Articles: anesthesia.
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Randomized Controlled Trial Clinical Trial
Reduction of pain on injection of etomidate.
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Randomized Controlled Trial Comparative Study Clinical Trial
Fentanyl and the metabolic response to gastric surgery.
The effect of the supplementation of nitrous oxide-oxygen anaesthesia with either 50 micrograms fentanyl/kg body weight or 0.5-1.0% halothane on the metabolic and hormonal response to gastric surgery was investigated in 16 patients. Those patients who received fentanyl showed a significant decrease (p less than 0.05) in the hyperglycemic response to surgery after 30 and 90 minutes and a significant decrease (p less than 0.05) in the plasma cortisol response after 30 minutes. ⋯ This required the intravenous administration of naloxone and careful supervision in the early postoperative period. It is concluded that the transient metabolic and endocrine benefits produced by fentanyl do not compensate for the severe respiratory problems postoperatively and thus 'high-dose fentanyl' cannot be recommended for upper abdominal surgery.
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Letter Randomized Controlled Trial Clinical Trial
Pain and movement following the injection of etomidate.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of baricity on spinal anaesthesia with bupivacaine.
In a double-blind study of spinal anaesthesia with 0.5% bupivacaine 3 ml with no glucose, 5% glucose or 8% glucose all three solutions gave consistently good nerve blocks. The hyperbaric solutions (5% and 8% glucose) produced a greater cephalad spread and were suitable for lower abdominal surgery, whereas the plain solution (no glucose) seldom affected the thoracic nerves. Cardiovascular changes were more marked with the hyperbaric solutions but only necessitated treatment on two occasions. The duration of block was not affected by baricity and was in the range 140-160 min.
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Randomized Controlled Trial Clinical Trial
Halothane uptake and nitrous oxide concentration. Arterial halothane levels during Caesarean section.
The effect on halothane uptake of changing the nitrous oxide concentration during the first few minutes of a general anaesthetic for Caesarean section was investigated. In 10 mothers anaesthesia was maintained with halothane 0.4%, nitrous oxide 33% and oxygen 66%. In 10 others the sole difference in anaesthetic technique was that the ratio of nitrous oxide to oxygen was reversed for the first 3 minutes only. ⋯ Cord blood concentrations between the two groups were comparable. The difference in halothane levels is a demonstration of the influence of the concentration effect of nitrous oxide on the uptake of halothane, the second gas effect. The relevance of anaesthetic uptake to obstetric anaesthesia and awareness is discussed.