British journal of anaesthesia
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Severe hypotension and bradycardia occurred in two patients after superior laryngeal nerve block for awake tracheal intubation. Both patients required treatment with anticholinergic drugs and i.v. infusions and made a good recovery.
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Randomized Controlled Trial Clinical Trial
Transdermal fentanyl for the relief of pain after upper abdominal surgery.
Transdermal fentanyl (n = 22) was compared with placebo (n = 18) in a double-blind study of pain after upper abdominal surgery. All patients also received i.v. morphine on demand for supplementary analgesia. ⋯ After operation, pain scores were significantly lower and peak expiratory flow rates significantly higher in the transdermal fentanyl group, who demanded significantly less morphine than the control group. Mean plasma fentanyl concentrations at 12 and 24 h were within the therapeutic range (1.5 and 2.0 ng ml-1, respectively).
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Randomized Controlled Trial Clinical Trial
Prevention of tourniquet pain by spinal isobaric bupivacaine with clonidine.
In order to assess the effect of spinal clonidine on tourniquet pain, 30 patients scheduled to undergo orthopaedic surgery under spinal anaesthesia were allocated randomly to two groups. Patients in group I (n = 15) received 0.5% isobaric bupivacaine 15 mg plus isotonic saline 1 ml. Patients in group II (n = 15) received 0.5% bupivacaine 15 mg plus clonidine 1 ml (150 micrograms). ⋯ Three patients in group I, but none in group II, experienced tourniquet pain. Hypotension and bradycardia were not worsened by spinal clonidine. The use of clonidine may be a useful technique to augment bupivacaine spinal block.
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Comparative Study
Comparison of i.v. sedation with midazolam and inhalation sedation with isoflurane in dental outpatients.
I.v. midazolam was compared with inhalation sedation using isoflurane in 80 dental outpatients. Preoperative anxiety was comparable in both groups and decreased after operation to similar values. ⋯ Midazolam produced faster induction of sedation (P less than 0.001) and more amnesia for the injection of local analgesic (P less than 0.001), whereas isoflurane produced more euphoria (P less than 0.01) and quicker recovery (P less than 0.001). The incidence of postoperative side effects was similar in the two groups.