Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 1986
Randomized Controlled Trial Clinical TrialComparative cutaneous histamine release by neuromuscular blocking agents.
Normal values of cutaneous wheal diameter following intradermal injection of six neuromuscular blocking drugs were determined. The relative cutaneous histamine-releasing ability of each drug was derived from calculated dose-response relationships. Equipotent neuromuscular blocking doses were found to have a cutaneous histamine releasing ability relative to pancuronium (= 1) of vecuronium 1.1: suxamethonium 1.7; alcuronium 5; atracurium 52; d-tubocurarine 172. A significant (P less than 0.001) variation was found between the dose-response slopes perhaps suggesting a variation in the mechanism of histamine release.
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Anaesth Intensive Care · Feb 1986
Randomized Controlled Trial Clinical TrialReduction of heat loss during transurethral resection of the prostate.
A prospective trial was performed on 100 patients to determine whether using a reflective blanket (Space Blanket) and heated glycine 1.5% bladder irrigation solution would decrease the fall in body temperature associated with transurethral resection of the prostate under spinal anaesthesia. Patients who received a combination of reflective blanket and heated glycine 1.5% solution had their fall in body temperature significantly reduced when compared with those patients managed without a reflective blanket and/or heated 1.5% glycine. There was a marked decrease in the number of patients shivering and no increase in blood loss was seen when heated bladder irrigation solution was used.
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Anaesth Intensive Care · Feb 1985
Randomized Controlled Trial Comparative Study Clinical TrialClinical comparison of atracurium and alcuronium in gynaecological surgery.
In a double-blind, prospective, randomised trial in 51 female patients, atracurium 0.6mg/kg provided acceptable intubating conditions more rapidly than did alcuronium 0.25 mg/kg. Atracurium produced more profound neuromuscular twitch suppression than alcuronium. ⋯ Two cases of sinus bradycardia were noted in the atracurium group, but hypotension was not a clinical problem in any patient. Atracurium appears to be a useful relaxant, but a smaller dose than that used here should be chosen for short procedures.
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Anaesth Intensive Care · Nov 1984
Randomized Controlled Trial Clinical TrialEvaluation of the transcutaneous electrical nerve stimulator for postoperative analgesia following cardiac surgery.
The effectiveness of transcutaneous electrical nerve stimulation (TENS) in postoperative pain relief was assessed in this prospective randomised controlled study of 31 patients during the first 72 hours after cardiac surgery. Fourteen patients were given functioning TENS units, and seventeen patients were given non-functioning units. Postoperative pulmonary function tests, analgesic requirements and the incidence of atelectasis were compared in the two groups. ⋯ The forced vital capacity (FVC) was significantly larger with functioning TENS units on the second postoperative day, but there were no other significant differences in forced expiratory volume in one second (FEV1) or forced vital capacity (FVC) values between the two groups. A questionnaire given to patients assessing their opinions of the effectiveness of the TENS unit for analgesia showed a placebo effect in some patients with non-functioning units. In summary, this study suggests that TENS may be of benefit in postoperative pain relief after cardiac surgery, especially on the second postoperative day.
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Anaesth Intensive Care · Nov 1984
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of morphine and buprenorphine for analgesia after abdominal surgery.
Eighty fit adults having elective abdominal hysterectomy or cholecystectomy received buprenorphine or morphine intravenously at the start of peritoneal closure, in a randomised double-blind trial. The anaesthetic sequence precluded the use of other narcotic analgesics. Pain scores were lower in patients who received buprenorphine, as were the cumulative numbers of patients withdrawn from the trial at each interval because of pain, statistical significance being achieved at all intervals from one to seven hours after administration. ⋯ One patient with protracted drowsiness and slow respiratory rate after buprenorphine received naloxone. No serious side-effects were noted. Buprenorphine 4-6 micrograms/kg provided adequate postoperative analgesia of greater duration than could be achieved with morphine, and the potency of buprenorphine when administered in this way was at least 33 times that of morphine.