British journal of anaesthesia
-
A comprehensive compilation of the current international literature on paediatric anaesthesia is lacking. The aim of this study was to identify all articles on clinical practice in paediatric anaesthesia, to name the respective journals, and to assess the publication activity and international recognition of selected countries for a 6-yr period (1993-1998). The search comprised an article-to-article evaluation ('hand search') of 12 peer-reviewed anaesthesia journals, as well as an Internet-based ('SilverPlatter') Medline-search (3,900 medical journals, US National Library of Medicine), both limited to original articles, case reports, reviews and editorials. ⋯ Authors from the UK ranked highest in publication activity, followed by those from Canada, Switzerland, Sweden and Denmark. The highest impact factor was achieved by US and UK authors. We conclude that publications on paediatric anaesthesia are clustered in a small number of journals and are written predominantly by authors from English-speaking countries, who achieved the highest international recognition.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Fentanyl versus sufentanil: plasma concentrations during continuous epidural postoperative infusion in children.
No pharmacokinetic data are available with respect to the plasma concentrations and fentanyl or sufentanil during epidural administration in children. This double-blind randomized study included 12 children (5-12 yr). Patients in group F were given an epidural loading dose of fentanyl 1.5 micrograms kg-1 and in group S sufentanil 0.6 microgram kg-1. ⋯ An epidural PCA system was also given to the children (bolus: bupivacaine 0.2 mg kg-1 and fentanyl 0.2 microgram kg-1 or sufentanil 0.08 microgram kg-1). Maximal median concentrations of plasma (0.117-0.247 ng ml-1 for fentanyl and 0.027-0.074 ng ml-1 for sufentanil) were reached approximately 30 and 20 min respectively after the loading doses. These values were similar to those measured after 48 h.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Peripheral lidocaine but not ketamine inhibits capsaicin-induced hyperalgesia in humans.
We examined the effect of the subcutaneous infiltration of ketamine, lidocaine and saline before injury on capsaicin-induced pain and hyperalgesia. Twelve healthy volunteers participated in two separate, randomized, double-blind, placebo-controlled crossover experiments. In experiment 1, 100 micrograms capsaicin was injected intradermally in one volar forearm 10 min after the skin had been pretreated with lidocaine 20.0 mg in 2.0 ml or 0.9% saline 2.0 ml at the capsaicin injection site. ⋯ Pain scores and areas of hyperalgesia were not affected when the contralateral site was infiltrated with ketamine or lidocaine. Lidocaine produced no side-effects, whereas ketamine produced paraesthesia, dizziness and sleepiness in six out of 24 (25%) cases. Blocking peripheral sodium channels with locally administered lidocaine reduces spontaneous pain and capsaicin-induced hyperalgesia but local block with the NMDA-type glutamate receptor antagonist ketamine has no effect on capsaicin-induced pain and hyperalgesia.
-
Randomized Controlled Trial Clinical Trial
Remifentanil inhibits muscular more than cutaneous pain in humans.
In experimental studies, drug-induced analgesia is usually assessed by cutaneous stimulation. If analgesics act differently on cutaneous and deep nociception, the results of these studies may not be entirely applicable to clinical pain involving deep structures. We tested the hypothesis that opioids have different abilities to inhibit cutaneous and muscular pain. ⋯ Pain thresholds were recorded. Remifentanil caused a higher increase in the muscular pain thresholds than in the cutaneous pain thresholds (P = 0.035). We conclude that opioids inhibit muscular pain more strongly than cutaneous pain in humans.