Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Ketamine as analgesic for total intravenous anaesthesia with propofol.
A prospective study of 18 patients who underwent noncardiac surgery was performed to study the use of ketamine as an analgesic during total intravenous anaesthesia with propofol. A comparison was made with the combination propofol/fentanyl. ⋯ Propofol seems to be effective in eliminating side effects of a subanaesthetic dose of ketamine in humans. We recommend the propofol/ketamine combination for total intravenous anaesthesia for surgery when stable haemodynamics are required.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of patient rewarming devices after cardiac surgery.
Three regimens for rewarming patients after cardiac surgery involving hypothermic cardiopulmonary bypass were studied in 30 patients. The control group (n = 10) received no active rewarming, the oesophageal group (n = 10) was warmed centrally using an oesophageal heat exchanger and the radiant group (n = 10) was warmed peripherally with an overhead radiant heater. There were no statistically significant differences between the groups apart from the higher mean skin temperatures in the peripheral group.
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A cumulative dose followed by an infusion was used to determine the dose response to suxamethonium in a patient with diagnosed myasthenia gravis who was in true remission (asymptomatic while receiving no therapy). The ED50 and ED90 values for suxamethonium were 0.08 mg/kg and 0.20 mg/kg, and an infusion rate of 3.2 mg/kg/hour was required to maintain a 90-95% depression of the single twitch response as monitored by integrated electromyography. These values are within the range for normal patients, and we conclude that myasthenic patients during a true remission may not demonstrate resistance to suxamethonium.
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Randomized Controlled Trial Comparative Study Clinical Trial
Modification of pain on injection of propofol--a comparison between lignocaine and procaine.
Pain on injection of propofol was assessed in a controlled, randomised study of 273 patients. They received either lignocaine 10 mg, procaine 10 mg or isotonic saline 0.5 ml, 15 seconds before the injection of propofol into a vein on the back of the hand. The incidence of pain on injection in the control group (51%) was comparable with other studies. Lignocaine and procaine both significantly reduced the pain (35% and 34% respectively, p less than 0.05) but there was no statistical difference between these two groups.
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Comparative Study
A comparison of the performance of 20 pulse oximeters under conditions of poor perfusion.
The performance of 20 pulse oximeters with finger probes was evaluated by comparison of their readings with directly measured arterial blood oxygen saturations. The samples were taken from patients who had undergone cardiac surgery under hypothermic cardiopulmonary bypass and had poor peripheral perfusion. ⋯ An overall ranking of performance of each pulse oximeter was calculated using five criteria (accuracy, precision, number of readings within 3% of standard, percentage of readings given within 3% of standard, expected overread limit in 95% of cases). Two pulse oximeters achieved a combination of accuracy and precision such that 95% of measurements would be expected to be within 4% of the co-oximeter value; these two also had the lowest drop-out rate.