British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Influence of preoperative gastric aspiration on the volume and pH of gastric contents in obstetric patients undergoing caesarean section.
Aspiration of gastric contents, the most common anaesthetic cause of maternal mortality, is decreased by emptying of the stomach and the use of antacids and H2-receptor antagonists. One hundred and eighty-three mothers presenting for emergency Cesarean section were allocated to three groups. In group 1, the stomach was emptied before operation via an orogastric tube and thereafter 30 ml of sodium citrate 0.3 mol litre-1 was ingested 5-15 min before induction of general anaesthesia (our usual practice). ⋯ However, the use of ranitidine and sodium citrate is preferred at subsequent times. Although our data show that preoperative gastric emptying decreased the mean intragastric volumes before Caesarean section, the number of patients at risk of acid aspiration was not reduced. In view of these findings and the unpleasantness of orogastric intubation, we suggest that routine preoperative gastric aspiration via an orogastric tube is not justified, although the manoeuvre should still be used following a recent meal.
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Randomized Controlled Trial Clinical Trial
Effect of prolonged sedation with propofol on serum triglyceride and cholesterol concentrations.
We compared changes in serum lipid concentrations in ICU patients receiving a 3-day continuous infusion of propofol with those in patients receiving conventional sedation. No adverse effects were observed and the serum lipid concentrations were not significantly influenced by propofol. It is concluded that propofol might be a suitable agent for long-term sedation in the ICU, although serum lipid concentrations should be monitored throughout its administration.
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This paper describes the development of a microprocessor controlled anaesthetic machine comprising an integrated anaesthetic apparatus and monitoring system. Following prolonged reliability trials in the laboratory, changes have been made to major components which were described in earlier publications.