British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Venous sequelae following the injection of etomidate or thiopentone i.v.
The frequency of local venous reactions after the injection i.v. of etomidate or thiopentone was studied in 61 patients undergoing surgery for prolapsed lumbar disc. Of the patients who received etomidate, 24% developed thrombophlebitis in the period after operation (up to 14 days). Of the patients who received thiopentone, 4% developed thrombophlebitis in the period after operation. Pain on injection occurred in 24% of the patients receiving etomidate, but there was no correlation between pain on injection and the subsequent thrombophlebitis.
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Randomized Controlled Trial Comparative Study Clinical Trial
Subarachnoid anaesthesia: comparison of hyperbaric solutions of bupivacaine and amethocaine.
Hyperbaric solutions of 0.5% bupivacaine and 0.5% amethocaine (2 and 3 ml) were compared in a double-blind study of 40 patients receiving subarachnoid anaesthesia for urological surgery. The drugs produced similar and satisfactory analgesia in the tested concentrations and volumes. Motor blockade was more profound and longer lasting with amethocaine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of bupivacaine and etidocaine in extradural blockade.
In a randomized, double-blind study, 40 female patients underwent major gynaecological surgery with extradural anaesthesia provided by 0.75% bupivacaine, 0.75% bupivacaine with adrenaline 5 micrograms ml-1, 1.5% etidocaine or 1.5% etidocaine with adrenaline 5 micrograms ml-1, 20 ml in each case. In all patients the resultant blockade was suitable for intra-abdominal pelvic surgery. Mean maximum spread of analgesia was around T3/4 with all four drugs. ⋯ There were no differences in the durations of motor blockade. Objective measurements of the duration of sensory blockade showed that there were no differences between the drugs and that the addition of adrenaline increased the duration of blockade. However, pain returned sooner following etidocaine than bupivacaine, and the additive effect of adrenaline was to increase this period of subjective analgesia.
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Minute ventilation (VE) (ml min-1), respiratory frequency (f), mixed expired carbon dioxide fraction (FECO2) and end-tidal carbon dioxide concentration (E'CO2) (%) were measured, and alveolar ventilation (VA), deadspace (VD), deadspace/tidal volume ratio (VD/VT) and carbon dioxide output (VCO2) calculated in 58 anaesthetized, spontaneously breathing infants and children weighing 2.8-20.5 kg. Although minute volumes varied, tidal volume correlated well with weight (r = 0.83), with a mean tidal volume (+/- 1SD) of 5.2 +/- 1.2 ml kg-1. ⋯ Respiratory frequency, VD/VT and total VD per minute were higher in the younger age group, which explained the finding of a high VE in relation to VCO2 for these patients. This inefficiency of ventilation emphasizes the need to minimize apparatus deadspace in breathing systems used for small infants.
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Intrathecal morphine was given to 56 children undergoing open-heart surgery. The first 27 patients received 0.03 mg kg-1 and the other 29 received 0.02 mg kg-1. Satisfactory postoperative analgesia, lasting for 22 h or longer, was obtained in over 60% of the patients in each group. Respiratory depression occurred in six of the first group (0.03 mg kg-1), and three in the second (0.02 mg kg-1), most frequently between 3.5 and 4.5 h after the administration of the intrathecal morphine.