British journal of anaesthesia
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Biography Historical Article Classical Article
Postoperative analgesia and lung function: a comparison of morphine with extradural block. 1971.
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Randomized Controlled Trial Comparative Study Clinical Trial
Topical anaesthesia of intact skin: liposome-encapsulated tetracaine vs EMLA.
In this randomized, double-blind study, we have compared the ability of 5% liposome-encapsulated tetracaine (amethocaine) (LET) vs 5% eutectic mixture of local anaesthetics (EMLA) to produce local anaesthesia of intact skin in 40 healthy volunteers. Volunteers had both preparations applied to their forearms under an occlusive dressing for 1 h. Superficial anaesthesia was measured by a total of nine 1-mm pinpricks on each arm. ⋯ In volunteers who had deeper anaesthesia assessed, there was no significant difference (P = 0.065) in VAS scores for LET (mean 1.5 (SD 1.4); n = 34) vs EMLA (2.4 (2.1); n = 28). Overall anaesthetic effect, as ranked by all of the subjects, was significantly better for LET compared with EMLA (P = 0.024). We have demonstrated that when applied in equal volumes, 5% LET produced better superficial local anaesthesia than EMLA.
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Randomized Controlled Trial Clinical Trial
Tenoxicam and paracetamol-codeine combination after oral surgery: a prospective, randomized, double-blind, placebo-controlled study.
We studied 90 adults undergoing surgical removal of at least both lower third molar teeth as day cases under standardized general anaesthesia. Patients were allocated randomly (with stratification for surgeon) to receive tenoxicam 40 mg, tenoxicam 20 mg or placebo i.v. at induction of anaesthesia and orally (effervescent tablets) with food on each of the subsequent 2 days. Panadeine (paracetamol 500 mg-codeine 8 mg) was given before operation and was available as needed for pain thereafter, to a limit of two tablets every 4 h. ⋯ Over the 6-day period, patients who received tenoxicam reported less pain on rest (area under the curve; P < 0.05) and less disturbance in sleep (P < 0.01) even though they used fewer Panadeine tablets (P < 0.05). Differences between tenoxicam 40 mg and 20 mg were not significant. There was no significant difference in nefopam requirements or side effects, and no adverse event attributable to the study medication.
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Randomized Controlled Trial Clinical Trial
Effect of infiltration with ropivacaine on blood loss during reduction mammoplasty.
Ropivacaine is a new aminoamide local anaesthetic agent. Unlike other agents in its class, such as bupivacaine, it has been found to be vasoconstrictive. We have sought to investigate if this property is clinically useful and may reduce surgical blood loss. ⋯ There was no significant difference between the two regimens for duration of surgery or amount of tissue excised; however, ropivacaine was associated with markedly greater intraoperative blood loss than bupivacaine (median 696 (range 305-1366) ml kg-1 vs 300 (169-608) ml kg-1; P = 0.04, Wilcoxon rank sum test). Postoperative blood loss was not significantly different between groups (116 (14-173) ml kg-1 vs 98 (13-332) ml kg-1; P = 0.69, Wilcoxon rank sum test). We conclude that the vasoconstrictive properties of ropivacaine were not sufficiently great to merit its use as a sole agent for infiltration before reduction mammoplasty.