Articles: anesthetics.
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Comparative Study Clinical Trial Controlled Clinical Trial
Efficacy of diphenhydramine hydrochloride for local anesthesia before oral surgery.
The efficacy of diphenhydramine hydrochloride with epinephrine was tested against lidocaine with epinephrine in a double-blind study. Patients with allergic reactions to general local anesthetics were safely and effectively treated with diphenhydramine hydrochloride as an anesthetic alternative.
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The state of anaesthesia is one of unconsciousness, lack of awareness, amnesia and reflex suppression to noxious stimuli. The depth of anaesthesia is generally considered adequate if the patient neither moves in response to surgical stimulus nor shows any signs of autonomic reflexes. Anaesthesia is generally considered inadequate if the patient has recall after surgery!
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Biography Historical Article
Anaesthetics. With special reference to Ivan Magill.
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The newer neuromuscular blocking drugs include vecuronium and atracurium. Vecuronium is a competitive neuromuscular blocking drug with a steroid nucleus. A dose of 0.1 mg/kg has an onset time of 2 minutes and provides surgical paralysis for 20 minutes. ⋯ The dose needed to induce sleep varies widely (0.15 to 0.5 mg/kg); onset is slow (1.5 to 5 minutes), and recovery may be prolonged. Midazolam is also used in lower doses as a sedative. Ketamine, an intravenous induction agent, has recently been used intrathecally and extradurally to provide analgesia.
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A short survey about the different methods available for producing postoperative analgesia is given, the goal being to make it clear to the clinician that there are quite a number of techniques to be used although the everyday clinical practice often sticks to simple and not too effective methods of pain treatment following surgery. Initially presenting short informations about the neurophysiology of pain and the pathogenesis and causes of postoperative pain two main groups of producing analgesia are then discussed. Thefirst group deals with the systemic use of analgesics be it nonnarcotic analgesic antipyretics or narcotic analgesics (opioids). ⋯ They present clear advantages over the local anesthetic methods as there are the long lasting analgesia and the selective blockade of pain not touching motor and sympathetic nerve fibers. A delayed respiratory depression however might be a serious danger showing an incidence of 0,3% in the epidural and some 10% in the subarachnoid route. Aiming to inform the clinician once again about the vast field of possibilities available to make the postoperative course painfree it is hoped that this important task in the postoperative period will be handled with more consequence and effectivity in the future.