Anaesthesia
-
Letter Randomized Controlled Trial Comparative Study Clinical Trial
Fentanyl versus morphine for patient-controlled analgesia.
-
The output of 30 Tec 3 vaporizers (halothane, enflurane and isoflurane) was studied, starting at the point where no liquid was visible in the content window. At 6 l.min-1 and 1% v/v initial output, consistent delivery was on average maintained for in excess of 90 (range 55-120) min. Thereafter, output declined rapidly. At the flows and concentrations studied there is a significant reserve in the vaporizing chamber, but it is likely that when higher flows and concentrations are used this reserve may be substantially reduced.
-
Randomized Controlled Trial Clinical Trial
Facilitation of laryngeal mask insertion. Effects of lignocaine given intravenously before induction with propofol.
The effects of pretreatment with lignocaine administered intravenously on the insertion of the laryngeal mask airway were investigated in 80 unpremedicated, ASA 1 or 2, adult day-case patients in a randomised, double-blind, placebo-controlled trial. Patients received either intravenous lignocaine 1.5 mg.kg-1 or an equivalent volume of sodium chloride 0.9%. Induction of anaesthesia was achieved with propofol given via a syringe driver at a fixed rate of 600 ml.h-1 until the patient dropped a weighted syringe. ⋯ There were no differences between the lignocaine and control groups with respect to induction dose of propofol, degree of jaw opening, or amount of gagging. Laryngeal mask insertion was facilitated by pretreatment with lignocaine administered intravenously, without an alteration in induction dose of propofol (p < 0.05). Coughing and airway obstruction were both significantly reduced by pretreatment with lignocaine, as was the incidence of failure of insertion requiring deepening of anaesthesia (p < 0.05).
-
Randomized Controlled Trial Comparative Study Clinical Trial
Prevention of nausea and vomiting after day case gynaecological laparoscopy. A comparison of ondansetron, droperidol, metoclopramide and placebo.
We have compared the efficacy of ondansetron, metoclopramide, droperidol and placebo in the prevention of postoperative nausea and vomiting in 118 day stay patients undergoing laparoscopic gynaecological procedures. All received a standardised general anaesthetic of fentanyl, propofol, nitrous oxide in oxygen and isoflurane. Three to five min before induction of anaesthesia, patients were allocated to receive ondansetron 4 mg, metoclopramide 10 mg, droperidol 1 mg or placebo in a randomised, double-blind manner. ⋯ The incidence of emesis was lower (p = 0.063) and time to first oral fluids was shorter (p < 0.05) in the ondansetron group. Oral analgesic requirements were significantly greater in the ondansetron group over the 48 h study period. Two patients, one each in the placebo and metoclopramide groups, had to remain in hospital overnight because of persistent emetic symptoms.
-
Randomized Controlled Trial Clinical Trial
Analgesia following day-case knee arthroscopy--the effect of piroxicam with or without bupivacaine infiltration.
Sixty patients presenting for day-case arthroscopy of the knee under general anaesthesia were studied. Patients were randomly allocated to receive, in addition to intramuscular piroxicam 20 mg, either bupivacaine 0.25% 20 ml applied locally to the knee at the end of the procedure (n = 30) or no further intra-operative analgesia (n = 30). ⋯ A higher proportion of patients in the piroxicam-only group required supplemental analgesia before discharge from hospital. The combination of piroxicam and bupivacaine provided superior analgesia to piroxicam alone.