Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anaesthesia and blood loss in total hip replacement.
Twenty-seven consecutive patients scheduled for total hip replacement were randomly divided into three groups. The first group had their operations under epidural analgesia, the second whilst breathing halothane spontaneously and patients in the third group were anaesthetised using a modified neuroleptoanaesthetic (NLA) technique. Blood lost during the operation was measured by a colorimetric technique. ⋯ There was no significant difference in the amounts of blood collected by closed suction drainage in any of the three groups and the mean values for total overall blood loss incurred by procedure were 734-1 +/- 40-7 ml (s.e.m.) for the epidural group, 986-3 +/- 94-9 ml (s.e.m.) for the halothane group and 1168-4 +/- 126 ml (s.e.m.) for the NLA group. In this series only 3 of 10 patients (30%) who had their operation under epidural anaesthesia required transfusion with whole blood, compared with 7 of 9 (78%) in the halothane group, and 7 of 8 (87-5%) in the neuroleptoanalgesia group. From this series it is evident that the need for transfusion of whole blood in total hip replacement can be significantly reduced by the use of epidural analgesia.
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Randomized Controlled Trial Clinical Trial
The value of topical lignocaine for bronchoscopy under general anaesthesia.
Patients for bronchoscopy were randomly allocated to two groups, one receiving 4 ml 4% lignocaine spray and a control group which was not sprayed. There were no significant differences in the incidence of cough and spasm on recovery between the groups. The findings of a double-blind study comparing patients sprayed with 0-9% saline or lignocaine showed a significantly higher incidence of spasm in the saline group.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative anaesthetic properties of various local anaesthetic agents in extradural block for labour.
Various concentrations of lignocaine, etidocaine and bupivacaine in 10-ml doses of plain solutions were studied in a double-blind manner as agents for extradural analgesia to relieve the pain of labour. In 67 patients in established labour the onset time and duration of analgesia were assessed by the abolition and recurrence of the pain of uterine contractions, motor block on a 0-2 scale, dermatomal spread by pinprick testing, and arterial pressure by standard sphygmomanometry. Increasing the drug concentration reduced the onset times and increased both the duration of analgesia and the degree of motor block, but had little effect on dermatomal spread or on the frequency of hypotension. Based on the results the agents have been classified with regard to onset and duration of analgesia and degree of motor blockade.
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British medical journal · Nov 1976
Randomized Controlled Trial Comparative Study Clinical TrialReversal of narcotic depression in the neonate by nalozone.
Naloxone 40 mug was administered intravenously one minute after birth to 20 out of 44 neonates whose mother had been given pethidine in labour. These neonates were compared with 20 others whose mothers had had only lumbar epidural block. ⋯ The naloxone-treated neonates were comparable with the epidural group, although the effects of naloxone were diminishing at 30 minutes. Naloxone is an effective narcotic antagonist which should be considered to be the drug of choice for treating narcotic depression in the neonate.
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Randomized Controlled Trial Clinical Trial
Efficacy of a nerve stimulator in regional analgesia; experience in a resident training programme.
Forty interscalene brachial plexus regional blocks and twenty sciatic-femoral lower limb blocks were performed by 1st and 2nd year anaesthesia residents. Nerve trunk location was equally but randomly divided between use of a peripheral nerve stimulator and reliance on paraesthesiae. ⋯ It is concluded that the stimulator is not a useful adjunct for nerve location, except in those patients who are unable to co-operate in eliciting paraesthesia. In such patients the stimulator permits a comparable success rate.