Anaesthesia
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An inflatable neck tourniquet has been developed for compression of the jugular veins during neurosurgery in the sitting position. Neck compression abolishes the subatmospheric pressure within the neck veins and therefore minimises the risk of air embolism. Compression can be applied throughout the initial part of the operation, a major period of risk during these surgical procedures, and released once full surgical exposure has been achieved. Venous congestion is then released and normal operating conditions are restored.
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Randomized Controlled Trial Comparative Study Clinical Trial
Forum. A comparison between the midline and paramedian approaches to the extradural space.
A prospective, randomised study was devised to compare the midline and paramedian approaches to the extradural space in women during labour. The two approaches were equally successful with respect to catheter insertion and analgesia and had a similar incidence of complications, although the paramedian approach caused patients more discomfort. Since only 2 ml of 1% lignocaine with adrenaline were infiltrated prior to insertion of the Tuohy needle, a greater volume of the local anaesthetic may reduce the discomfort of using the paramedian approach.
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Randomized Controlled Trial Clinical Trial
The analgesic effect of a low dose of alfentanil.
The effect of a single small dose of alfentanil (6 micrograms/kg) on postoperative pain was compared with saline using a double blind study. Pain was assessed using a linear analogue scale and shown to decrease at 2, 5 and 10 minutes after injection of alfentanil (p less than 0.01). ⋯ There were no changes in pain or PE'CO2 in the control group throughout the study. Intravenous alfentanil given to patients in pain provides quick effective analgesia for a short period of time, but respiratory depression may occur.
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Randomized Controlled Trial Comparative Study Clinical Trial
Plasma catecholamine concentrations. The effects of infiltration with local analgesics and vasoconstrictors during nasal operations.
Plasma catecholamine concentrations were measured in 19 patients allocated randomly to receive submucous infiltration with 4 ml of either 0.5% lignocaine with adrenaline 1:200 000 or prilocaine 0.5% with octapressin 0.03 iu per ml. Venous blood samples were obtained before and at 2, 5, and 10 minutes following infiltration. Plasma adrenaline increased from 0.35 to 1.72 p mol/ml at 2 minutes infiltration with the former solution whilst there was little change in plasma noradrenaline concentration. No similar peak in adrenaline concentration occurred after infiltration with prilocaine/ octapressin solutions but with both solutions there was a small increase in plasma noradrenaline and adrenaline concentrations 10 minutes after infiltration, at the time of surgical stimulation.
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Comparative Study
Infusion analgesia for acute war injuries. A comparison of pentazocine and ketamine.
Continuous intravenous infusions of ketamine and pentazocine have been used to provide analgesia in 18 patients with acute war injuries. The drugs were given alternately. ⋯ Arterial blood pressure and respiratory rate were maintained following ketamine but tended to fall after pentazocine. It is suggested that ketamine would be the better agent in patients with hypovolaemia or respiratory depression.