British journal of anaesthesia
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We have analysed, with the aid of an online database, the number of all types of contributions from scientists of various countries to four leading international anaesthesia journals (British Journal of Anaesthesia, Anaesthesia, Anesthesia and Analgesia and Anesthesiology) during the period 1987-1991. Although American and British publications played the leading roles in the total number of anaesthetic publications (40.4% and 32.5%, respectively), more detailed analysis revealed an unexpectedly high "publication output" of smaller countries, which sometimes exceeded those of larger nations (publications per million inhabitants: United Kingdom 41.9, Denmark 24.2, Sweden 15.4, Finland 15.3, Israel 14.6, Ireland 13.1, U. S. A. 11.9, Switzerland 11.0).
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We have compared the effects of two different frequencies of train-of-four stimulation of the ulnar nerve (2-Hz stimulation once every 10 or 20 s) on onset time and potency of atracurium, vecuronium and mivacurium during balanced anaesthesia. The adductor pollicis EMG was recorded simultaneously in both hands of 24 children aged 2-12 yr. After administration of an ED50 dose of each blocker, onset times were mean 21 (SEM 10) s shorter (P < 0.05) and decreases in neuromuscular function were 22 (3)% greater (P < 0.001) in the hand which was stimulated once every 10 s. We conclude that it is not possible to compare potency estimates of neuromuscular blocking agents if different stimulation patterns have been used.
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We report a case of tracheal rupture in an 84-yr-old patient after tracheal intubation. The aetiology and treatment are discussed and the recent literature is reviewed.
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In order to study the neuromuscular interactions between suxamethonium and magnesium sulphate (MgSO4), we have determined the dose-response relationship of suxamethonium and the neuromuscular actions of 1.25 x ED50 dose of suxamethonium, both before and after pretreatment with MgSO4. We have also compared the effect of 1.25 x ED50 dose of suxamethonium in the absence and in the presence of 50% neuromuscular block, established previously by infusion of MgSO4. Twenty-one cats were anaesthetized with urethane. ⋯ Twitch depression produced by 1.25 x ED50 dose of suxamethonium decreased significantly with MgSO4 pretreatment, from 76.7 (2.6)% before MgSO4 to 61.7 (6.4)% after MgSO4 60 mg kg-1 and 48.7 (7.5)% after MgSO4 90 mg kg-1 (P < 0.05). With stable 50% neuromuscular block, established previously by infusion of MgSO4, the 1.25 x ED50 dose of suxamethonium produced more twitch augmentation (133 (6.3)% vs 108.3 (1.3)%; P < 0.05) and less twitch depression (31.6 (9.6)% vs 74.1 (0.6)%, P < 0.05) than in the absence of MgSO4. The results of all three methods demonstrated that the pharmacological interaction between suxamethonium and magnesium was antagonistic.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the analgesic and emetic properties of ketorolac and morphine for paediatric outpatient strabismus surgery.
In a prospective, double-blind, randomized study, we have compared i.v. ketorolac and morphine in paediatric outpatients undergoing strabismus surgery. Forty-two ASA I or II children, aged 2-12 yr, were allocated randomly to receive either ketorolac 0.75 mg kg-1 i.v. or morphine 0.1 mg kg-1 i.v. and metoclopramide 0.15 mg kg-1. Anaesthesia was induced with propofol and maintained with propofol and nitrous oxide. ⋯ There was no difference in pain behaviour scores or recovery times. The incidence of nausea and vomiting during the first 24 h was 19% in the ketorolac group and 71% in the morphine group (P < 0.001). We concluded that ketorolac was an effective analgesic for this type of surgery and that it was associated with less postoperative emesis than morphine and metoclopramide.