British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Volume replacement with hydroxyethyl starch solution in children.
In 30 consecutive children undergoing cardiac surgery, two different types of fluid were given randomly for volume replacement in the pre-bypass period. In group 1 (n = 15), low molecular weight hydroxyethyl starch solution (LMW-HES) (6% HES; mean molecular weight 200,000 Da, molar substitution 0.5) and in group 2 (n = 15) 20% albumin (HA) was infused from the induction of anaesthesia until the start of cardiopulmonary bypass (CPB). In addition to haemodynamic values, various laboratory variables were measured before and after CPB until the morning of the 1st day after operation. ⋯ Post-bypass urine output and creatinine values also did not differ between the groups. Anaphylactic reactions were not observed in any of the patients. It can be concluded that LMW-HES solution can be used effectively and safely for volume replacement in the pre-bypass period in small children undergoing cardiac surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the sedative and amnesic effects of midazolam and propofol.
We have compared the sedative and amnesic effects of midazolam and propofol in 35 volunteers. Sedation was measured by simple reaction time immediately before and after a bolus injection and 1 h after the commencement of a subsequent continuous infusion. Memory was measured three times using two memory tests: perceptual facilitation provided an implicit memory measure and recognition provided an explicit memory measure. ⋯ In contrast, midazolam had a more profound amnesic effect than propofol on the recognition memory test. The drugs had little effect on performance with the implicit memory test. Performance on the memory tests was unrelated to sedation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Potency estimation of mivacurium: comparison of two different modes of nerve stimulation.
We have assessed the potency of mivacurium, a new non-depolarizing neuromuscular blocker, using two different modes of nerve stimulation in patients anaesthetized with thiopentone, fentanyl and nitrous oxide in oxygen. The force of contraction of adductor pollicis was measured after single twitch stimulation at 0.1 Hz or train-of-four stimulation (TOF) at 2 Hz every 10 s. ⋯ The difference between the ED95 doses was not significant (P = 0.051), but the difference between the ED50 doses was significant (P = 0.03), suggesting greater sensitivity of the neuromuscular junction using TOF stimulation. The results show that the information obtained using single twitch stimulation at 0.1 Hz is not the same as that obtained from the first response of the TOF stimulation.
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Randomized Controlled Trial Clinical Trial
Tracheal tube cuff inflation as an aid to blind nasotracheal intubation.
We have assessed the efficacy of tracheal tube cuff inflation in the oropharynx as an aid to blind nasotracheal intubation in 20 ASA I and II patients undergoing elective oral surgery. The trachea was intubated once using the technique of tracheal tube cuff inflation in the oropharynx and once keeping the tracheal tube cuff deflated throughout the manoeuvre. With the cuff deflated, intubation was successful in nine of 20 (45%) patients; in eight of 20 (40%) it was successful on the first attempt. ⋯ The success rates were significantly different (P < 0.01). Times to intubate were not significantly different (P > 0.05). We conclude that, in normal patients, tracheal tube cuff inflation in the oropharynx increases the success rate of blind nasotracheal intubation.
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Randomized Controlled Trial Clinical Trial
Evaluation of the analgesic effect of metoclopramide after opioid-free analgesia.
Metoclopramide may enhance opioid analgesia, but it is not known if the drug is analgesic itself. This question was examined in a double-blind, randomized study of 38 patients undergoing knee arthroscopy with opioid-free anaesthesia comprising propofol, isoflurane and nitrous oxide in oxygen. At the end of surgery, patients received either metoclopramide 0.5 mg kg-1 or placebo i.v. ⋯ There were no significant differences between the groups in the patterns of pethidine consumption. However, the VAS-pain scores tended to be smaller in the metoclopramide group; this difference was significant 30 min after operation. These results do not demonstrate conclusively a clinically relevant analgesic action of metoclopramide.