Propofol and chemotherapy-induced emesis.
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Biomedical subjects
Publications and source records attributed to A Ravalia.
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We report the results of a study of the effects of spinal and epidural anaesthesia for Caesarean section on commonly used indicators of a patient's ability to cough effectively. Both spinal and epidural anaesthesia, after the achievement of a block adequate for surgery, were associated with statistically significant decreases (p less than 0.05) in all the respiratory variables recorded: forced vital capacity, forced expiratory volume in one second, peak expiratory flow rate and maximum expiratory pressure. We conclude that although the observed changes are unlikely to impair the normal patient's ability to cough effectively in these circumstances, there may be clinically significant impairment in the presence of an inadvertently high block or in a patient with pre-existing pulmonary disease.
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A case is presented in which intermittent i.v. alfentanil was titrated to meet the analgesic requirements in a patient with extensive rib fractures, during each session of intensive chest physiotherapy. This method of analgesia is discussed and compared with other analgesic techniques.
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A patient required respiratory support with jet ventilation via a minitracheotomy tube 2 days after right upper lobectomy. After initial improvement, the patient's condition deteriorated because of migration of the minitracheotomy tube out of the larynx. This complication has not been described previously. A number of possible causative factors and remedies are discussed.
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