British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Prevention of hypothermia during orthotopic liver transplantation: comparison of three different intraoperative warming methods.
Hypothermia is a frequent and sometimes clinically important problem during orthotopic liver transplantation. Numerous methods have been suggested to reduce intraoperative heat loss and promote active warming. In this study we compared an electric under mattress, a warm air under mattress and a forced warm air convective heating blanket. The forced air convective warming system was shown to produce significantly higher patient temperatures than the two other systems.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Extradural ropivacaine and bupivacaine in hip surgery.
We studied 126 patients undergoing elective hip surgery; they received 20 ml of 0.5%, 0.75%, 1.0% ropivacaine or 0.5% bupivacaine extradurally in a double-blind design. Sensory block (pinprick), motor block (modified Bromage scale), quality of analgesia and neuromuscular block were assessed intermittently. Heart rate and arterial pressure were measured at regular intervals. ⋯ Duration and quality of analgesia and motor block increased with the concentration of ropivacaine. Ropivacaine 1.0% provided a longer duration of analgesia and motor block, more intense motor block and more patients with satisfactory analgesia than 0.5% bupivacaine. More patients treated with the higher concentrations of ropivacaine required treatment for hypotension and bradycardia.
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Randomized Controlled Trial Clinical Trial
Effect of arm position on the effectiveness of perivascular axillary nerve block.
The influence of arm position on the effectiveness of perivascular axillary nerve block with a catheter was assessed prospectively in two groups of patients. Ninety patients were allocated randomly to receive 1% mepivacaine with adrenaline 40 ml with the arm either adducted or abducted. ⋯ There were no statistically significant differences in onset time, spread of analgesia, motor block or success rate between the two groups. Proximal flow of the local anaesthetic-contrast agent mixture was neither facilitated by arm adduction nor was it necessary for the development of a successful block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antagonism of pancuronium- and pipecuronium-induced neuromuscular block.
We have compared the antagonism of neuromuscular block produced by pipecuronium with pancuronium in 80 anaesthetized surgical patients using mechanomyography and electromyography. Pancuronium 0.1 mg kg-1 or pipecuronium 0.07 mg kg-1 was given after induction of anaesthesia and neuromuscular block was adjusted to 75% twitch depression at the time of antagonism. The following regimens were used: edrophonium 0.5 and 1.0 mg kg-1, neostigmine 0.04 mg kg-1, pyridostigmine 0.3 mg kg-1 and edrophonium 0.25 mg kg-1 with pyridostigmine 0.15 mg kg-1. ⋯ However, TOF fade antagonism was more complete with pyridostigmine, neostigmine and edrophonium 1.0 mg kg-1 than with edrophonium 0.5 mg kg-1. The head lift test indicated somewhat less antagonism with edrophonium 0.5 and 1.0 mg kg-1. Using five monitoring methods, the rank order of reversal potency was: pyridostigmine approximately neostigmine > edrophonium 1.0 mg kg-1 > edrophonium+pyridostigmine > edrophonium 0.5 mg kg-1.
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Randomized Controlled Trial Clinical Trial
Spread of subarachnoid hyperbaric amethocaine in pregnant women.
In order to examine how the gestational period influences the spread of spinal anaesthesia, we have measured the extent of spinal block produced by hyperbaric amethocaine 8 mg in 90 women. The patients were allocated to one of five groups according to the gestational period: non-pregnant group (n = 17), first trimester group (6-12 weeks, n = 14), second trimester group (13-24 weeks, n = 26), third trimester group (25-36 weeks, n = 15) and term group (37-41 weeks, n = 18). Maximum cephalad spread of analgesia was significantly higher in the second trimester (median T3 (range T9-C6)), third trimester (T3 (T4-C7)) and term groups (T2.5 (T4-C8)) than in the nonpregnant (T4 (T8-T2)) and first trimester groups (T4 (T11-C7)). We found that not only term pregnancy but also second and third trimester pregnancies enhanced the spread of spinal anaesthesia, and that first trimester pregnancy did not affect the spread of spinal anaesthesia.