British medical journal
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British medical journal · Aug 1980
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory effects of analgesia after cholecystectomy: comparison of continuous and intermittent papaveretum.
Two methods of administering papaveretum for relieving postoperative pain were compared in two groups of patients who had undergone cholecystectomy. In one group a loading dose of papaveretum was administered by continuous intravenous infusion (1 mg/min) until the patient could breathe deeply without undue pain. ⋯ The intravenous regimen relieved pain better than the intramuscular regimen, which may have reflected the larger dose of papaveretum given to the intravenous group, but it was accompanied by a greater degree of respiratory depression and potentially life-threatening changes in respiratory pattern. These findings suggest that the fear which often accounts for inadequate postoperative pain relief-that larger dose of analgesics will cause respiratory complications-is well founded.
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British medical journal · Feb 1980
Randomized Controlled Trial Comparative Study Clinical TrialLoperamide, diphenoxylate, and codeine phosphate in chronic diarrhoea.
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British medical journal · Jul 1979
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia: a comparison of intravenous on-demand fentanyl with epidural bupivacaine.
In a randomised trial postoperative pain relief was provided by either epidural injections of bupivacaine or an infusion of fentanyl adjusted by the patient to achieve adequate pain relief. Both techniques produced satisfactory analgesia without respiratory depression after peripheral arterial surgery. The technique of infusing intravenously a potent analgesic in a dose adjusted by the patient appears to offer several advantages in postoperative care.
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British medical journal · Apr 1978
Randomized Controlled Trial Comparative Study Clinical TrialRandomised trial of a mobile coronary care unit for emergency calls.
A randomised trial was conducted to assess the value of sending a mobile coronary care unit (MCCU) to all emergency calls other than those for children or for patients injured in road-traffic accidents or brawls. Over 15 months 6223 calls for emergency ambulances were considered for the study, but a routine ambulance had to be dispatched on 2583 occasions because the MCCU was not available. ⋯ During the same period general practitioners sent 190 patients with heart attacks to hospital in routine ambulances and none of them died during the interval between the call for the ambulance and arrival at hospital. Although it may be worth equipping all emergency ambulances with a defibrillator, MCCUs as at present envisaged will not appreciably affect mortality from heart attacks.
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British medical journal · Jul 1977
Randomized Controlled Trial Clinical TrialEffects of naloxone on pethidine-induced neonatal depression. Part I--Intravenous naloxone.
Infants whose mothers had had pethidine during labour were given either naloxone 40 microgram or isotonic saline administered intravenously double-blind within one minute of birth. Peak alveolar carbon dioxide tension, carbon dioxide excretion, alveolar ventilation, feeding behaviour, and habituation to a specific sound stimulus were measured regularly up to 48 hours after birth. Alveolar carbon dioxide tension was significantly lower and alveolar ventilation significantly higher half an hour after birth in the naloxone-treated group than in the saline-treated group, but these differences between the groups were not significant at any other time, and there were no significant differences in sucking frequency or pressure, milk consumption, or habituation to the auditory stimulus.