Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of lignocaine with prilocaine in axillary brachial plexus anaesthesia.
Twenty patients received either lignocaine 1.5% with 1/200,000 adrenaline (group L), or prilocaine 1.5% plain (group P) as a brachial plexus block for surgery to the upper limb, in a randomised double-blind study. The two groups were comparable in age, weight and duration of surgery and there were no significant differences between the two groups with regard to onset, pattern or degree of sensory loss. ⋯ All the blocks were performed using the same technique and provided complete surgical anaesthesia. Prilocaine 1.5% plain provides adequate sensory and motor blockade for brachial plexus anaesthesia and is a suitable agent for medium duration surgery to the upper limb.
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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.
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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.
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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.
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Biography Historical Article
Francis Percival de Caux (1892-1965). An anaesthetist at odds with social convention and the law.
All doctors practice medicine within the confines of what is termed 'acceptable practice'. This acceptable practice is delineated by medical ethics, the actions of one's colleagues, social custom, and the laws of the country. Failure to conform to any or all of these constraints may result in professional ostracism or even loss of liberty. The life and work of Frances Percival de Caux clearly shows these effects in their most damaging manner.