British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Ilioinguinal nerve blockade for analgesia after caesarean section.
Bilateral ilioinguinal nerve blockade was performed, using 0.5% plain bupivacaine 10 ml to each side, in 13 patients having elective Caesarean section under general anaesthesia. Pain scores and requirement for postoperative analgesia were compared with 13 patients in a control group. ⋯ In the control group, patients required more analgesia in the first 24 h after surgery compared with patients having ilioinguinal nerve blockade. There were no observed adverse effects following nerve blocks.
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Stained, quick setting resin was injected into the thoracic paravertebral spaces of six cadavers to assess the suitability of this material for delineating the spread of injected substances in an area of the human body which is being re-evaluated currently as a repository for analgesic drugs. The distribution and spread of the resin in relation to intercostal spaces, vertebral bodies and the spinal cord were noted, and compared with other studies.
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The incidence of immediate postoperative hypoxaemia following general anaesthesia was studied using a pulse oximeter in 120 ASA category I and II patients during transport to the recovery room. Thirty-two percent of those not given oxygen during transport developed desaturation (SaO2 less than 90%) in spite of receiving 100% oxygen for 5 min before transport. ⋯ None of the patients given oxygen 2 litre min-1 via a nasopharyngeal catheter during transport exhibited an SaO2 less than 90%. The only variable which correlated with the development of desaturation was the duration of anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
High- and low-dose fentanyl anaesthesia: hormonal and metabolic responses during cholecystectomy.
We have compared two groups of patients given low- or high-dose fentanyl anaesthesia. Arterial blood samples were collected for measurement of glucose, free fatty acids (FFA), glycerol, beta-hydroxy-butyrate, insulin, c-peptide, glucagon, human growth hormone (HGH), cortisol and adrenaline concentrations. After induction of anaesthesia, blood concentrations of most of these substances decreased. ⋯ In the group that received high-dose fentanyl anaesthesia the plasma concentrations of almost all the hormones and substances measured remained relatively low. The differences between the two groups during surgery were significant for adrenaline (P less than 0.001) and cortisol (P less than 0.001). High-dose fentanyl appears to block the trauma-induced stress response seen in patients anaesthetized with low dose fentanyl.
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Randomized Controlled Trial Clinical Trial
Use of the post-tetanic count to monitor recovery from intense neuromuscular blockade in children.
The post-tetanic count was investigated as a method of monitoring intense neuromuscular blockade in children. One of five myoneural blockers (atracurium, vecuronium, pancuronium, tubocurarine or alcuronium) was given to groups of six children during nitrous oxide-oxygen-halothane anaesthesia. ⋯ The interval between the appearance of the first post-tetanic response and the first train-of-four response was typically 5-10 min for the intermediate-acting agents vecuronium and atracurium, and 20-30 min for the long-acting agents pancuronium, alcuronium and tubocurarine. A post-tetanic count of 6 with alcuronium and tubocurarine, or 7 with vecuronium, atracurium and pancuronium indicated that recovery of the first train-of-four response was imminent.