Periconallocal anaesthesia with subtenon supplementation was used to provide anaesthesia for 94 patients having vitreoretinal surgery. Of these, 44 patients also received general anaesthesia with neuromuscular block. None of these patients received opioid or antiemetic before or during surgery. In comparison with a retrospective control group, patients who had received local anaesthesia as part of their anaesthetic technique were less likely to be given a parenteral opioid (P < 0.001) or to vomit (P < 0.001) within six hours of the completion of surgery. They also experienced significantly fewer bradycardic episodes during surgery (P= 0.001). For patients having general anaesthesia, administration of an intraoperative antiemetic reduced the incidence of vomiting within six hours of the completion of surgery (p=0.008). For patients who did not receive local anaesthetic, shorter operating time was a factor associated with both reduced postoperative vomiting (P= 0.0015) and administration of parenteral opioid (P= 0.0014). It is suggested that the use of local anaesthesia as part of the anaesthetic technique for vitreoretinal surgery is associated with improved patient comfort.
We have compared 2% lignocaine 3.5 ml with 0.5% hyperbaric bupivacaine 3 ml in a randomized, double-blind study in 30 patients undergoing subarachnoid anaesthesia for transurethral surgery. A sensory level of T10 was produced more quickly (P = 0.0001) and maximum height reached sooner (P = 0.0002) with lignocaine, although there was a greater reduction in systolic arterial pressure (P = 0.03) and a trend towards slower heart rates (P = 0.056). Return of full sensory and motor function occurred earlier with lignocaine (P = 0.00005 and P = 0.02).
hydrocarbons (including coal seam and shale gas) and nuclear sources present a range of geoscientific issues. Water is essential for the sustenance of all life, agriculture, leisure activities, manufacturing industry and (a small proportion) for mineral and energy production. Greater efficiencies of use cannot avoid increasing demand for this precious resource. Geoscience studies are vital in understanding, husbanding and managing water resources, especially groundwater. Given ongoing rapid development of the BRIC economies and the inevitable future development of populous African and other countries, new sources of good quality minerals, energy and groundwater will need to be discovered to satisfy demand in the long term. Finding the massive amounts of natural resources to satisfy the needs of society in the long-term will be challenging and it is important to establish what should be done in the next 10 to 20 years to help. That is the objective of the proposed international collaborative program which IUGS is referring to as Resourcing Future Generations (RFG). The broad concept is that RFG will last about a decade and be an umbrella activity under which a range of new activities related to securing the mineral, energy and water resources required by future generations can be developed, coordinated and funded. It will provide a bridge between industry, academia and geosurveys, and other Unions under ICSU will be invited to participate. The purpose of this article is to outline the rationale for RFG, how it will be developed, contextual issues which need to be considered, indicative scientific questions to be considered and the capacity building and training needs. Rationale Our aspiration for the Resourcing Future Generations initiative is relevant groups from governments, universities, and companies around the world working together to improve resource discovery and development. It is proposed that Earth science research driven by the RFG initiative be fully incorporated into Earth System Science programs. In that regard it is hoped that RFG work will be integrated into the major new global initiative "Future Earth", being implemented by a global consortium led by the International Council for Science (ICSU) http://www.icsu.org/future-earth. It is proposed
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