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At least 127 records · Page 7Linked to original sources
PubMed1984

Plasma catecholamine concentrations. The effects of infiltration with local analgesics and vasoconstrictors during nasal operations.

Plasma catecholamine concentrations were measured in 19 patients allocated randomly to receive submucous infiltration with 4 ml of either 0.5% lignocaine with adrenaline 1:200 000 or prilocaine 0.5% with octapressin 0.03 iu per ml. Venous blood samples were obtained before and at 2, 5, and 10 minutes following infiltration. Plasma adrenaline increased from 0.35 to 1.72 p mol/ml at 2 minutes infiltration with the former solution whilst there was little change in plasma noradrenaline concentration. No similar peak in adrenaline concentration occurred after infiltration with prilocaine/ octapressin solutions but with both solutions there was a small increase in plasma noradrenaline and adrenaline concentrations 10 minutes after infiltration, at the time of surgical stimulation.

Adolescent↗
PubMed1989

Regional anaesthesia for surgery of the forearm and hand. A technique of combined supraclavicular and discrete blocks.

Eighty patients who presented for surgery of the forearm or hand were allocated randomly to one of two groups. In Group A, surgery was performed under supraclavicular brachial plexus block only; a mixture of equal parts of prilocaine 1% and bupivacaine 0.5% without adrenaline was used. In Group B, supraclavicular brachial plexus block was performed using prilocaine 1% alone, but in addition discrete nerve blocks were performed at elbow level using 0.5% bupivacaine without adrenaline. Patients in Group B had a significantly shorter duration of unwanted postoperative motor blockade and a significantly longer duration of postoperative analgesia (p less than 0.005).

Anesthesia, Conduction↗
PubMed1991

Plasma catecholamine response to cataract surgery: a comparison between general and local anaesthesia.

We studied the plasma catecholamine, plasma glucose and cardiovascular responses to cataract surgery in 20 elderly patients allocated randomly to receive either general anaesthesia or local anaesthesia by retrobulbar block. Local anaesthesia prevented the increase in plasma noradrenaline, adrenaline and glucose concentrations found in those patients who received general anaesthesia and also improved cardiovascular stability. The results show the beneficial effects of local anaesthesia in preventing the hormonal, metabolic and cardiovascular changes found when cataract surgery is conducted under general anaesthesia.

Aged↗
PubMed1988

Comparison of the effect of cisapride and metoclopramide on morphine-induced delay in gastric emptying.

1. The effects of metoclopramide or cisapride on morphine-induced delay in gastric emptying in patients before surgery were compared. 2. Forty patients were allocated randomly to receive one of four premedications i.m.: placebo only, morphine 10 mg alone, morphine 10 mg with metoclopramide 10 mg and morphine 10 mg with cisapride 10 mg. Gastric emptying after each premedication was assessed indirectly from the rate of absorption of oral paracetamol. 3. Cisapride 10 mg reversed the delay in gastric emptying due to morphine. Its effects were significantly greater than those of metoclopramide 10 mg.

Acetaminophen↗
PubMed1987

Comparison of a positive expiratory pressure (PEP) mask with postural drainage in patients with cystic fibrosis.

The use of a positive expiratory pressure (PEP) mask was compared with postural drainage in the treatment of 10 patients with cystic fibrosis. The patients were allocated randomly in a crossover fashion to the two regimens and evaluated initially by a physiotherapist and over a 4 week treatment period by use of a diary card. There was no significant difference in sputum production or change in lung function between each technique as assessed by the physiotherapist. Diary card evaluation also failed to demonstrate a difference in sputum production, symptom score or peak expiratory flow rate between the 4 week treatment periods. It was concluded that PEP mask therapy is an acceptable and effective alternative to postural drainage in interval therapy of patients with cystic fibrosis, although the patients have tended to revert to postural drainage during acute exacerbations.

Adolescent↗
PubMedDate not supplied

[Comparative evaluation of psychoactive drugs used in patients with subacute and chronic cerebrovascular disorders].

