Canadian Anaesthetists' Society journal
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The effect of epidural morphine on the duration of action of epidural 2-chloroprocaine was studied in a double-blind fashion in 30 patients following elective Caesarean section. When compared to epidural saline controls (n = 15), patients (n = 15) who received epidural morphine (4.0-5.0 mg) did not experience a prolongation or reduction in the duration of the somatic or sympathetic nervous system blockades produced by epidural 2-chloroprocaine.
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Anticholinesterases were administered in an attempt to antagonize prolonged neuromuscular blockade following the administration of succinylcholine in a patient later found to be homozygous for atypical plasma cholinesterase. Edrophonium 10 mg, given 74 min after succinylcholine, when train-of-four stimulation was characteristic of phase II block, produced partial antagonism which was not sustained. ⋯ Spontaneous respiration recommenced 200 min after succinylcholine administration. It is concluded that anticholinesterases are only partially effective in restoring neuromuscular function in succinylcholine apnoea despite muscle twitch activity typical of phase II block.
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Comparative Study
Comparison of oral pentazocine, oral diazepam and intramuscular pentazocine for paediatric premedication.
Oral pentazocine-atropine, oral diazepam-atropine and IM pentazocine-atropine were compared as preoperative medication in children. Observations in 300 children ages 1-14 years included the emotional state at time of induction of anaesthesia, smoothness of induction, dryness of oral mucosa and tongue, incidence of vomiting, and emotional state and length of stay in the recovery room. The incidence of a calm state at the time of induction and smoothness of induction of anaesthesia was the same following oral and IM premedication. ⋯ However, children in age groups 1-4 and 5-9 years who received diazepam-atropine were more restless in the recovery room than those who received oral or IM pentazocine-atropine. More children in groups 1-4 and 5-9 years who received IM pentazocine-atropine stayed longer in the recovery room. We conclude that oral diazepam-atropine and oral pentazocine-atropine are comparable as to preoperative medication IM pentazocine-atropine and that they can be given as an alternate to intramuscular injection.
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Biography Historical Article
Canadian Anaesthetists' Society Medal. Dr. Richard G.B. Gilbert.