British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Is the clinical efficacy of epidural diamorphine concentration-dependent when used as analgesia for labour?
The physicochemical properties of diamorphine (3,6-diacetylmorphine) enhance its bioavailability compared with more lipid-soluble opioids when administered into the epidural space. However, the influence of concentration, volume or mass on the clinical efficacy of diamorphine is not known. ⋯ We conclude that diamorphine provides analgesia in labour by a concentration-dependent effect.
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Randomized Controlled Trial Clinical Trial
Minimum effective local anaesthetic dose of isobaric levobupivacaine and ropivacaine administered via a spinal catheter for hip replacement surgery.
Continuous spinal anaesthesia with spinal catheters allows incremental dosing of local anaesthetic and, consequently, less haemodynamic changes. However, little is known about the required doses. Therefore, we designed a study to assess the minimum effective local anaesthetic dose (MLAD) of levobupivacaine and ropivacaine in this context. ⋯ These doses are significantly smaller than doses reported before for single-shot spinal anaesthesia. Continuous spinal anaesthesia allows the use of relatively small doses of local anaesthetic.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of isoflurane and propofol on cortical somatosensory evoked potentials during comparable depth of anaesthesia as guided by bispectral index.
The aim of this study was to determine if propofol caused less suppression of cortical somatosensory evoked potentials (SSEPs) during spine surgery compared with isoflurane during comparable depth of anaesthesia as guided by bispectral index (BIS) measurements. ⋯ Propofol anaesthesia caused less suppression of the cortical SSEP, with better preservation of SSEP amplitude, and less variability at an equivalent depth of anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of halothane, sevoflurane and propofol on left ventricular diastolic function in humans during spontaneous and mechanical ventilation.
There is limited knowledge of the effects of anaesthetics on left ventricular (LV) diastolic function in humans. Our aim was to evaluate these effects in humans free from cardiovascular disease. ⋯ Halothane and sevoflurane did not impair LV relaxation, whereas propofol caused a mild impairment. However, the impairment by propofol was of a magnitude that is unlikely to cause clinical diastolic dysfunction.
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Randomized Controlled Trial Clinical Trial
Double-blind comparison of intrapleural saline and 0.25% bupivacaine for ipsilateral shoulder pain after thoracotomy in patients receiving thoracic epidural analgesia.
The aim of this prospective double-blind randomized placebo-controlled study was to investigate the effect of intrapleural bupivacaine on ipsilateral post-thoracotomy shoulder pain in patients receiving thoracic epidural analgesia. ⋯ Intrapleural administration of 40 ml of bupivacaine 0.25% does not provide effective pain relief for ipsilateral post-thoracotomy shoulder pain.