British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiac arrhythmias during outpatient dental anaesthesia: comparison of halothane with enflurane.
In 75 young female patients undergoing extraction of 3rd molar teeth during halothane or enflurane anaesthesia, the electrocardiogram was recorded on magnetic tape and analysed subsequently for arrhythmias, using a high-speed analyser. Enflurane induced a much lower frequency of arrhythmia during surgery than halothane, but there was otherwise little difference between the two drugs in the quality of anaesthesia or recovery. Many arrhythmias occurred before exposure of the patient to enflurane or halothane; the significance of this is discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of flupirtine maleate and dihydrocodeine in patients following surgery.
Flupirtine maleate 100 mg was compared with dihydrocodeine 60 mg when given by mouth to 50 women on the first 3 days following abdominal hysterectomy in a double-blind parallel-group trial. The analgesia produced was similar for both preparations, and the consumption of active drug was the same in both groups. The only significant differences in side-effects were an increased frequency of depression in patients receiving flupirtine and of sleepiness in those receiving dihydrocodeine.
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Clinical Trial Controlled Clinical Trial
Metoprolol, fentanyl and stress responses to microlaryngoscopy. Effects on arterial pressure, heart rate and plasma concentrations of catecholamines, ACTH and cortisol.
Forty patients undergoing microlaryngoscopy were anaesthetized with thiopentone and nitrous oxide. Twenty patients received metoprolol 200 mg in a slow-release tablet once daily for 4 days up to, and including, the morning of operation, and 10 mg i.v. shortly before induction of anaesthesia. The other patients received placebo tablets and physiological saline i.v., instead. ⋯ Arterial plasma noradrenaline concentrations during microlaryngoscopy were enhanced by metoprolol, in comparison with placebo, the reverse being the case for cortisol concentrations. Fentanyl decreased arterial pressure and plasma ACTH and cortisol concentrations regardless of whether the patient had received metoprolol. Plasma adrenaline and noradrenaline concentrations were decreased by fentanyl in the patients receiving metoprolol.
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An extradural catheter was inserted at the third lumbar interspace for relief of pain during labour in a 21-year-old gravid patient. Attempts to withdraw the catheter met with resistance and produced severe pain in the distribution of the second left lumbar nerve. Radiography revealed an acutely angled loop of the catheter over the L2-3 nerve root.
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The pattern of ventilation was studied in eight healthy male volunteers breathing, in sequence, air and then two subanaesthetic concentrations of nitrous oxide (20% and 40%). The effect of these gas mixtures on the response to an added inspiratory resistance (3.88 kPa litre-1s-1) was examined. During unrestricted breathing of 40% nitrous oxide, there was a significant decrease (P less than 0.05) in inspiratory time (TI), a concomitant increase in the rate of ventilation and a significant decrease (P less than 0.05) in the end-tidal carbon dioxide tension (PE'CO2) compared with air breathing. ⋯ TI, VT, minute volume and PE'CO2 were similar for each gas mixture during steady state breathing against resistance. The increase in PE'CO2 when breathing 40% nitrous oxide against the resistance represented a significant (P less than 0.01) difference in response to the load compared with that breathing air. There was no significant change in these variables when breathing 20% nitrous oxide.