British journal of anaesthesia
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Randomized Controlled Trial
Supplementary oxygen for emergency Caesarean section under regional anaesthesia.
Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. ⋯ Breathing 60% oxygen during emergency CS under regional anaesthesia increased fetal oxygenation with no associated increase in lipid-peroxidation in the mother or fetus.
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Randomized Controlled Trial Multicenter Study Comparative Study
Urinary catheterization in labour with high-dose vs mobile epidural analgesia: a randomized controlled trial.
Dense perineal block from epidural analgesia increases the risk of urinary catheterization in labour. Mobile epidurals using low-dose local anaesthetic in combination with opioid preserve maternal mobility and may reduce the risk of bladder dysfunction. We conducted a three-arm randomized controlled trial to compare high-dose epidural pain relief with two mobile epidural techniques. ⋯ Relative to conventional high-dose block, mobile epidural techniques encourage the retention of normal bladder function and reduce the risk of urinary catheterization in labour.
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Pain after craniotomy is often under-treated. Opiates carry distinct disadvantages. Non-steroidal anti-inflammatory drugs have an anti-platelet action and carry a bleeding risk. Cyclo-oxygenase 2 inhibitors such as parecoxib are not associated with a bleeding risk and would be welcome analgesics if shown to be effective. ⋯ We found only limited evidence to support parecoxib as an analgesic after craniotomy.
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Randomized Controlled Trial
Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia.
Perioperative use of dexmedetomidine is associated with reduction in postoperative analgesic requirements. This study examined whether dexmedetomidine added to i.v. patient-controlled analgesia (PCA) morphine could improve analgesia while reducing opioid-related side-effects. ⋯ The addition of dexmedetomidine to i.v. PCA morphine resulted in superior analgesia, significant morphine sparing, less morphine-induced nausea, and was devoid of additional sedation and untoward haemodynamic changes.
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Randomized Controlled Trial
Effect of low-dose ketamine on inflammatory response in off-pump coronary artery bypass graft surgery.
Off-pump coronary artery bypass graft surgery (OPCAB) is still associated with a marked systemic inflammatory response. The aim of this study was to investigate whether pre-emptive, low dose of ketamine, which has been reported to have anti-inflammatory activity in on-pump coronary artery bypass surgery, could reduce inflammatory response in low-risk patients undergoing OPCAB. ⋯ Low-dose ketamine administered during anaesthesia induction did not exert any evident anti-inflammatory effect in terms of reducing the serum concentrations of pro-inflammatory markers in low-risk patients undergoing OPCAB.