Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
A case of respiratory obstruction caused by an armoured silicone rubber tracheal tube is reported and the literature reviewed. New silicone tubes have shown defects in design and manufacture formerly associated with those made of latex rubber. The authors found disposable polyvinyl chloride tubes to be more reliable.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia with a bupivacaine-fentanyl mixture in obstetrics: comparison of repeated injections and continuous infusion.
We compared the efficacy and side-effects of continuous infusion versus repeated injections of epidural bupivacaine-fentanyl during labour. Forty-four parturients were randomly distributed into two groups balanced for population size, morphology and parity. Analgesia was begun at the same stage of labour with a mixture of 20 ml 0.25 per cent plain bupivacaine and 2 ml (100 micrograms) fentanyl. ⋯ The course of labour, and maternal and neonatal status were comparable in the two groups. Assays showed no difference in bupivacaine blood concentrations between the two groups nor signs of drug accumulation. The constant infusion technique is advantageous since it provides a more regular degree of analgesia with lower doses than those required for patients having repeated injections.
-
Randomized Controlled Trial Clinical Trial
Gastric fluid volume and pH in elective inpatients. Part II: Coffee or orange juice with ranitidine.
In order to assess the effect of preoperative oral fluids, with and without ranitidine, on gastric fluid volume and pH 300 elective surgical inpatients, ASA physical status I and II, were randomly allocated to one of six groups. The three ranitidine groups (Groups 4, 5, and 6) are discussed in this paper (Part II), and the three placebo groups (Groups 1, 2, and 3) in Part I. Between two and three hours before the scheduled time of surgery, patients received 150 ml coffee with oral ranitidine 150 mg (Group 4), 150 ml orange juice with oral ranitidine 150 mg (Group 5), or oral ranitidine alone (Group 6). ⋯ The volume of residual gastric fluid, which was aspirated into a 60 ml syringe, was recorded, and its pH was measured. There were no statistically significant differences between groups with respect to volume (Group 4: 14.3 +/- 15.4; Group 5: 14.8 +/- 17.0; Group 6: 9.7 +/- 12.6 ml). The mean pH in all groups was greater than 5.40 (Group 4: 5.65 +/- 2.12; Group 5: 5.41 +/- 2.12; Group 6: 6.21 +/- 1.51).
-
Randomized Controlled Trial Clinical Trial
Priming with nondepolarizing relaxants for rapid tracheal intubation: a double-blind evaluation.
Results of a series of controlled, randomized, double-blind trials investigating intubation conditions with priming sequences of nondepolarizing relaxants are reported. In Phase I of the study the groups received: Group A, tubocurarine (DTC) 3 mg + succinylcholine 1.5 mg.kg-1, Group B, atracurium 0.05 mg.kg-1 + 0.35 mg.kg-1, Group C, vecuronium, 0.01 mg.kg-1 + 0.07 mg.kg-1; in Phase II: Group D, no relaxant, Group E, DTC 0.05 mg.kg-1 + vecuronium 0.07 mg.kg-1, Group F, vecuronium 0.01 mg.kg-1 + vecuronium 0.12 mg.kg-1; in Phase III, Group G, DTC 3 mg + succinylcholine 1.5 mg.kg-1, Group H, vecuronium 0.01 mg.kg-1 + 0.09 mg.kg-1, Group I vecuronium 0.1 mg.kg-1 as a single bolus. Intubation conditions were assessed at 60 seconds. ⋯ Priming produced significantly better intubating conditions than an equivalent single bolus; however, intubating conditions with priming did not appear to match the uniformly excellent conditions produced by succinylcholine. The data suggest that a four-minute priming interval is as effective as a seven-minute interval. The results of this study differed substantially from previous unblinded studies; therefore, it is suggested that a randomized, double-blind design with simultaneous succinylcholine controls be considered a prerequisite for future studies of intubation conditions.