British journal of anaesthesia
-
Randomized Controlled Trial Clinical Trial
Prophylactic ephedrine during spinal anaesthesia: double-blind study in patients in ASA groups I-III.
Forty-eight patients scheduled to undergo spinal anaesthesia were allocated to three groups of 16 each according to ASA classification I-II-III. Each patient received a fluid load of 7 ml kg-1 and either ephedrine 12.5 mg i.v. and 37.5 mg i.m., or placebo. ⋯ In ASA risk group III, all patients in the placebo group had a decrease in mean arterial pressure exceeding 20%; in 50% of these patients, the decrease exceeded 33%. We conclude that prophylactic ephedrine is desirable for spinal anaesthesia, especially in ASA III patients.
-
Randomized Controlled Trial Clinical Trial
Neuromuscular block by suxamethonium following treatment with histamine type 2 antagonists or metoclopramide.
We have examined the effect of preoperative i.v. administration of three different histamine type 2 (H2) antagonists (cimetidine 400 mg, ranitidine 80 mg and famotidine 20 mg) or metoclopramide 10 mg i.v. on the duration of neuromuscular block produced by an intubating dose (1 mg kg-1) of suxamethonium. The study was conducted blindly in 70 post partum patients, weighing between 45 and 120 kg, scheduled for tubal ligation. ⋯ The time from onset of 95% block to 25% recovery ("block time") was not significantly different between the groups receiving cimetidine (A), ranitidine (B), famotidine (C), and control (E). However, there was prolongation of neuromuscular block in patients receiving suxamethonium and metoclopramide (D).
-
Randomized Controlled Trial Clinical Trial
Effect of peroperative normothermia on postoperative protein metabolism in elderly patients undergoing hip arthroplasty.
We have examined in elderly patients the effect of maintenance of normothermia during hip surgery on postoperative protein metabolism. In one group of six patients (warmed group) heat loss was minimized during surgery and in the recovery period by warming fresh gases, i.v. fluids and wrapping the exposed parts of the body with a warming blanket. In a second group of six patients (cold group), routine care was provided. ⋯ Total body potassium (TBK), measured as an index of body cell mass, decreased significantly after surgery in both groups. However, 7 days after surgery the reduction in TBK in the cold group remained significantly lower than that of the warmed group (P less than 0.05). Maintenance of normothermia during hip surgery appeared to attenuate, but not eliminate, protein breakdown and nitrogen loss after surgery.
-
The multiple occlusion technique was used to study the effects of paralysis on ventilatory mechanics during anaesthesia. Total respiratory compliance (Crs) was measured during spontaneous breathing and following neuromuscular block with controlled ventilation in 23 infants. ⋯ A possible cause of these differences may be the type of controlled ventilation given during paralysis, with tidal volume directly influencing values of Crs obtained. The results of this study suggest that values of Crs obtained during spontaneous breathing and paralysis should not be used interchangeably until further studies have been performed to assess factors influencing Crs during controlled ventilation.