The report is based on 315 patients with subacute and chronic cerebral circulatory disturbances caused mostly by atherosclerosis aged 30 to 82 years, treated for 1-6 months. In 90 cases Piracetam (Nootropil) was given, 107 received Piritinol (Encephabol, Enerbol), 77 Piriditol, 41 Centrophenoxin. The patients were allocated randomly to these groups. In the treated patients improvement was achieved in a considerable proportion of cases (44-82%) treated with different drugs. This improvement manifested itself as regression or decreased intensity of neurotic complaints, labyrinthine-cerebellar signs, pyramidal signs, anxiety and fears, improvement of recent memory, attention, psychomotor activity. The best results were obtained with Nootropil, moderately good with Centrophenoxin, Encephabol, and poor with Piriditol. Drug tolerance was best with Encephabol, while that of other drugs was slightly worse. The only disquieting symptoms was activation of epileptic seizures in several patients treated with Nootropil or Centrophenoxin. The best way of administration was giving the drugs in two doses in the morning hours and at noon. The authors regard as useful the treatment of patients with subacute and chronic cerebral circulatory failure with psychoenergizing drugs.

Adult↗
PubMed2005

Randomization and allocation concealment: a practical guide for researchers.

Although the randomized controlled trial is the most important tool currently available to objectively assess the impact of new treatments, the act of randomization itself is often poorly conducted and incompletely reported. The primary purpose of randomizing patients into treatment arms is to prevent researchers, clinicians, and patients from predicting, and thus influencing, which patients will receive which treatments. This important source of bias can be eliminated by concealing the upcoming allocation sequence from researchers and participants. Although there are many approaches to randomization that are known to effectively conceal the randomization sequence, the use of sequentially numbered, opaque sealed envelopes (SNOSE) is both cheap and effective. The purpose of this tutorial is to describe a step-by-step process for the preparation of SNOSE. We will outline how to prepare SNOSE to preserve allocation concealment in a trial that (a) uses unrestricted (simple) randomization, (b) stratifies randomization on one factor, (c) uses permuted blocks and, and (d) is conducted at more than 1 study site.

Humans↗
PubMed1980

Is a fat stitch necessary?

Two hundred and eight consecutive patients undergoing surgery were allocated randomly in a trial of the use of a plain catgut subcutaneous fat stitch, compared with no fat suture. There was no appreciable difference between the two trial groups in wound infection rate following either clean (4 out of 74 with and 1 out of 68 without a fat stitch) or contaminated operations (4 out of 27 with and 4 out of 41 without). Likewise, there were no differences in haematoma rates. There is therefore no appreciable benefit to be derived from the use of this stitch.

Adipose Tissue↗
PubMed1988

Mallet finger: a trial of two splints.

Over a period of twelve months, 116 cases of mallet finger were allocated randomly to treatment with either a Stack or Abouna splint. The two splints were equally effective, producing a cure or a significant improvement in approximately 50% of cases. However, the Stack splint was much preferred by the patients, who found it more comfortable, more robust and easier to keep clean.

Adult↗
PubMed1987

[Propofol in urological endoscopy in elderly patients. Comparison with methohexital].

Twenty patients undergoing cystoscopy (group A) and forty patients undergoing transurethral resection (group B), aged more than 65 years, were anaesthetized. Duration of anaesthesia was less than 15 min for cystoscopy, and more than 30 min for transurethral resection. No premedication was given. The patients were ASA I or ASA II. Group A patients were allocated randomly to receive either 1.5 mg . kg-1 propofol (n = 10) or 2 mg . kg-1 methohexitone (n = 10) for induction of anaesthesia. Anaesthesia was maintained using incremental doses of propofol or methohexitone and 60% N2O with a face-mask. Forty group B patients undergoing transurethral resection were randomly assigned to four equal groups (PB: propofol 1.5 mg . kg-1; MB: methohexitone 2 mg . kg-1; PF: propofol and 1.5 micrograms . kg-1 fentanyl; PFV: propofol, 2 micrograms . kg-1 fentanyl and 0.1 mg . kg-1 vecuronium). Suxamethonium (1 mg . kg-1; groups PB, MB and PF) and vecuronium (0.1 mg . kg-1; group PFV) were given to facilitate endotracheal intubation. Anaesthesia was maintained by infusion of propofol or methohexitone, using a calibrated pump started immediately after intubation. Ventilation was controlled only in group PFV. Induction with 1.5 mg . kg-1 propofol resulted in stopping counting after 62 s and loss of the eye-lash reflex after 84 s versus 47 and 67 s respectively with methohexitone. The anaesthesist's assessment was favourable for cystoscopy with propofol and methohexitone; recovery times were similar for the two drugs in cystoscopy lasting less than 30 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Cardiac arrhythmias during anaesthesia for laparoscopy.

