Articles: anesthesia.
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Randomized Controlled Trial Clinical Trial
Efficacy of an epidural test dose in children anesthetized with halothane.
The effect of an intravenous (iv) injection of lidocaine with epinephrine was studied to determine if such a test dose would cause a reliably detectable increase in heart rate and systemic blood pressure in children anesthetized with halothane and nitrous oxide. The effect of the injection of atropine before the test dose on these parameters was also determined. Sixty-five children 1 month to 11 yr of age and weighing 3.9-35 kg were studied. ⋯ Following the iv test dose, 6 of 21 children in group 2 had an increase in heart rate of less than 10 beats/min, while only one child in group 1 had an increase in heart rate of less than 10 beats/min. Intravenous test doses that did not contain epinephrine (groups 3 and 4) had no effect on heart rate or blood pressure. Atropine, 10 micrograms/kg, improves the reliability of an epidural test dose in children anesthetized with halothane and nitrous oxide but does not ensure total reliability in detecting an intravascular injection.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of complications associated with single-holed and multi-holed extradural catheters.
Adverse events associated with single-holed and multi-holed extradural catheters were compared in obstetric practice. Two hundred and forty-five patients were given an extradural block using a single-holed catheter and 229 received a block via a multi-holed catheter. ⋯ Flow of fluid under gravity in the catheter was restricted significantly more often in the single-holed catheters. Blood was found significantly more often in the multi-holed catheters.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
The Bain, ADE, and Enclosed Magill breathing systems. A comparative study during controlled ventilation.
The Enclosed Magill, Humphrey ADE and the Bain breathing systems are all used for controlled ventilation of the lungs. This study compares the three systems in vitro with a lung model and in clinical practice. No difference was observed, with ventilatory variables commonly used in clinical practice, between the Bain and the ADE, while significantly lower end-tidal carbon dioxide values were observed with the Enclosed Magill (about 7%). Lower fresh gas flows can be used under these circumstances to maintain normocapnia with the Enclosed Magill than either the Bain or the Humphrey ADE.
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Randomized Controlled Trial Comparative Study Clinical Trial
Paediatric postoperative analgesia. A comparison of rectal diclofenac with caudal bupivacaine after inguinal herniotomy.
Forty-three children for day case inguinal herniotomy under general anaesthesia were assigned randomly to receive either 1 ml/kg caudal bupivacaine 0.25% or rectal diclofenac 0.25 mg/kg intra-operatively to provide postoperative analgesia. Pain and demeanour were assessed by an observer in the early postoperative period after operation and by questionnaire for the parents over the first 24 hours. Caudal bupivacaine provided more pain-free patients at first but later the incidence of pain was similar in the two treatment groups. Rectal diclofenac is a useful alternative to caudal blockade in this group of patients.
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Randomized Controlled Trial Clinical Trial
Depth and duration of skin analgesia to needle insertion after topical application of EMLA cream.
We have determined the depth and duration of analgesia to needle insertion after topical application of EMLA cream (Eutectic Mixture of Local Analgesics). EMLA was applied for 30, 60, 90 and 120 min and the sensory and pain threshold depths were determined before analgesia (1.0 and 1.9 mm, respectively) and up to 4 h after the cream was removed from the skin. ⋯ For application times shorter than 120 min, the depth of analgesia increased during the period after removal of the cream. This suggests new guidelines for the use of this topical analgesic.