Anaesthesia
-
Randomized Controlled Trial Clinical Trial
Analgesia following femoral neck surgery. Lateral cutaneous nerve block as an alternative to narcotics in the elderly.
In a prospective controlled randomised trial on patients undergoing operative repair of fractured neck of femur via a lateral incision, the postoperative analgesic requirements of one group of patients who received a lateral cutaneous nerve block were compared with a second group who received no block. The former group were found to need significantly less intramuscular pethidine in the first 24 hours, and 44% required no supplementary analgesia whatsoever during this period. The time to first dose of opioid in the remainder was greatly increased. No untoward sequelae associated with the nerve block were seen.
-
The depth of the epidural space at different intervertebral interspaces was measured in 1000 parturients. Overall the median distance from the skin to the epidural space was 4.7 cm, but this varied with the lumbar interspace at which it was measured, being greatest at the third (L3-4) interspace (4.93 cm) and least at the first (L1-2) interspace (4.23 cm). The clinical significance of these findings is discussed.
-
A case of an allergic reaction to Syntocinon (synthetic oxytocin) administered during Caesarean section is reported.
-
Bilateral compression of the jugular veins to raise temporarily cerebral venous pressure, is a manoeuvre recommended frequently in the immediate management of venous air embolism during neurosurgery. One method of compressing the neck veins is to inflate a pneumatic cuff secured around the neck with adhesive tape. This method of neck vein compression had been assessed in upright anaesthetised sheep and found to be an easily controlled and efficient way to raise the cerebral venous pressure. Advantages, dangers and potential problems associated with the use of an inflatable cuff in the clinical situation are discussed.