Anaesthesia
-
Randomized Controlled Trial Clinical Trial
Continuous propofol administration for suxamethonium-induced postoperative myalgia.
The effect of continuous propofol administration on creatine kinase and suxamethonium-induced postoperative myalgia was evaluated in 50 patients randomised into two groups of 25 patients each. Induction of anaesthesia was identical in all patients. Anaesthesia was maintained with 66% nitrous oxide in oxygen supplemented by either isoflurane 1% or continuous propofol. ⋯ Myalgia was evaluated postoperatively by a blinded observer. The median level of myalgia was reduced significantly in the continuous propofol group (p = 0.011). The median creatine kinase value increased significantly in the isoflurane group (from 90 to 160 IU, p = 0.001).
-
Randomized Controlled Trial Clinical Trial
Development and evaluation of combined rectus sheath and ilioinguinal blocks for abdominal gynaecological surgery.
We describe the development of a technique of combined rectus sheath and ilioinguinal blocks for patients undergoing abdominal gynaecological surgery, and its use in a series of 37 patients (21 midline and 16 transverse incisions). Up to 60 ml of bupivacaine 0.25% with adrenaline 1:400,000 was used, depending on the patient's weight. ⋯ Six-hourly pain scores within the first 48 h after surgery were < or =1 (mild pain) in 11 out of 21 (52%) and < or =2 (moderate pain) in 18 out of 21 (86%) patients with midline incisions and in 5 out of 16 (31%) and 13 out of 16 (81%) patients with transverse incisions, respectively. No patient had emetic symptoms worse than mild nausea during the 48-h postoperative study period.
-
An ambient pressure oxygen reservoir bag apparatus for connecting to the nonventilated lung as soon as single-lung ventilation is initiated is described. The theoretical benefits are the facilitation of collapse of the lung on the side of surgery and a reduced likelihood of arterial desaturation. Although these main benefits are yet to be proven, the authors believe that the weight of theoretical argument and practical observation serves to justify the use of the apparatus while the outcome of suitably designed clinical trials is awaited. It can be used for all one-lung anaesthetics and is especially recommended for thoracoscopic surgery, where temporary re-expansion of the nonventilated lung is either counter-productive or contraindicated, and where there is a possibility that lung collapse may be delayed.