Anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
The haemodynamic effects of bronchoscopy. Comparison of propofol and thiopentone with and without alfentanil pretreatment.
The haemodynamic response to bronchoscopy under general anaesthesia was investigated. Forty patients were allocated at random to receive either thiopentone or propofol; half the patients in each group received in addition 18 micrograms/kg of alfentanil one minute before induction of anaesthesia. The heart rate, noninvasive blood pressure and Holter ECG was monitored in all patients. ⋯ No significant haemodynamic changes were seen in either of the groups which received propofol. ST segment changes on subsequent Holter analysis were seen in four patients, but there were no significant differences between the groups. Anaesthesia with propofol alone provides adequate haemodynamic stability for bronchoscopy and the addition is superfluous.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Intubation with propofol augmented with intravenous lignocaine.
Sixty patients of ASA grade 1 and aged 18 to 55 years were admitted to a double-blind study. Anaesthesia was induced with propofol 2.5 mg/kg after intravenous pretreatment with lignocaine 1.5 mg/kg or a similar volume of isotonic saline. The quality of subsequent tracheal intubation was graded and the pressor response to tracheal intubation assessed. There were no significant differences between treatment groups.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of lumbar plexus block versus conventional opioid analgesia after total knee replacement.
A randomised controlled study was undertaken to assess the analgesic efficacy of continuous lumbar plexus block for the first 48 hours after total knee replacement surgery. Boluses of 0.5% bupivacaine with adrenaline 1 in 200,000 (0.3 ml/kg) were administered through a cannula inserted into the neurovascular sheath of the femoral nerve. Thirteen patients who received this block required significantly less morphine than a control group of 16 patients. Pain scores were similar and there were no complications related to this technique.
-
Fifteen volunteers underwent intravenous regional anaesthesia on two occasions using 40 ml 0.5% prilocaine, to which had been added either 2 ml 0.9% saline or 0.1 mg fentanyl (resultant concentration 2.5 micrograms/ml). There was no difference in the rate of onset of blockade of cold sensation from an ethyl chloride spray, or to sharp and touch pinprick sensation in either group. There was an increase in the incidence of nausea after tourniquet release in the fentanyl group. It is concluded that the addition of fentanyl 2.5 micrograms/ml to prilocaine 0.5% confers no benefit in intravenous regional anaesthesia.
-
Comparative Study
Pulse oximeter probes. A comparison between finger, nose, ear and forehead probes under conditions of poor perfusion.
The performances of 10 pulse oximeters using finger probes were compared with the same pulse oximeters using alternative probes (eight finger probes, two nose probes and a forehead probe) in poorly perfused patients. All readings were then compared with directly measured arterial blood oxygen saturations. The mean difference (bias, 'accuracy'), standard deviation (precision) and 'drop out' rate for each pulse oximeter combination was determined. ⋯ Some ear probes performed well compared to some finger probes, but the overall performance of probes in other sites compared to finger probes was worse, (p = 0.05). Two of eight ear probes and no nose or forehead probes would be expected to be within 4% of the reference value in 95% of readings. The use of finger probes rather than probes in other sites is recommended in the patient with poor peripheral perfusion.