British journal of anaesthesia
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A system for the non-invasive monitoring, recording and storing haemodynamic indices has been developed using an Apple II microcomputer, a Dinamap automatic arterial pressure monitor and a non-invasive cardiac output monitor based on bio-electrical impedance. This system was used during the induction and maintenance of anaesthesia. Numerical and graphical displays of heart rate, arterial pressure, cardiac output and systemic vascular resistance are available. A print-out of data can be produced for later analysis.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of chloral hydrate and midazolam by mouth as premedicants in children undergoing otolaryngological surgery.
Chloral hydrate 25, 50 or 75 mg kg-1 or midazolam 0.4, 0.5 or 0.6 mg kg-1, all given by mouth in combination with atropine 0.03 mg kg-1, were compared as premedication in 248 children in a randomized, double-blind study. Chloral hydrate was significantly less palatable than midazolam. The anxiolytic effect of chloral hydrate 75 mg kg-1 was "good" in children younger than 5 yr, whereas the other doses of chloral hydrate, and all doses of midazolam, provided only "fair" anxiolysis in this age group. ⋯ The mean total recovery score (0-10) based on activity, ventilation, heart rate, conscious level and colour ranged between 5.8 and 6.8 at 10 min and between 9 and 9.5 at 70 min after extubation in all groups. Midazolam 0.5 mg kg-1 is recommended for children less than 5 yr of age and midazolam 0.4-0.5 mg kg-1 for older ones. Chloral hydrate 75 mg kg-1 provided good anxiolysis in both age groups; however, it was less palatable than the midazolam.
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Comparative Study
Comparison of the adductor pollicis and the first dorsal interosseous muscles during atracurium and vecuronium blockade: an electromyographic study.
The pattern of neuromuscular blockade in the first dorsal interosseous muscle (1st DI) and the adductor pollicis muscle was compared electromyographically following atracurium or vecuronium. There were no clinically significant differences between the muscles in respect of onset time, maximum blockade, train-of-four ratio, or recovery index. There were no problems in recording a consistent electromyogram from the 1st DI, which appears to be well suited to clinical monitoring.
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Randomized Controlled Trial Clinical Trial
Influence of neostigmine on postoperative vomiting.
Thirty-eight patients undergoing elective hip or knee surgery were randomly allocated to two groups. Neuromuscular blockade in group A was antagonized with neostigmine 2.5 mg and atropine 1.2 mg, while group B received no drugs to facilitate antagonism of blockade. The incidence and severity of postoperative nausea and vomiting were assessed 24 h after operation. ⋯ The incidence of nausea in group A was 68%, compared with 32% in group B (P less than 0.01). The incidence of vomiting was 47% in group A, compared with 11% in group B (P less than 0.02). A significant relationship was shown between postoperative emetic symptoms and the antagonism of neuromuscular blockade by neostigmine and atropine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal anaesthesia with 0.5% bupivacaine 3 ml: comparison of plain and hyperbaric solutions administered to seated patients.
In a double-blind study, 0.5% bupivacaine 3 ml in plain (n = 10) or hyperbaric (n = 10) solution was injected intrathecally to 20 patients who were in the sitting position, to produce spinal anaesthesia for transurethral resection of prostate. No statistically significant differences were found in time to maximum cephalad spread of analgesia nor in the level reached. ⋯ There was no difference in the incidence of complete motor block, but a longer duration of lesser degrees of motor block was found with the plain solution (P less than 0.05). The plain solution produced a more predictable level of blockade.