Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Regional anaesthesia for circumcision in adults: a comparative study.
Penile block (PB) in adults is not a well-recognized technique. The aim of this study was to compare, in a randomized prospective manner, five different techniques of PB in 250 adults undergoing circumcision with regard to anaesthetic quality, complications and postoperative analgesia. Patients were divided into five groups (50 per group) according to the technique used: Group A--"10, 30-13, 30" approach; Group B--the subpubic approach; Group C--subcutaneous ring block; Group D--a combination of frenulum infiltration and the "10, 30-13, 30" approach; Group E--a combination of frenulum infiltration and the subpubic approach. ⋯ The five groups did not differ with regard to adverse effects or time until the onset of postoperative pain when the blocks were successful. It is concluded that good surgical anaesthesia, a low rate of adverse effects and prolonged postoperative analgesia can be achieved by the use of either subcutaneous ring block or a combination of dorsal nerve block (using the "10, 30-13, 30" or the subpubic approach) and infiltration of the frenulum. These approaches to the PB are effective anaesthetic techniques for circumcision in adults.
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Comparative Study
A comparison of sevoflurane with halothane, enflurane, and isoflurane on bronchoconstriction caused by histamine.
This study was conducted to assess the effect of sevoflurane on lung resistance and compliance, and its responsiveness to histamine. We studied eight dogs to compare the effect of sevoflurane, isoflurane, enflurane, and halothane on bronchoconstriction caused by histamine. Baseline values of pulmonary resistance (RL) and dynamic pulmonary compliance (Cdyn) were measured prior to administration of histamine. ⋯ In preventing decreases in Cdyn, sevoflurane was less effective than halothane only at 8 micrograms.kg-1 of histamine under 1 and 2 MAC anaesthesia. There was no difference in attenuating effect on changes in RL and Cdyn between sevoflurane and isoflurane or enflurane. We concluded that sevoflurane was less potent than halothane in attenuating changes in RL and Cdyn in response to iv histamine.
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Watson's syndrome is an uncommon genetic disorder whose features include mental retardation and pulmonary valvular stenosis. The purpose of this report is to describe one management strategy used successfully to anaesthetize a woman with this disorder who presented for Caesarean section. Epidural anaesthesia using 0.5% bupivacaine without epinephrine in 2-3 ml boluses to a total dose of 15 ml was administered over 30 min. ⋯ Postoperative analgesia was provided using 3 mg epidural morphine. The patient was observed in the intensive care unit for the first postoperative day and experienced an uncomplicated intra- and postoperative course. We conclude that this technique represents a safe and effective method for anaesthetizing patients with this complicated problem for Caesarean section.