British journal of anaesthesia
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Case Reports
Successful epidural anaesthesia for Caesarean section in a patient with spondyloepiphyseal dysplasia.
Spondyloepiphyseal dysplasia congenita is a rare genetic entity in which it is very important to involve anaesthetists early on to discuss the possible anaesthetic complications for both general or regional anaesthesia. A case is described of a patient with spondyloepiphyseal dysplasia and multifetal pregnancy in which successful epidural anaesthesia for caesarean section was performed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of two neurostimulation techniques for axillary brachial plexus blockade.
This prospective, randomized, double-blind study compared two techniques of axillary brachial plexus block using a peripheral nerve stimulator. Both groups received initial musculocutaneous nerve block followed by either a single injection on median nerve stimulation (group 1) or a double injection divided between median and radial nerves (group 2). ⋯ Complete sensory blockade of all six peripheral nerves occurred in 53% and 97% of patients in groups 1 and 2, respectively (P<0.001), with a more rapid onset of blockade occurring in group 2 patients (P<0.001). Complete motor blockade was evident in 30% and 83% of patients in groups 1 and 2, respectively (P<0.001).
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of effects of remifentanil and alfentanil on cardiovascular response to tracheal intubation in hypertensive patients.
In a randomized double-blind study, we compared the effect of remifentanil and alfentanil on the cardiovascular response to laryngoscopy and tracheal intubation in patients on long-term treatment for hypertension. Forty ASA II-III patients were allocated to receive (i) remifentanil 0.5 microg kg(-1) followed by an infusion of 0.1 microg kg min(-1) or (ii) alfentanil 10 microg kg(-1) followed by an infusion of saline; all patients received glycopyrrolate 200 microg before the study drug. Anaesthesia was induced with propofol and rocuronium and maintained with 1% isoflurane and 66% nitrous oxide in oxygen. ⋯ There were no incidences of bradycardia. Seven patients in the remifentanil group and four in the alfentanil group received ephedrine for hypotension (i.e. SAP<100 mm Hg).