British journal of anaesthesia
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We have studied the pharmacokinetics of ketamine administered rectally in a dose of 10 mg kg-1 to five children aged 6-9 yr and mean weight 28.80 (SD 6.55) kg. An acceptable level of anaesthesia was not obtained in any patient. Despite this, the degree of analgesia obtained was good and no child required further administration of analgesics during the postoperative period. ⋯ The absorption of ketamine was found to be relatively fast, with a median peak concentration of 160 ng ml-1 (range 96-250 ng ml-1) at 0.75 h (range 0.50-1.00 h) after administration. The plasma concentrations of norketamine were greater than those of the parent drug, with a maximum of 510 ng ml-1 (range 450-810 ng ml-1) at 0.81 h (range 0.50-1.00 h) after administration. The medians of the half-lives of ketamine and norketamine were 3.15 h and 2.56 h, respectively (range 1.57-4.95 h and 1.47-5.30 h, respectively).
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Comparative Study
Vascular response of human skin after analgesia with EMLA cream.
We investigated vascular responses after cutaneous application of EMLA cream (a eutectic mixture of lignocaine and prilocaine) by skin reflectance spectroscopy and laser Doppler blood flowmetry. In healthy subjects, EMLA cream produced a biphasic vascular response with an initial vasoconstriction, maximal after 1.5 h of application. ⋯ Vasoconstriction was also observed initially with two non-EMLA creams applied under occlusion, whereas the occlusive plastic film alone did not alter the vascular state. Thus late vasodilatation was unique to EMLA cream.
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Comparative Study
Comparative potency of pipecuronium bromide and pancuronium bromide.
Cumulative dose-response curves were constructed to determine the comparative potency of pipecuronium and pancuronium. From these, the ED50 and ED95 values were calculated. These were 24.96 micrograms kg-1 and 44.96 micrograms kg-1, respectively, for pipecuronium and 30.42 micrograms kg-1 and 61.12 micrograms kg-1, respectively, for pancuronium.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effects of extradural clonidine with those of morphine on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block.
We have examined the effects of extradural clonidine 150 micrograms or morphine 4 mg on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block in a double-blind, randomized study in 20 patients undergoing hysterectomy with general anaesthesia. Observations were made for 6 h after each patient's first request for analgesia. Clonidine provided greater pain relief than morphine only for the first 2 h of observation (P less than 0.001). ⋯ After clonidine, mean arterial pressure decreased from 100 (SEM 3) mm Hg to 70 (3) mm Hg (P less than 0.05), but there was no change after morphine. There were no significant changes in heart rate, pulmonary function (FEV1), motor function or sensory analgesia to touch, temperature and pinprick in both groups. Additional systemic opioids were required by five and six patients in the clonidine and morphine groups, respectively.