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67coagulation at which the risk becomes clinically relevant are totally unknown. The results of this study, despite these limitations, may help to rationalise anaesthetic practice with regard to requests for coagulation screens on such patients.
AcknowledgmentsWe thank Professor A.L. Bloom
SummaryPain on injection of propofol was assessed in a controlled, randomised study of 273 patients. They received either lignocaine 10 mg, procaine 10 rng or isotonic saline 0.5 ml, 15 seconds before the injection of propofol into a vein on the back of the hand. The incidence of pain on injection in the'control group (51 %) was comparable with other studies. Lignocaine and procaine both significantly reduced the pain (35% and 34% respectively, p < 0.05) but there was no statistical difference between these two groups.
1 Buprenorphine is a new antagonist analgesic which was offered sublingually to 141 patients with moderate cancer pain as an alternative to their current analgesic. These patients were not on regular strong morphine‐like analgesics. 2 Forty‐seven patients used the drug on demand in unit doses ranging from 0.15‐0.8 mg for an average of 12 weeks. A full‐time nurse‐observer was used throughout the studies. 3 Good analgesic results were obtained. Certain difficult chronic dull aching pains in the head and neck were especially helped by the drug. There was no indication of dependence or tolerance in this study. 4 The main side‐effect was drowsiness which lessened with usage of the drug. A major advantage of the drug was the absence of constipation as a side‐effect. 5 This sublingual preparation seems worthy of addition to the commercially available range of analgesics in clinical practice.
The cumulative urinary excretion over 24 h of pentazocine, under conditions of acidic urinary pH, has been measured in smokers and non‐ smokers using both male and female subjects (seventy subjects in total). A restricted urban population was studied. An overall three‐ fold inter‐subject variation in elimination was observed. The cumulative urinary excretion of pentazocine was normally distributed in both smokers and non‐smokers. Smokers metabolize 40% more pentazocine than non‐smokers. It is concluded that induction is principally responsible for the observed subject variability.
rare, but perphenazine does produce some adrenergic blockade. There is some potentiating effect on barbiturates and other narcotics, but this effect is much less than with chlorpromazine. With intensive dosage (un- Burtles and Peckett (1957) noted that both chlorpromazine and promethazine given with the premedication were equally effective in reducing post-operative vomiting. They stated that chlorpromazine had undesirable side-effects, including delayed recovery of consciousness, hypotension, dizziness, vasodilatation, occasional restlessness, and pain at the site of the intramuscular injection. They considered promethazine prefer ble, as these side-effects were largely avoided, but oc asional mild dizziness and a cerebral depressant acAon (additive to anaesthetic and premedicant agents) were still noted. In our experience promethazine leads to undesirable prolongation of the recovery period.
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