British journal of anaesthesia
-
Randomized Controlled Trial Clinical Trial
Use of i.m. ranitidine for the prophylaxis of aspiration pneumonitis in obstetrics.
Twenty patients who underwent elective Caesarean section received ranitidine 150 mg by mouth 8-14 h, and 50 mg i.m. 90 min, before surgery. Intraoperative gastric aspiration resulted in contents with a pH greater than 2.5 and volume less than 25 ml in all patients (mean pH 6.5 (SD 0.8); mean volume 9.0 (SD 7.2) ml). Sixty patients in labour, who received ranitidine 50 mg i.m. 6-hourly, underwent emergency surgery. ⋯ Ranitidine medication resulted in a mean aspirated gastric volume of 31.4 (26.6) ml and pH of 5.3 (2.1); five of 30 patients had a pH less than 2.5. The addition of sodium citrate 0.3 mol litre-1 resulted in gastric pH greater than 2.5 in all patients and a mean gastric volume of 43.2 (38.3) ml. The group who received only sodium citrate 0.3 mol litre-1 had a mean pH of 5.3 (1.1) and a mean volume 122.7 (98.2) ml.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of propofol and thiamylal for induction and maintenance of anaesthesia for outpatient surgery.
In an open, randomized study we have compared the safety and efficacy of propofol with thiamylal for induction and maintenance of anaesthesia supplemented by nitrous oxide in elective termination of pregnancy. Induction of anaesthesia was achieved with either propofol 2.5 mg kg-1 or thiamylal 4.0 mg kg-1 followed by maintenance with 70% nitrous oxide in oxygen and repeat boluses of 25% of the induction dose i.v. as indicated clinically. ⋯ The patients in the propofol group were alert and orientated early in the postoperative period, with less nausea or vomiting. Propofol has properties that are of particular benefit in anaesthesia for ambulatory surgery.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Pipecuronium and pancuronium: comparison of pharmacokinetics and duration of action.
The pharmacokinetics of pipecuronium 0.07 mg kg-1 and pancuronium 0.1 mg kg-1 were compared in 39 ASA class I or II patients. Plasma concentrations of these agents were measured for 6 h following administration, using a sensitive and specific capillary gas chromatographic assay. Concentration v. time data were analysed by non-linear regression and fitted to a two- or three-compartment model as appropriate. ⋯ The volumes of the central compartment, distribution and elimination half-lives and mean residence times were similar for both agents and within the range expected for drugs of this type. The durations of action (injection to 25% recovery of twitch tension) of pipecuronium and pancuronium were similar: 98.0 (36.1) min and 117.2 (35.8) min, respectively. We conclude that the time courses of neuromuscular blockade following pipecuronium and pancuronium are similar, despite the differences in Vss and Cl.
-
Randomized Controlled Trial Clinical Trial
Ilioinguinal nerve blockade for analgesia after caesarean section.
Bilateral ilioinguinal nerve blockade was performed, using 0.5% plain bupivacaine 10 ml to each side, in 13 patients having elective Caesarean section under general anaesthesia. Pain scores and requirement for postoperative analgesia were compared with 13 patients in a control group. ⋯ In the control group, patients required more analgesia in the first 24 h after surgery compared with patients having ilioinguinal nerve blockade. There were no observed adverse effects following nerve blocks.