Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Pipecuronium versus high dose vecuronium. I. A comparison of speed of onset and cumulation during isoflurane anaesthesia.
The onset time and tendency to cumulation of pipecuronium and high-dose vecuronium were studied during nitrous oxide anaesthesia supplemented with isoflurane. Pipecuronium 0.06 mg.kg-1 had a similar duration of action to vecuronium 0.015 mg.kg-1 (42 vs 49 min). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p less than 0.01). The use of pipecuronium was associated with marked cumulation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pipecuronium versus high dose vecuronium. II. A comparison of speed of onset and cumulation during propofol anaesthesia.
The onset time and tendency to cumulation of pipecuronium and high-dose vecuronium were compared during nitrous oxide anaesthesia supplemented with a propofol infusion. Pipecuronium 0.06 mg.kg-1 had a similar duration of action to vecuronium 0.2 mg.kg-1 (49 vs 43). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p less than 0.01). Neither pipecuronium nor vecuronium showed marked cumulation.
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Randomized Controlled Trial Clinical Trial
2% propofol for sedation in the intensive care unit. A feasibility study.
A 2% solution of propofol has been compared with the 1% formulation for sedation in patients whose lungs were being mechanically ventilated in an intensive care unit following coronary artery bypass surgery. There were no significant differences in the amount of propofol used in the two groups, the rate of propofol infusion or the number of changes made to the infusion rate to maintain the desired level of sedation. ⋯ The mean heart rates of those receiving 2% propofol were significantly higher throughout the period of the study for no apparent reason. Propofol 2% was found to be safe, easy to administer and a practical alternative to the 1% solution for sedating cardiac surgical patients.
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Pulmonary embolism remains one of the commonest causes of maternal death. Regional blockade is reported to decrease the incidence of postoperative thrombo-embolic disease. We describe a case in which a fatal pulmonary embolism followed an emergency Caesarean section for which the patient was given a spinal anaesthetic. We believe it to be the first time this has been reported.