British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Minimum dose of intrathecal diamorphine required to prevent intraoperative supplementation of spinal anaesthesia for Caesarean section.
Intraoperative discomfort during spinal anaesthesia for Caesarean section is the commonest cited anaesthetic cause of litigation in obstetric practice. Intrathecal opioids are used to improve intraoperative comfort and postoperative analgesia for these operations. The minimum intrathecal diamorphine dose that prevents intraoperative supplementation requires determination. ⋯ The ED(95) for the amount of intrathecal diamorphine required to prevent intraoperative supplementation during spinal anaesthesia for Caesarean section is 0.4 mg in clinical terms. Times to first requests for analgesia, incidence of nausea, vomiting and pruritus increase with dose.
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Randomized Controlled Trial Clinical Trial
Bispectral index changes following etomidate induction of general anaesthesia and orotracheal intubation.
Etomidate-associated hypnosis has only been studied using standard clinical criteria and raw EEG variables. We conducted a BIS-based investigation of etomidate induction of general anaesthesia. ⋯ Etomidate induction doses do not predict the time for BIS to decrease to 50 as this variable varies markedly following three etomidate dose regimen.
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A patient was scheduled for inguinal herniorrhaphy under subarachnoid block. Lumbar puncture was difficult and several attempts were needed before it could be achieved. ⋯ A CT scan showed a small pneumocephalus at the level of the brainstem. The symptoms persisted for approximately 70 min, after which they disappeared.
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This review focuses on the development, current techniques, and clinical use of continuous intravascular blood gas monitoring (CIBM) devices in anaesthesia and intensive care. The operating principles, range of application, performance, limitations, costs, and impact on patient treatment and outcome, are discussed. Studies of early and currently available CIBM devices were analysed. ⋯ Performance in the clinical setting was not as satisfactory, especially for PO(2) values. However, the performance and accuracy of CIBM devices appear to be sufficient for clinical use and they are being used clinically in selected patient groups. Several factors affecting the performance of CIBM are considered.