British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Recovery from day-case anaesthesia. Comparison between methohexitone, Althesin and etomidate.
One hundred unpremedicated patients, undergoing short gynaecological procedures, were randomly allocated to receive one of three i.v. hypnotic agents (methohexitone, Althesin and etomidate) alone or in combination with fentanyl, to supplement 66% nitrous oxide in oxygen. Recovery was assessed by the time patients took to open the eyes, to give correct date of birth, to achieve a certain level of manipulative skill with a children's post-box toy, and to perform a paper and pencil test. ⋯ Administration of fentanyl with Althesin or methohexitone did not significantly prolong the "post-box" recovery time. Side-effects were less common with Althesin, with or without fentanyl and etomidate with fentanyl was associated with the greatest frequency of complications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Controlled comparison of I.M. morphine and buprenorphine for analgesia after abdominal surgery.
In a double-blind randomized non-crossover trial 47 patients received either morphine or buprenorphine by regular i.m. injection for 24 h after abdominal surgery. The two drugs were equally effective as analgesics at the doses used. ⋯ The remainder of the buprenorphine group developed progressively slower respiration rates after 12 h. The results indicate that buprenorphine has a synergistic respiratory depressant effect with fentanyl and phenoperidine and may have a cumulative effect when given regularly on a 6-hourly regimen.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative glucose tolerance during extradural analgesia.
Thirteen patients undergoing lower abdominal gynaecological surgery were allocated to general anaesthesia (halothane and nitrous oxide) or general anaesthesia plus extradural analgesia (T8-S5). I.v. glucose tolerance tests were performed on the day before surgery and 8 h after skin incision. ⋯ Extradural analgesia blocked the hyperglycaemic response to surgery but not the late postoperative cortisol response, although values were significantly less than in the group receiving general anaesthesia alone. Impairment of glucose tolerance and of insulin response to the glucose load in the period after operation were not influenced by extradural analgesia and this may have resulted from insufficient inhibition of the stress-induced release of catecholamines or cortisol, or both, or from blockade of stimulatory efferent sympathetic pathways to pancreatic islets.