Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Cannulation of the epidural space. A comparison of 18- and 16-gauge needles.
A group of 685 obstetric patients were randomly allocated to have their epidural block performed using either a 16-gauge or an 18-gauge Tuohy needle. Bleeding was noted from needle or catheter trauma in 18% of patients and it proved impossible to insert the catheter in 3%. ⋯ Epidural analgesia, although safe, is not without hazard. It may be difficult to perform and may, rarely, cause considerable discomfort.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal buprenorphine for postoperative analgesia in the elderly patient.
Ninety patients aged 56-85 years scheduled for suprapubic prostatectomy, randomly received intrathecally either bupivacaine 30 mg (group A, n = 30), bupivacaine 30 mg plus buprenorphine 0.03 mg (group B, n = 30) or bupivacaine 30 mg plus buprenorphine 0.045 mg (group C, n = 30). Prolonged postoperative analgesia, minimal disturbance of consciousness and comfortable breathing were common to the groups that received buprenorphine. ⋯ The only side effects found in the buprenorphine groups were nausea and vomiting in 11 and 14 patients, respectively, in groups B and C. Our study shows that buprenorphine is an effective analgesic, suitable for the management of postoperative pain in elderly patients.
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Case Reports
Fibreoptic bronchoscopic nasotracheal intubation of a neonate with Pierre Robin syndrome.
A case of nasotracheal intubation using a fibreoptic bronchoscope and the Seldinger technique is described. A guide wire was passed through the suction channel of the fiberscope after the epiglottis and the vocal cords were seen; the fiberscope was removed and a nasotracheal tube passed over the wire into the trachea.