Anaesthesia
-
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.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Paediatric postoperative analgesia. A comparison between caudal block and wound infiltration of local anaesthetic.
Fifty children who underwent day case herniotomy received either a caudal injection of 1 ml/kg bupivacaine 0.25% or infiltration of the wound edges at the end of surgery with 0.5 ml/kg bupivacaine 0.25%, allocated at random. Postoperative pain and demeanour were assessed initially by an observer and later by use of a parental questionnaire. Wound infiltration of local anaesthetic solution provided analgesia which was comparable to that associated with caudal block, and the incidence of side effects was similar in the two groups. Wound infiltration of local anaesthetic offers a simple, safe alternative to caudal block for provision of postoperative analgesia in this group of patients.
-
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.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A single dose epidural technique for caesarean section. A comparison between 0.5% bupivacaine plain and 0.5% bupivacaine with adrenaline.
An epidural technique based on a fractionated injection through a Tuohy needle of 20 ml over 10 minutes, was investigated in 40 mothers who underwent elective caesarean section. Mothers were randomized to receive either 0.5% bupivacaine plain or 0.5% bupivacaine with adrenaline 1:200,000. After a 2-ml test dose, the remaining 18 ml was injected over 5 minutes. ⋯ Mean time to onset of adequate surgical anaesthesia was 20 minutes. Only 10 patients required more than the initial 100 mg of bupivacaine. Epidural anaesthesia was supplemented in eight patients with nitrous oxide and/or intravenous opioids.