Fifty-six patients undergoing elective laparoscopy were allocated randomly to two groups. Group H received alcuronium and were ventilated artificially using 0.5% halothane and nitrous oxide in oxygen. Group E breathed spontaneously a mixture of enflurane and nitrous oxide in oxygen. Arterial pressure, heart rate, tidal volume, respiratory rate and end-tidal carbon dioxide tension (PECO2) were monitored. The electrocardiogram (ECG) was recorded continuously using magnetic tape, from before induction until the patient left the recovery area. The incidence of arrhythmias was similar in the two groups. No arrhythmias occurred after the insufflated carbon dioxide had been removed from the abdomen. Spontaneous ventilation with enflurane anaesthesia is a simple and safe, technique for routine laparoscopy, providing the intra-abdominal pressure does not exceed 25 mm Hg.

Adolescent↗
PubMed1987

Intrathecal sufentanil as a supplement to subarachnoid anaesthesia with lignocaine.

The combination of low-dose sufentanil with lignocaine for subarachnoid anaesthesia was studied in a double-blind comparative trial in 40 urological patients. Patients were allocated randomly to two groups and received 5% heavy lignocaine 1.5 ml together with either 1.5 ml of sufentanil 5 micrograms ml-1, or physiological saline 1.5 ml. No statistically significant differences were observed between the two groups with respect to analgesia or anaesthesia. The only clear benefit of the addition of a low dose of sufentanil to lignocaine was the significantly longer period of postoperative analgesia. There was no significant difference in the number of patients requiring supplementary analgesics. Side-effects were similar in both groups.

Adjuvants, Anesthesia↗
PubMed1990

Comparison of neuromuscular block in the diaphragm and hand after administration of tubocurarine, pancuronium and alcuronium.

The onset and offset of neuromuscular block in the diaphragm and in the adductor pollicis muscle were recorded using unilateral supramaximal stimulation of phrenic and ulnar nerves. Thirty patients were allocated randomly to receive tubocurarine 0.4-0.5 mg kg-1, pancuronium 0.07-0.08 mg kg-1 or alcuronium 0.2-0.3 mg kg-1. In all cases the onset of neuromuscular block occurred in the diaphragm before adductor pollicis, and spontaneous recovery was evident first in the diaphragm. There was a correlation between the time of spontaneous reappearance of twitch in the diaphragm and in the adductor pollicis only in the patients who received pancuronium (r = 0.97, P less than 0.05 for reappearance of the first twitch of the train-of-four of each muscle). The duration of paralysis in the diaphragm was less than 5 min in five patients who received tubocurarine and in one who received alcuronium; this corresponded to a period of paralysis in the adductor pollicis muscle of more than 25 min in each case.

Adolescent↗
PubMed1990

Paediatric glucose homeostasis during anaesthesia.

