Anaesthesia
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Comparative Study
The measurement of right ventricular ejection fraction by thermodilution. A comparison of values obtained using differing injectate ports.
Thermodilution measurements of cardiac output and right ventricular ejection fraction were obtained using a rapid response pulmonary artery catheter. Values were compared when injectate was administered via either a cannula within the right internal jugular vein or the dedicated right atrial port of the pulmonary artery catheter. Mean (SD) bias for cardiac output and right ventricular ejection fraction measurements were 0.08 (0.32) l.min-1 and 2.6 (6.6)% respectively. We therefore conclude that both injectate techniques will provide similar values for cardiac output but dissimilar values for right ventricular ejection fraction measurement.
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A constant pressure differential valve for the control of tracheal tube cuff pressure was tested under clinical conditions. Fifty-one patients underwent controlled ventilation and 20 patients were allowed to breathe spontaneously. Nitrous oxide 66% with oxygen 33% and halothane were used via a circle system. ⋯ Fifty-two control patients had the same incidence of sore throat (40%) and hoarseness (30%) at 24 h. With spontaneous ventilation, fresh gas flows of 5-15 l.min-1 maintained the cuff pressure above 10 cmH2O. We conclude that this valve prevents excessive tracheal cuff pressure while maintaining the airway seal.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural tramadol for postoperative pain relief.
The efficacy of epidurally administered tramadol hydrochloride, a weak centrally acting analgesic, was studied for the relief of postoperative pain. Sixty patients undergoing abdominal surgery were randomly allocated to three treatment groups to be given the following agents by the epidural route: group 1 tramadol 50 mg; group 2 tramadol 100 mg; group 3 10 ml of bupivacaine 0.25%. The drugs were administered at the patients' request with each patient being allowed four doses in the first 24 h following surgery. ⋯ The mean interval between doses for groups 1, 2 and 3 was 7.40 h, 9.36 h and 5.98 h respectively. The mean interval in group 2 was significantly longer than in group 3 (p < 0.05). The incidence of nausea and vomiting in group 2 was significantly higher than in group 3 (p < 0.05).