British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Extradural morphine and pain relief following episiotomy.
One hundred and fifty obstetric patients, who had received intrapartum extradural analgesia with bupivacaine, and had required episiotomy, were given a final postpartum injection of preservative-free morphine in saline, or saline alone, on a double-blind basis. The degree of perineal analgesia was assessed by linear analogue scale at intervals up to 36 h, and oral analgesic requirements were recorded. A significant degree of analgesia was obtained for up to 12 h with morphine 2 mg, compared with saline. Increasing the dose to 4 mg increased the occurrence of side-effects, and was associated with less marked analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Subarachnoid anaesthesia with 0.5% bupivacaine: effects of density.
The effects of subarachnoid administration of 0.5% bupivacaine 4 ml in 8%, 5% or 0% glucose were investigated in a double-blind study in 30 women undergoing laparotomy through a lower abdominal incision. The onset time for maximum segmental spread of analgesia was 10-15 min for all solutions. Cephalad segmental spread of analgesia was three to four segments higher with the hyperbaric solutions (T4-5 v. ⋯ Duration of motor blockade generally decreased with increasing glucose concentration, only the hyperbaric solutions providing useful for abdominal surgery, with a duration of 1-1.5 h. Anaesthesia (halothane) was required in seven of 10 patients in the glucose-free group and in five of 20 in the hyperbaric groups. No occurrence of "post-spinal headache" was recorded in the study.