The perioperative blood glucose regulatory response was compared in 20 healthy children (aged 1-5 yr) presenting for minor surgery and allocated randomly to either a fasted or a glucose group. All children received a milk feed at midnight. The fasted group received no oral intake thereafter, whereas the glucose group received 5% dextrose water 10 ml kg-1 orally about 4 h before operation. The mean plasma glucose concentrations in the two groups were similar before operation and were within normal limits. The pattern of change in the concentrations of plasma glucose, insulin, cortisol, growth hormone and glucagon were also similar between the two groups. Ten percent of patients in the fasted group and 33% in the glucose group had gastric aspirates in excess of 0.4 ml kg-1. The pH of all gastric samples was less than 2.5. The results suggest that healthy preschool children were able to maintain glucose homeostasis after 8 h of fasting. Feeding within 4-6 h before surgery may increase the risk of pulmonary aspiration.

Anesthesia, Inhalation↗
PubMed1992

Changes in cardiac index and estimated systemic vascular resistance during induction of anaesthesia with thiopentone, methohexitone, propofol and etomidate.

Changes in cardiac index (CI) and estimated systemic vascular resistance (ESVR) were assessed non-invasively using pulsed Doppler ultrasound during induction of anaesthesia. Ninety-six ASA I patients were allocated randomly to one of four groups to receive alfentanil 8 micrograms kg-1 followed by a dose of thiopentone, methohexitone, propofol or etomidate sufficient to obtund the eyelash reflex. CI increased significantly by 8% 1 min after administration of both methohexitone (P < 0.05) and propofol (P < 0.05), returning to pre-induction values thereafter. CI increased after thiopentone but the increase was not statistically significant. There was a significant decrease in CI of 16% after induction with etomidate (P < 0.001). ESVR decreased significantly from pre-induction values by 18% after methohexitone (P < 0.001) and 23% after propofol (P < 0.001). ESVR in the thiopentone group decreased, but this was not statistically significant. ESVR increased significantly by 12% 1 min after induction of anaesthesia with etomidate (P < 0.05) and then decreased towards pre-induction values. The results suggest that the cardiostability of etomidate may not be as complete in all groups of patients as previous studies have suggested.

Blood Flow Velocity↗
PubMed1985

Increased hepatic microsomal enzyme activity after surgery under halothane or spinal anesthesia.

Thirty-two fit patients scheduled for explorative arthrotomy of the knee were allocated randomly to either halothane/oxygen anesthesia or spinal anesthesia with bupivacaine 0.25 mg X kg-1. The day before and 1, 10, and 21 days after surgery, the aminopyrine breath test (ABT) was performed. The day before and 5, 10, and 21 days after surgery, the antipyrine clearance (APcl) was measured by the single sample saliva technique. The ABT as well as the APcl were increased significantly postoperatively (P less than 0.01). The day after surgery the ABT was increased by 13 +/- 21% in the spinal anesthesia group only, whereas a late increase by 14 +/- 31% was found in the halothane group. Five days after surgery, the APcl was increased by 36 +/- 45% in the spinal anesthesia group and by 21 +/- 28% in the halothane group. Both tests returned to base line values within 3 weeks postoperatively. In five volunteers following the same sampling scheme but receiving bupivacaine 0.25 mg X kg-1 im without surgery, no change in the ABT or the APcl was observed. The authors conclude that surgery may cause microsomal enzyme induction regardless of the anesthetic agent or technique used. The mechanism of this induction remains to be elucidated.

Adolescent↗
PubMed1989

Bed rest and postlumbar puncture headache. The effectiveness of 24 hours' recumbency in reducing the incidence of postlumbar puncture headache.

A prospective, blind, randomised trial was undertaken to determine if the incidence of postlumbar puncture headache is significantly altered by 24 hours' recumbency. One hundred and two patients were allocated randomly to rest supine in bed for either 4 or 24 hours after spinal anaesthesia for urological or gynaecological surgery. A standardised spinal anaesthetic technique was applied that incorporated the use of a 22-gauge needle. All patients were followed-up prospectively to determine if there was a difference in the incidence of postlumbar puncture headache between the two groups. Five patients (11.6%) who were recumbent for 4 hours developed postlumbar puncture headache, a result which was not statistically significantly different from the seven patients (11.9%) in the other group who complained of postlumbar puncture headache.

Aged↗