British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Optimal dose of lignocaine for preventing pain on injection of propofol.
The purpose of this study was to define the optimum dose of lignocaine required to reduce pain on injection of propofol. We conducted a prospective, randomized, double-blind trial on 310 patients undergoing anaesthesia. Patients were allocated to four groups according to the lignocaine dosage: group A (control), no lignocaine; group B, lignocaine 0.1 mg kg-1; group C, lignocaine 0.2 mg kg-1; group D, lignocaine 0.4 mg kg-1. Our results showed that a dose of lignocaine 0.1 mg kg-1 significantly reduced the incidence of pain and that there was no improvement when the dose was increased.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of four subarachnoid solutions in a needle-through-needle technique for elective caesarean section.
We have used both spinal and extradural anaesthesia with a 26-gauge, long spinal needle through a 16-gauge Tuohy needle for elective Caesarean section. Four different subarachnoid solutions of bupivacaine were compared: 0.5% heavy bupivacaine alone, or with adrenaline, fentanyl or adrenaline and fentanyl. ⋯ The technique is recommended because it allows rapid onset of anaesthesia and the advantages of an extradural catheter. The subarachnoid solution of choice was 0.5% heavy bupivacaine 12.5 mg with fentanyl 10 micrograms.
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Randomized Controlled Trial Clinical Trial
Postoperative protein metabolism: effect of nursing elderly patients for 24 h after abdominal surgery in a thermoneutral environment.
We have studied the effect of intraoperative body heat conservation and 24-h thermoneutrality on postoperative whole body protein turnover using stable isotope methodology in a group of elderly patients undergoing colorectal surgery for rectosigmoid adenocarcinoma. Two groups of eight patients were studied. One group (control, or cold) received routine intraoperative and postoperative care. ⋯ Whole body protein breakdown and synthesis, as assessed by stable isotope methodology, increased significantly 2 and 4 days after surgery in both groups (P less than 0.01), but the increase in protein breakdown in the warmed group on day 2 was significantly less than that in the cold group (P less than 0.05). The increase in leucine oxidation in the warmed group on the 2nd day after surgery was not significant, and was less than the increase observed in the cold group (P less than 0.05). However, by the 4th day, leucine oxidation was enhanced significantly in both groups (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Clonidine does not delay recovery from anaesthesia.
Clonidine is known to reduce anaesthetic requirements and improve haemodynamic stability when given as premedication. This study, of 46 ASA I-II patients undergoing thyroid surgery, was designed to assess if clonidine interferes with recovery from anaesthesia. Patients were allocated randomly to three groups to receive, 2 h before surgery, flunitrazepam 1 mg, clonidine 150 micrograms, or both drugs. ⋯ Psychomotor performance was decreased significantly after operation in the three groups (P less than 0.05) and returned to baseline at 240 min. There was no significant difference between the three groups. This study indicates that clonidine 150 micrograms orally before surgery does not delay recovery from anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Accuracy of placement of extradural needles in the L3-4 interspace: comparison of two methods of identifying L4.
The certainty with which the L3-4 vertebral interspace can be identified was investigated by studying 50 cadavers. These were allocated randomly to two groups, differing in the way in which the L4 spinous process was identified. Identification of L4 by physically constructing Tuffier's line on the subject led to an increase in the number of catheters sited at the correct level (P less than 0.01).