Anaesthesia
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Letter Randomized Controlled Trial Comparative Study Clinical Trial
Fentanyl versus morphine for patient-controlled analgesia.
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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.
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We performed a prospective study in our teaching hospital to determine the demand for a High Dependency Unit where none had existed before. An admission criteria protocol was designed for medical and surgical patients and this was used in an intense surveillance of 22 acute wards over 2 weeks. It was predicted that a high dependency unit of eight beds would operate to capacity 50% of the time. An analysis of this type over a short period of time using similar admission criteria could be used to assist in the prediction of the necessary size of a High Dependency Unit facility in any hospital.
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Eleven brain-dead organ donors were studied during surgery. Plasma levels of adrenaline and noradrenaline were measured before and after skin incision, upon sternotomy and 15, 30 and 45 min thereafter. ⋯ Plasma catecholamines increased promptly with the onset of surgical stimuli. We conclude that surgical stress can evoke an excessive rise of plasma adrenaline and noradrenaline and thus could impair allograft function.
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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.