Anaesthesia and intensive care
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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 Pain scores were lower in patients who received buprenorphine, as were the cumulative numbers of patients withdrawn from the trial at each interval because of pain, statistical significance being achieved at all intervals from one to seven hours after administration.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.
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Anaesth Intensive Care · May 1984
Randomized Controlled Trial Comparative Study Clinical TrialA controlled trial of pain on skin infiltration with local anaesthetics.
A double-blind, randomised controlled trial was performed to compare the pain experienced on intradermal and subcutaneous injection of lignocaine 1% with adrenaline 1:100,000, lignocaine 1%, procaine 1% and normal saline. A linear analogue pain scale was used to assess pain. ⋯ These differences were significant at p less than 0.05 or greater for all comparisons except procaine 1% and normal saline. In conclusion, procaine 1% appears to be the local anaesthetic of choice from among those tested for intradermal and subcutaneous injection.
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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.
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Anaesth Intensive Care · Nov 1981
Randomized Controlled Trial Clinical TrialSpinal anaesthesia or general anaesthesia for emergency hip surgery in elderly patients.
One hundred and thirty-two elderly patients undergoing emergency hip surgery were randomly allocated to receive subarachnoid block (SAB) or general anaesthesia (GA). Using the 125. I fibrinogen uptake test, deep vein thrombosis was found to occur in 17 of 37 patients in the SAB group and 30 of 39 patients in the GA group (P 0.05). ⋯ At 24 hours postoperatively the fall in PaO2 was similar in both groups and recovered only slowly during the first week. Twelve patients died, three in the SAB group and nine in the GA group. This difference in mortality was not statistically significant.