Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Cannulation of the epidural space. A comparison of 18- and 16-gauge needles.
A group of 685 obstetric patients were randomly allocated to have their epidural block performed using either a 16-gauge or an 18-gauge Tuohy needle. Bleeding was noted from needle or catheter trauma in 18% of patients and it proved impossible to insert the catheter in 3%. ⋯ Epidural analgesia, although safe, is not without hazard. It may be difficult to perform and may, rarely, cause considerable discomfort.
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Randomized Controlled Trial Comparative Study Clinical Trial
Paediatric postoperative analgesia. A comparison between caudal block and wound infiltration of local anaesthetic.
Fifty children who underwent day case herniotomy received either a caudal injection of 1 ml/kg bupivacaine 0.25% or infiltration of the wound edges at the end of surgery with 0.5 ml/kg bupivacaine 0.25%, allocated at random. Postoperative pain and demeanour were assessed initially by an observer and later by use of a parental questionnaire. Wound infiltration of local anaesthetic solution provided analgesia which was comparable to that associated with caudal block, and the incidence of side effects was similar in the two groups. Wound infiltration of local anaesthetic offers a simple, safe alternative to caudal block for provision of postoperative analgesia in this group of patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
A single dose epidural technique for caesarean section. A comparison between 0.5% bupivacaine plain and 0.5% bupivacaine with adrenaline.
An epidural technique based on a fractionated injection through a Tuohy needle of 20 ml over 10 minutes, was investigated in 40 mothers who underwent elective caesarean section. Mothers were randomized to receive either 0.5% bupivacaine plain or 0.5% bupivacaine with adrenaline 1:200,000. After a 2-ml test dose, the remaining 18 ml was injected over 5 minutes. ⋯ Mean time to onset of adequate surgical anaesthesia was 20 minutes. Only 10 patients required more than the initial 100 mg of bupivacaine. Epidural anaesthesia was supplemented in eight patients with nitrous oxide and/or intravenous opioids.
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Comparative Study
Subarachnoid anaesthesia for elective caesarean section. A comparison of two hyperbaric solutions.
Forty patients who underwent elective lower segment Caesarean section under subarachnoid anaesthesia received either 2.0 ml 0.5% cinchocaine in 6% dextrose or 2.5 ml 0.5% bupivacaine in 8% dextrose via a 26-gauge needle with the patient in the left lateral position. Onset time was rapid in both groups and the distribution of maximum ascent of sensory analgesia was T1-T6. ⋯ There were no significant differences between the two groups either in the incidence and severity of complications or in the condition of the neonates. The high incidence (50-65%) and often profound extent of hypotension seen throughout the trial, confirm the ineffectiveness of crystalloid preload of 1500 ml as a single prophylaxis against hypotension.
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Comparative Study
A comparison of two pulse oximeters. Assessment of accuracy at low arterial saturation in paediatric surgical patients.
The accuracy of the Ohmeda Biox 3700 and the Nellcor N100E was assessed in 25 cyanosed children. The readings obtained from the two pulse oximeters were compared with arterial blood measurements using a Radiometer OSM-2 co-oximeter. Both pulse oximeters differed significantly from the co-oximeter measurements and in these patients the error of both machines exceeded the manufacturers' claims. However, the machines appeared to reflect changes in saturation accurately in the same patient.