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  • 1
    Electronic Resource
    Electronic Resource
    Patient controlled analgesia for labour: a comparison of remifentanil with pethidine (2005)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 60 (2005), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We compared the analgesic efficacy and safety of remifentanil and pethidine via patient controlled analgesia for women in established uncomplicated labour. Women received either remifentanil 40 μg with a 2-min lockout (n = 20) or pethidine 15 mg with a 10-min lockout (n = 19). Visual analogue scores for pain during the study and for overall pain were similar for both groups (mean (SD) 6.4 (1.5) cm for remifentanil and 6.9 (1.7) cm for pethidine). The area under the curve for visual analogue scores of satisfaction with analgesia was higher for remifentanil than for pethidine (p = 0.001). Maternal arterial oxygen saturation was similar in both groups. Neurologic and Adaptive Capacity Scores at 30 min were higher for remifentanil than for pethidine (median (interquartile range [range]) 36 (34.5–37 [32–39]) vs 34 (33–35 [30–35]), respectively; p = 0.003).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.03975.x
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  • 2
    Electronic Resource
    Electronic Resource
    Assessment of tracheal intubation in children after induction with propofol and different doses of remifentanil (2004)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 59 (2004), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Tracheal intubating conditions were assessed in 112 children after induction of anaesthesia with propofol and remifentanil 1.0, 2.0 or 3.0 µg.kg−1. Subjects in a control group were given propofol and mivacurium 0.2 mg.kg−1. Haemodynamic and respiratory parameters were recorded. Plasma catecholamine levels were measured in a subgroup of 40 children. Intubating conditions were acceptable in 14/28 (50%), 18/26 (69%) and 22/27 (82%) in those subjects given remifentanil 1.0, 2.0 or 3.0 µg.kg−1, respectively, and in 27/28 (96%) of the control group. Intubating conditions in subjects given remifentanil 3.0 µg.kg−1 were better than in those given remifentanil 1.0 µg.kg−1 (p 〈 0.05). There were no significant differences in intubating conditions between those given remifentanil 3.0 µg.kg−1 and the control group. Systolic blood pressure and heart rate increased in response to tracheal intubation in subjects given remifentanil 1.0 µg.kg−1 and in the control group (p 〈 0.05). Time to resumption of spontaneous respiration was prolonged in subjects given remifentanil 3.0 µg.kg−1 (p 〈 0.001). In conclusion, remifentanil 2 µg.kg−1 provides acceptable intubating conditions and haemodynamic stability without prolonging the return of spontaneous respiration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.03524.x
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  • 3
    Electronic Resource
    Electronic Resource
    Tracheal intubating conditions after induction with sevoflurane 8% in children (2000)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 55 (2000), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied tracheal intubating conditions in 120 healthy children, aged 3–12 years, in a blinded, randomised clinical trial. Children were randomly allocated to one of three groups: group PS, propofol 3 mg.kg−1 and succinylcholine 1 mg.kg−1 (n = 40); group PA, propofol 3 mg.kg−1 and alfentanil 10 µg.kg−1 (n = 40); group SF, sevoflurane 8% in 60% nitrous oxide in oxygen for 3 min (n = 40). Tracheal intubating conditions were graded according to ease of laryngoscopy, position of vocal cords, coughing, jaw relaxation and movement of limbs. Overall intubating conditions were acceptable in 39 of 40 children in the propofol/succinylcholine group, 21 of 40 children in the propofol/alfentanil group and 35 of 40 children in the sevoflurane group. Children receiving propofol and succinylcholine or sevoflurane had better intubating conditions overall than those given propofol and alfentanil (p 〈 0.01). In conclusion, anaesthetic induction and tracheal intubation using sevoflurane 8% for 3 min is a satisfactory alternative to propofol with succinylcholine in children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2000.01470.x
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  • 4
    Electronic Resource
    Electronic Resource
    The effect of alkalinisation of lignocaine on axillary brachial plexus anaesthesia (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 51 (1996), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Alkalinisation of local anaesthetic drugs is a controversial technique for improving regional blockade. Forty-two patients scheduled for upper limb surgery received axillary brachial plexus anaesthesia using a cannula technique. Patients were randomly allocated to receive either lignocaine 1.5% with 1 in 200 000 adrenaline (pH = 4.2) or lignocaine 1.5% with I in 200000 adrenaline (pH = 7.2). There was no significant difference in the incidence of satisfactory blockade or distribution of anaesthesia between the two groups. The percentage of patients with complete anaesthesia at 10, 20 and 30 min following injection was significantly increased in the alkalinised group with regard to the ulnar and median nerves, and the median cutaneous nerve of the arm (p 〈 0.05). In the alkalinised group, there was a significant reduction in the time to useful anaesthesia and a reduced requirement for adjuvants (p 〈 0.05). There was no effect on the duration of anaesthesia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1996.tb07712.x
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  • 5
    Electronic Resource
    Electronic Resource
