British journal of anaesthesia
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Parkinson's disease is an increasingly common disease of elderly patients who present a particular anaesthetic challenge. This review explores the epidemiology, aetiology, pathogenesis, and pathophysiology of the condition, particularly the possible role of genetic factors. ⋯ Particular anaesthetic problems in patients with Parkinson's disease are respiratory, cardiovascular, and neurological. Potential drug interactions are described and recommendations are made about suitable anaesthetic techniques.
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Infection and epidural abscess are important complications of epidural analgesia. Difficult insertion may be associated with an increased risk of bacterial contamination of the epidural needle or catheter. ⋯ Difficult epidural insertion is not associated with an increased risk of needle contamination and is therefore an unlikely source of epidural infection.
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Randomized Controlled Trial Clinical Trial
Effects of intramuscular administration of lidocaine or bupivacaine on induction and maintenance doses of propofol evaluated by bispectral index.
Interest in combining local and general anaesthesia has lead to studies investigating possible interactions. In a prospective, randomized, double-blind study, we tested whether local anaesthetics administered i.m. potentiate the hypnotic effect of propofol. ⋯ I.M. administered local anaesthetics are associated with a decrease in both the induction and maintenance doses of propofol during total i.v. anaesthesia and a reduction in haemodynamic responses.