Articles: treatment.
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Vecuronium bromide 70 micrograms kg-1 was used to facilitate tracheal intubation and provide neuromuscular blockade in 52 patients undergoing laparoscopic sterilization. Anaesthesia was maintained with 67% nitrous oxide in oxygen. Patients were monitored clinically and by tactile assessment of the evoked response of the adductor pollicis to a supramaximal train-of-four stimulation. ⋯ Residual neuromuscular blockade was antagonized rapidly at completion of surgery by neostigmine 2.5 mg i.v., which was administered provided there was at least one twitch response. The mean duration of the procedure was 14.3 min (SD 2.5 min). The mean time from injection of neostigmine to satisfactory spontaneous breathing and neuromuscular recovery was 1.6 min (SD 0.7 min).
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The treatment of varicose veins includes injection/compression sclerotherapy and surgical stripping or ligation or both. Surgery appears to be favoured when the saphenous system is involved or when the patient is 35 to 64 years old or presents with ankle edema or flare. On the other hand, sclerotherapy has been found to be more effective in patients with dilated superficial veins or incompetent perforating veins in the lower legs and to be more acceptable and less expensive than surgical treatment.
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The diagnosis of ectopic pregnancy has become precise and reliable. Consequently, the management of ectopic pregnancy has progressed to the point where the physician is often able to preserve fertility. Therefore, conservative surgery is indicated if the patient desires future fertility and conditions are appropriate. ⋯ Although ectopic pregnancy can be diagnosed early and managed conservatively, it is, and will remain a potentially life-threatening disease and must be approached as such. Table 3 summarizes our proposed surgical management of tubal pregnancy. Table 4 summarizes the results of conservative surgery for tubal pregnancy.