BACKGROUND AND OBJECTIVES: We compared the efficacy of a mixture of ropivacaine and lidocaine with a mixture of bupivacaine and lidocaine for providing peribulbar anesthesia for cataract surgery. We used the time to adequate block for surgery and ocular and eyelid movement scores as clinical end points. METHODS: Ninety patients were allocated randomly to receive 7-10 mL of an anesthetic mixture of equal parts 0.75% bupivacaine and 2% lidocaine or a mixture in which ropivacaine 1% was substituted for bupivacaine. Hyaluronidase 15 IU x mL(-1) was added to both solutions. RESULTS: The median time at which the block was adequate to start surgery was 8 minutes for each group. Median ocular movement scores were similar in both groups at all times. Ropivacaine produced decreased eyelid movement scores at 2 (P = .047), 6 (P = .038), and 8 minutes (P = .016). No differences were observed between the groups in the incidence of minor complications or of pain during insertion of the block. Seven patients in the ropivacaine group and 12 patients in the bupivacaine group required supplementary anesthesia. CONCLUSIONS: Ropivacaine 1% is an effective alternative to 0.75% bupivacaine for peribulbar anesthesia, when combined with lidocaine and hyaluronidase.

Aged↗

PubMedDate not supplied

Long distance exercise in the horse: Golden Horseshoe Ride 1978.

As part of a study of the metabolic effects of long distance riding the results of biochemical analyses of blood samples taken from horses before, immediately after and one hour after an 80 km ride are reported. The results show that the horses were moderately dehydrated, they were working aerobically using fats as metabolic substrates and blood glucose was reduced. There was no evidence of post exercise ketosis and circulating alanine levels fell. Metabolic hormone levels are reported and are related to the availability of substrates for gluconeogenesis. There was evidence of reduced kidney and liver function which was showing little sign of recovery in the first hour after the ride.

Animals↗

PubMedDate not supplied

Substrate mobilisation during surgery. A comparison between halothane and fentanyl anaesthesia.

A study was undertaken in twenty-eight patients to compare the effects of the supplementation of nitrous oxide and oxygen anaesthesia with either 0.5--1.0% halothane or 50 microgram fentanyl/kg on the metabolic and hormonal response to gynaecological surgery. The results showed that the increases in blood glucose, plasma cortisol and growth hormone concentrations observed in the halothane group of patients were abolished in those who received fentanyl. It is postulated that the ability of large doses of fentanyl to inhibit the cortisol and growth hormone response to surgery may be of value in ameliorating the catabolic response to trauma.

Adult↗