British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of induction and recovery between sevoflurane and halothane supplementation of anaesthesia in children undergoing outpatient dental extractions.
We have compared sevoflurane and halothane in a double-blind controlled study for supplementation of nitrous oxide and oxygen anaesthesia in 80 children undergoing dental extraction as outpatients. Induction of anaesthesia was more rapid in those who received sevoflurane compared with those who received halothane (89 s compared with 127 s for loss of eyelash reflex). In both groups, mean duration of administration of anaesthesia was less than 4 min. ⋯ The incidence of complications during induction and maintenance was low in both groups and return to normal appetite and activity occurred in the majority of children on the same day. More children who received halothane suffered nausea after leaving hospital. We conclude that sevoflurane is a suitable alternative to halothane, with more rapid induction of anaesthesia, but in these short procedures, awakening time was slower than after halothane.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesia after day-case knee arthroscopy: double-blind study of intra-articular tenoxicam, intra-articular bupivacaine and placebo.
Arthroscopy of the knee is performed regularly on a day-case basis. Intra-articular bupivacaine produces transient analgesia and reports of analgesia using intra-articular morphine have produced conflicting results. Non-steroidal anti-inflammatory drugs given systemically can provide effective analgesia for this procedure. ⋯ Less analgesia was used in the first 24 h by patients in the tenoxicam group but the difference in time to first analgesia was not statistically significant. Side effects and disturbance by pain were similar in all groups. The use of intra-articular tenoxicam 20 mg at the end of arthroscopy reduced oral analgesic requirements during the first day after operation but did not alter patients' perception of pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Do anxiety or hypocapnia predispose to apnoea after induction of anaesthesia?
We have studied the incidence of apnoea after induction of anaesthesia in patients allocated randomly to receive a standardized dose of either propofol or etomidate. We measured anxiety before operation with a standard questionnaire and end-tidal carbon dioxide concentration from a mask during breathing 35% oxygen, before induction of anaesthesia. Respiration was measured by pneumotachograph and impedance pneumograph. ⋯ There was no relationship between apnoea and end-tidal carbon dioxide concentration in these patients. Anxiety did not relate to the incidence of apnoea with either induction agent. We conclude that apnoea after induction of anaesthesia with propofol is more likely if hypocapnia is present but we could not relate apnoea or hypocapnia to anxiety in the ward before operation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Blood loss during first trimester termination of pregnancy: comparison of two anaesthetic techniques.
We have compared the effects of two anaesthetic techniques on blood loss during suction termination of pregnancy. Forty-eight ASA grade I-II patients were allocated randomly to one of two groups: group 1 received propofol induction followed by a standard propofol infusion; group 2 received propofol induction followed by maintenance with 1% isoflurane. Both groups received bolus doses of either propofol (group 1) or isoflurane (group 2) if anaesthesia was too light. ⋯ Estimation of blood loss was performed by atomic absorption spectrometry. Mean blood losses were 40.4 ml for the isoflurane group and 18.8 ml for the propofol group. This difference was statistically significant (P = 0.0011), although actual volumes of blood loss were small and not clinically significant.
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Randomized Controlled Trial Clinical Trial
Low-dose mivacurium supplementation of prilocaine i.v. regional anaesthesia.
We have compared in two groups of five healthy volunteers, the motor effect of prilocaine i.v. regional anaesthesia of the forearm with and without addition of mivacurium 0.6 mg. Although addition of mivacurium might, theoretically, provide the benefit of increased neuromuscular block with rapid plasma cholinesterase degradation in the isolated limb, we observed prolonged forearm weakness in the mivacurium group using tests of grip strength (median recovery to 90% of control, 80 min (range 60 min to > 8 h) vs control median recovery to 90% of 16 (8-24) min) and bead transfer (median recovery to 90% of control 36 (24-48) min vs control median recovery to 90% of 12 (8-16) min). This weakness was considerably in excess of that predicted by rapid systemic degradation of mivacurium. The mivacurium group experienced symptoms of local anaesthetic toxicity which did not occur in the control group and which could not be replicated by administration of mivacurium alone.