British journal of anaesthesia
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Comment Letter Clinical Trial Controlled Clinical Trial
Paravertebral block for post-cholecystectomy pain relief.
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Randomized Controlled Trial Comparative Study Clinical Trial
Controlled trial of extradural bupivacaine with fentanyl, morphine or placebo for pain relief in labour.
In a prospective, randomized double-blind study carried out on 255 parturients, fentanyl 80 micrograms (n = 81), morphine 4 mg (n = 83) or placebo (n = 85) was added to 0.25% bupivacaine administered extradurally for pain relief during labour. Fentanyl increased the mean duration of bupivacaine analgesia by 30% and did not reduce the rate of inadequate pain relief. Morphine did not increase the mean duration of bupivacaine analgesia significantly, but increased the rate of inadequate pain relief. It was concluded that morphine 4 mg added to extradural 0.25% bupivacaine was of no value.
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Anaesthetic techniques for malignant hyperthermia susceptible (MHS) patients should include drugs which do not trigger MH and provide stress free conditions. Thus all new drugs should be screened for their susceptibility to trigger MH. ⋯ However, the same animals developed MH when exposed to halothane alone or with suxamethonium. Despite the problems of extrapolating from this study to man, it is unlikely that propofol may trigger an episode of MH.
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Randomized Controlled Trial Clinical Trial
Awareness following different techniques of general anaesthesia for caesarean section.
Using the isolated arm technique, the frequency of awareness was evaluated in 50 full-term patients undergoing elective Caesarean section under general anaesthesia. In 20 patients, anaesthesia was induced with thiopentone 4 mg kg-1, and in the other 30 patients, induction was with ketamine 1.5 mg kg-1. ⋯ Awareness was significantly greater after induction with thiopentone (14/20) than after ketamine (4/30). There were no significant differences in Apgar scores or umbilical vein blood-gas values in the newborns.