SummaryIn a double-blind randomised study, we compared conditions during insertion of the laryngeal mask airway in 150 patients who received either fentanyl 1 mg.kg À1 , mivacurium 0.04 mg.kg À1 or normal saline, before induction of anaesthesia with propofol 2 mg.kg
À1. Insertion conditions, including mouth opening, swallowing, gagging or coughing, head or limb movement and ease of insertion, were each graded using a three-point scale. The median (interquartile range) summed insertion scores were more favourable with the use of fentanyl [8.0 (7.0±9.0)] and mivacurium [7.5 (6.8±8.3)] than with normal saline [9.0 (7.8±10.3); p < 0.01]. Fentanyl and mivacurium decreased swallowing and head or limb movement, and mivacurium improved mouth opening. Insertion conditions were similar between fentanyl and mivacurium, while both prolonged apnoea. Fentanyl and mivacurium are equally effective in facilitating insertion of the laryngeal mask airway following anaesthetic induction with propofol.
SummaryWe have evaluated the effects of the volume and speed of administration of local anaesthetic during peribulbar anaesthesia. One hundred and forty patients scheduled for cataract surgery were randomly allocated to one of four groups of 35. Each patient received an injection of the same mixture of lignocaine, bupivacaine and hyaluronidase. Patients in group A were given 9 ml at a speed of 5 ml.min À1 , group B were given the same volume at 12 ml.min À1 , group C were given 13.5 ml at 5 ml.min À1 and group D were given 13.5 ml at 12 ml.min À1 . A significantly higher incidence of satisfactory akinesia was found in group D, whose pain score at injection was no higher than for the other groups. Large volumes of local anaesthetic significantly affected intraocular pressure. The incidences of early and late ptosis or diplopia were not affected by either the rate of injection or the volume of local anaesthetic.
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