    Respiratory effects of spinal anaesthesia for Caesarean section (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 51 (1996), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report the changes observed in a number of pulmonary function tests performed on 36 patients undergoing Caesarean section under spinal anaesthesia. The tests comprised peak expiratory flow, forced expiratory volume in one second, forced vital capacity, forced expiratory volume in one second to forced vital capacity ratio and the maximal mid-expiratory flow. Significant changes occurred that are consistent with a restrictive ventilatory defect. These changes persisted for four hours after the induction of spinal anaesthesia. Administration of 35% oxygen by facemask failed to change significantly fetal umbilical vein pH or partial pressure of oxygen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1996.tb15046.x
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  • 6
    Electronic Resource
    Electronic Resource
    Intrathecal alfentanil with and without bupivacaine for analgesia in labour (2000)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 55 (2000), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Combined spinal–epidural (CSE) for analgesia in labour is widely used as a method of providing pain relief while minimising motor blockade. Aiming to further reduce the associated motor weakness, we investigated the use of alfentanil alone as the initial intrathecal injection in a double-blind study. Thirty women were randomly allocated to receive either alfentanil 0.25 mg with bupivacaine 2.5 mg intrathecally, or alfentanil 0.25 mg in the same volume. Onset of analgesia did not differ significantly between groups but duration was significantly longer in those receiving alfentanil–bupivacaine (mean 55 min vs. 40 min; p 〈 0.05). Quality of analgesia was satisfactory for all women, although the cumulative analgesia scores were significantly lower in the women receiving the alfentanil–bupivacaine mixture (p = 0.003). More women in the alfentanil–bupivacaine group developed both a sensory level (15/15 vs. 6/15; p 〈 0.01) and sympathetic block (12/15 vs. 4/15; p 〈 0.01). Sixty per cent of women receiving the alfentanil–bupivacaine mixture demonstrated an impaired ability to straight leg raise compared with none of the women in the alfentanil–saline group (p 〈 0.01). The incidence of adverse effects in mother and fetus was similar in both groups. We conclude that intrathecal alfentanil 0.25 mg alone as part of a CSE technique provides rapid analgesia of satisfactory quality without detectable motor blockade.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2000.01547-3.x
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  • 7
    Electronic Resource
    Electronic Resource
    Probable seizure after remifentanil in a 4-year-old boy (2000)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 55 (2000), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2000.01425-19.x
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  • 8
    Electronic Resource
    Electronic Resource
    Epidural infusion of alfentanil or diamorphine with bupivacaine in labour—a dose finding study (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Following induction of epidural analgesia with 0.375% bupivacaine, 120 healthy parturients were randomly assigned in a double blind fashion to one of eight infusion groups. All received 8ml.h-1 of0.125% bupivacaine either alone (control group), or with alfentanil at 133, 266 or 400μg.h-1 (groups A1-A3) or with diamorphine at 133, 266, 400 or 533μg.h1 (groups D1-D4). Significantly longer top-up intervals were achieved with the two highest doses of both alfentanil and diamorphine when compared with bupivacaine alone (p〈0.01), making the minimum effective doses 266 μg.h-1 of alfentanil and 400 ng.h-1 of diamorphine. Perineal analgesia was better in all the opioid groups compared with the control group (p 〈 0.05). The intensity of motor block was greater in the control group (p 〈 0.05). The incidence of pruritus did not differ between groups. The highest dose of diamorphine caused significantly more nausea. No significant neonatal side-effects were demonstrated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb05996.x
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  • 9
    Electronic Resource
    Electronic Resource
    Two approaches to the axillary brachial plexus (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A new technique of cannulation of the axillary neurovascular sheath, using loss of resistance to saline, was evaluated and compared to the established technique of eliciting paraesthesiae with a short-bevelled needle. The cannulation technique produced a more reliable block of axillary, musculocutaneous and radial nerves, significantly fewer incomplete blocks and a lower incidence of accidental vessel puncture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1992.tb02119.x
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  • 10
    Electronic Resource
    Electronic Resource
    Diagnostic gold standard for soft tissue tumours: morphology or molecular genetics? (2000)
    Oxford, UK : Blackwell Science Ltd
    Histopathology 37 (2000), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The recognition of recurrent genetic alterations in specific tumour types has provided the basis for the reclassification of certain soft tissue neoplasms, and molecular analysis of patient material has the potential to provide both diagnostic and prognostic information. In this review, we evaluate the role of molecular genetic testing as the prospective ‘gold standard’ for sarcoma diagnosis. Molecular genetic testing, as with every new method, promises to improve accuracy and to be more sensitive and less subjective, claims that have been made previously by histochemistry, electron microscopy and immunohistochemistry. Technical limitations in molecular assays, as well as more general specificity issues, decrease the clinical usefulness of molecular pathological testing significantly and suggest that, at present, molecular evaluation is best considered an ancillary technique that neither supersedes other ancillary techniques nor eclipses traditional pathological examination.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2000.01107.x
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