Anaesthesia
-
Randomized Controlled Trial
Significance of the injection timing of ephedrine to reduce the onset time of rocuronium.
We postulated that the onset time of rocuronium can be accelerated effectively if it is administered at the time when the effect of ephedrine on cardiac output has reached its maximum. Seventy-five male, anaesthetised, patients were randomly allocated to three groups. Ephedrine 70 microg.kg(-1) was administered at 4 min (Early) or 30 s (Late) before administering rocuronium. ⋯ The onset time of rocuronium in the Early group was significantly shorter than in the Control group, but there was no difference in the onset time between the Late and Control groups. There were no significant differences in the intubating conditions of the three groups. Ephedrine 70 microg.kg(-1) can reduce the onset time of rocuronium effectively if rocuronium is administered at 4 min following the ephedrine injection, when the effect of ephedrine on cardiac output is expected to reach its maximum.
-
Randomized Controlled Trial
Epidural morphine injections for prevention of post dural puncture headache.
A prospective, randomised, double-blind trial was conducted to study the effect of epidural morphine in prevention of post dural puncture headache in 25 parturients after inadvertent dural puncture. Women were randomly allocated to receive two epidural injections, 24 h apart, of either 3 mg morphine in 10 ml saline (morphine group) or 10 ml saline (saline group). ⋯ Therapeutic epidural blood patches were required in six patients in the saline group and none of the patient in the morphine group (p = 0.022). It was concluded that epidural morphine appears to be a simple and effective technique for prevention of post dural puncture headache after accidental dural puncture in high risk obstetric patients.
-
Randomized Controlled Trial
Pre-oxygenation in pregnancy: the effect of fresh gas flow rates within a circle breathing system.
We have investigated the effect of oxygen flow rate on pre-oxygenation in pregnant patients at term using a circle system. Twenty patients presenting for elective Caesarean section maintained tidal volume breathing through a standard circle system for 3 min. Subjects were pre-oxygenated using oxygen flow rates of 5 l.min(-1), 10 l.min(-1) and 15 l.min(-1) presented in random order. ⋯ Entrainment of air occurred in 22% of pre-oxygenation sessions. Oxygen flow rates of 10 l.min(-1) or above provide optimal pre-oxygenation using a circle system in term parturients. In our study, entrainment of air occurred in a surprisingly high percentage of cases.