Articles: anesthetics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Split skin grafting using topical local anaesthesia (EMLA): a comparison with infiltrated anaesthesia.
The analgesic efficacy of EMLA cream was compared with that produced by infiltration of lignocaine solution when used to provide anaesthesia for cutting of skin grafts. The study was performed as an open parallel group comparison in 80 patients. ⋯ On administration, infiltration produced varying amounts of pain in all patients, but in contrast EMLA produced no discomfort. In view of this lack of discomfort and the consequent greater freedom afforded regarding the area of donor site anaesthetised, EMLA can be considered the treatment of choice when skin grafts are harvested under local anaesthetic.
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Comparative Study
Propofol reduces seizure duration in patients having anaesthesia for electroconvulsive therapy.
Twenty-five patients received either methohexitone 1.0 mg kg-1 or propofol 1.3 mg kg-1 to induce anaesthesia during two separate electroconvulsive therapy (ECT) treatments. A forearm was isolated before administration of suxamethonium 0.5 mg kg-1, so that unmodified seizure duration could be measured. ⋯ Median (quartile deviation) duration of seizure was reduced significantly after propofol (19.0 (9.0) s), compared with after methohexitone (33.0 (7.8) s). Therefore propofol may not be an appropriate anaesthetic for ECT because of its adverse effect on seizure duration.
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Local anaesthetic with vasoconstrictor combinations are often used to reduce bleeding and hence improve the operating field in septal surgery. Two commonly used combinations are lignocaine with adrenaline and prilocaine with felypressin (citanest with octapressin). Most surgeons prefer to use lignocaine with adrenaline but because of the risks of cardiac dysrhythmias when used with halothane anaesthetists prefer prilocaine with felypressin. ⋯ The mean blood loss in the adrenaline group was 7.5 ml. and 32.7 ml. with felypressin. Both combinations were equally effective in producing adequate local anaesthesia. It is concluded that lignocaine with adrenaline is superior to prilocaine with felypressin in achieving a dry operating field in septal surgery under local anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison between propofol and thiopentone for induction of anaesthesia in children.
Propofol 2.5 mg/kg was compared with thiopentone 5 mg/kg in a randomised open study, as an induction agent in paediatric anaesthesia. One hundred and twenty children who were to undergo elective surgery were included in the study. Both propofol and thiopentone produced a rapid and smooth induction with a low incidence of side effects. ⋯ Respiratory upsets occurred less frequently with propofol than with thiopentone, but propofol frequently induced discomfort on injection. Both agents provided satisfactory and controllable induction of anesthesia and no major adverse reactions occurred during or after anaesthesia. We conclude that propofol is a useful alternative as an induction agent in children.