RESUMEN
Intrathecal pethidine as a sole anaesthetic agent for surgical procedures of the lower limbs, perineum and inguinal areas was investigated and compared with hyperbaric Bupivacaine. A total of 90 patients were studied and randomly divided into groups 1 (bupivacaine) and 2 (pethidine). In group 2, 26 of 46 patients (59) had their procedures successfully with intrathecal pethidine alone and did not require or request any additional sedation or analgesia. This compared to 24 of 44 patients (52.2) in the bupivacaine group. Pethidine had a prolonged postoperative analgesia and was more cost-effective. The incidences of side effects were acceptable. (hypotension 13.6, bradycardia 9.09, nausea and vomiting 11.4, and pruritus 15.9). Pethidine can be used as a sole anaesthetic agent for operative procedures of the lower limbs; side effects are mild and can be treated.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Meperidina , Analgésicos Opioides/administración & dosificación , Perineo , Insuficiencia Respiratoria , Bradicardia , Perna , Procedimientos Quirúrgicos Ambulatorios , Ingle , Anestesia Raquidea , Meperidina , Náusea , Analgésicos Opioides/efectos adversos , Anestésicos Locales/administración & dosificación , Bupivacaína/administración & dosificación , Hipotensión/etiología , Método Doble CiegoRESUMEN
OBJECTIVE: To determine whether pre-eclamptic patients receiving spinal anaesthesia require prior coagulation screening studies. METHODS: This was a retrospective study of all patients with pre-eclampsia receiving spinal anaesthesia during the period January 1995 to March 2001. The control group was patients without pre-eclampsia who also received spinal anaesthesia. A total of 240 patients were studied, 134 in the pre-eclamptic group and 106 controls. The results reported are the mean ñ standard deviation, and range; p< 0.005 was considered significant. RESULTS: The mean age of the pre-eclamptic women was 28 ñ 5.7 years compared with 30 ñ 5.4 years for the controls (p= 0.029). The mean platelet count for the pre-eclamptics was 205.7 ñ 68.0 x 10/1 (range 23.0-394.0 x 10/1) while the mean platelet count of the controls was 204.5 ñ 43.6 x 10/1 (range 150.0-339.0 x 10/1) (p= 0.873). Differences between mild pre-eclamptic and severe pre-eclamptic subgroups were also evaluated. Mean age and haemoglobin levels between the two subgroups were no different (p= 0.370 and p= 0.310, respectively) but the mean platelet count was significantly lower (p= 0.002) in the severe pre-eclamptic subgroup. Coagulation testing included prothrombin time (PT) and partial thromboplastin time (PTT). There was a significant difference in PTT between mild and severe pre-eclamptics (p= 0.013) but no correlation between abnormally low platelet counts and abnormal coagulation times was demonstrated (p= 0/751. r= -0.063). Overall, there was no difference between the groups in outcome variables, including any intermediate or long-term neurological deficits. CONCLUSIONS: Data from this study therefore support limiting the coagulation screening in pre-eclamptics to patients who demonstrate a diminished platelet count. (AU)
Asunto(s)
Femenino , Adulto , Humanos , Anestesia Raquidea/métodos , Preeclampsia/sangre , Pruebas de Coagulación Sanguínea , Estudios Retrospectivos , JamaicaRESUMEN
Intrathecal pethidine as a sole anaesthetic agent for surgical procedures of the lower limbs, perineum and inguinal areas was investigated and compared with hyperbaric Bupivacaine. A total of 90 patients were studied and randomly divided into groups 1 (bupivacaine) and 2 (pethidine). In group 2, 26 of 46 patients (59%) had their procedures successfully with intrathecal pethidine alone and did not require or request any additional sedation or analgesia. This compared to 24 of 44 patients (52.2%) in the bupivacaine group. Pethidine had a prolonged postoperative analgesia and was more cost-effective. The incidences of side effects were acceptable. (hypotension 13.6%, bradycardia 9.09%, nausea and vomiting 11.4%, and pruritus 15.9%). Pethidine can be used as a sole anaesthetic agent for operative procedures of the lower limbs; side effects are mild and can be treated.
Asunto(s)
Analgésicos Opioides/administración & dosificación , Meperidina/administración & dosificación , Adulto , Anciano , Procedimientos Quirúrgicos Ambulatorios , Analgésicos Opioides/efectos adversos , Anestesia Raquidea , Anestésicos Locales/administración & dosificación , Bradicardia/etiología , Bupivacaína/administración & dosificación , Método Doble Ciego , Femenino , Ingle/cirugía , Humanos , Hipotensión/etiología , Pierna/cirugía , Masculino , Meperidina/efectos adversos , Persona de Mediana Edad , Náusea/etiología , Perineo/cirugía , Insuficiencia Respiratoria/etiologíaRESUMEN
The results of this study indicated that patients aged 3-13 years who had a history of previous hospitalization appeared to be significantly more distressed than patients without such previous history (p<0.05). Previously hospitalized children were more uncooperative and displayed anxious, immature behaviour patterns. Children who were hospitalized for more than a month were also interviewed about their concerns and response to hospitalization. The study highlighted the need for hospitalized children to be better prepared for hospitalization, to have greater parental involvement in the management of their behaviour and to have efficiently run programmes geared at addressing their educational and emotional needs.(Au)
Asunto(s)
Niño , Preescolar , Femenino , Humanos , Masculino , Adolescente , Niño Hospitalizado/psicología , Jamaica , Adaptación Psicológica , Factores de Edad , Conducta Infantil , Hospitalización , Hospitales Universitarios , Estudios LongitudinalesRESUMEN
Intrathecal pethidine as a sole anaesthetic agent for surgical procedures of the lower limbs, perineum and inguinal areas was investigated and compared with hyperbaric Bupivacaine. A total of 90 patients were randomly divided into groups 1 (bupivacaine) and 2 (pethidine). In group 2, 26 of 46 patients (59 percent) had their procedures successfully with intrathecal pethidine alone and did not require or request any additional sedation or analgesia. This compared to 24 of 44 patients (52.2 percent) in the bupivacaine group. Pethidine had a prolonged postoperative analgesia and was more cost-effective. The incidences of side effects were acceptable. (hypotension 13.6 percent, bradycardia 9.09 percent, nausea and vomiting 11.4 percent, and pruritus 15.9 percent). Pethidine can be used as a sole anaesthetic agent for operative procedures of the lower limbs; side effects are mild and can be treated. (AU)