British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Controlled trial of extradural bupivacaine with fentanyl, morphine or placebo for pain relief in labour.
In a prospective, randomized double-blind study carried out on 255 parturients, fentanyl 80 micrograms (n = 81), morphine 4 mg (n = 83) or placebo (n = 85) was added to 0.25% bupivacaine administered extradurally for pain relief during labour. Fentanyl increased the mean duration of bupivacaine analgesia by 30% and did not reduce the rate of inadequate pain relief. Morphine did not increase the mean duration of bupivacaine analgesia significantly, but increased the rate of inadequate pain relief. It was concluded that morphine 4 mg added to extradural 0.25% bupivacaine was of no value.
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Randomized Controlled Trial Clinical Trial
Awareness following different techniques of general anaesthesia for caesarean section.
Using the isolated arm technique, the frequency of awareness was evaluated in 50 full-term patients undergoing elective Caesarean section under general anaesthesia. In 20 patients, anaesthesia was induced with thiopentone 4 mg kg-1, and in the other 30 patients, induction was with ketamine 1.5 mg kg-1. ⋯ Awareness was significantly greater after induction with thiopentone (14/20) than after ketamine (4/30). There were no significant differences in Apgar scores or umbilical vein blood-gas values in the newborns.
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Randomized Controlled Trial Clinical Trial
Neurobehavioural effects of propofol on the neonate following elective caesarean section.
Forty mothers undergoing elective Caesarean section under general anaesthesia were allocated randomly to receive either propofol 2.8 mg kg-1 (n = 20) or thiopentone 5 mg kg-1 (n = 20) for induction of anaesthesia. Twenty neonates delivered by uncomplicated vaginal delivery were evaluated also as unmedicated controls. Neurobehavioural examinations were carried out at 1, 4 and 24 h after delivery. ⋯ Newborn children examined 1 h after birth, after maternal anaesthesia with propofol, showed a depression in alert state, pinprick and placing reflexes, and mean decremental count in Moro and light. There was a generalized irritability in 25% of them. This depression was not observed at 4 h.
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Randomized Controlled Trial Clinical Trial
Accelerated recovery from combined atracurium-vecuronium neuromuscular block.
Patients given combinations of non-depolarizing neuromuscular blocking drugs have been reported to recover from neuromuscular block more rapidly than patients given a single drug. This study was designed to assess if this phenomenon occurred with the combination of atracurium and vecuronium. ⋯ All patients had 100% neuromuscular block, and times to block onset did not differ significantly between the three groups. Recovery to 10, 25, 50 and 90% of control twitch height was significantly faster in the group receiving the combination of drugs.