental analgesic requirements between Groups 2, 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anaesth Intensive Care · Apr 1993
Randomized Controlled Trial Comparative Study Clinical TrialHigh-dose adrenaline in adult in-hospital asystolic cardiopulmonary resuscitation: a double-blind randomised trial.
Forty intensive care unit patients requiring cardiopulmonary resuscitation were randomised to receive either the standard dose of adrenaline (1 mg every five minutes) or high-dose adrenaline (10 mg every five minutes). In the majority of patients, overwhelming sepsis was the major contributing factor leading to cardiac arrest. In this group of patients no difference could be detected in response to high-dose adrenaline compared with the standard dose. Although no side-effects were noted with this high dose of adrenaline, more investigation is required prior to its routine use in cardiopulmonary resuscitation.
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Anaesth Intensive Care · Feb 1993
Randomized Controlled Trial Clinical TrialEnteral feeding, gastric colonisation and diarrhoea in the critically ill patient: is there a relationship?
In this prospective study we aimed to determine whether there is any relationship between enteral feeding, gastric colonisation and diarrhoea in the critically ill patient. Sixty-two critically ill patients from an intensive care unit of a major teaching hospital, who satisfied the usual criteria for enteral feeding, were randomised to receive enteral feeding or not for three days followed by a second randomisation to enterally feed or not for three days. ⋯ Gastric colonisation was unrelated to feeding practice and to the development of diarrhoea. We conclude that in the critically ill patient, enteral feeding does not cause or promote diarrhoea.