Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparison between preincisional and postincisional lidocaine infiltration and postoperative pain.
We conducted a randomized, double-blind trial to compare the efficacy of preincisional and postincisional wound infiltration with 1% lidocaine (40 mL) on the postoperative pain of 37 patients scheduled for elective inguinal herniotomy. The demand for additional postoperative analgesics occurred earlier in those who received lidocaine infiltration after incision (165 min) than in those who received preincisional lidocaine (225 min, P less than 0.05). The preincisional lidocaine infiltration group also had fewer patients requiring supplemental analgesics (58%) than the postincisional group (94%) (P less than 0.05). We conclude that preincisional infiltration of the surgical wound with lidocaine is a more effective method of providing postoperative analgesia than is postincisional infiltration.
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Anesthesia and analgesia · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol versus ketamine for anesthesia in pediatric patients undergoing cardiac catheterization.
Intravenous propofol was compared with ketamine in 20 pediatric patients undergoing cardiac catheterization. The study patients were randomly assigned to treatment groups so that 10 patients received ketamine and 10 patients received propofol. The hemodynamic responses and recovery characteristics of the two groups were compared. ⋯ Time to full recovery (mean +/- SD) was significantly less in the propofol group (24 +/- 19 min vs 139 +/- 87 min, P less than 0.001). In the ketamine group only, significant correlations (P less than 0.05) included time to full recovery with duration of anesthetic (r = 0.71) and time to full recovery with total drug dose per kilogram (r = 0.82). The authors conclude that propofol anesthesia is a practical alternative for pediatric patients undergoing elective cardiac catheterization and may be preferable to ketamine because of the significantly shorter recovery time.
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Anesthesia and analgesia · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialSubhypnotic doses of propofol possess direct antiemetic properties.
Propofol is associated with a low incidence of postoperative nausea and vomiting. In a prospective, randomized, double-blind, placebo-controlled study, we investigated the possible direct antiemetic properties of a subhypnotic dose of propofol. Fifty-two ASA physical status I or II patients, aged 15-60 yr with nausea and vomiting after minor gynecologic, orthopedic, or digestive tract surgery, were included in the study and received either propofol (10 mg = 1 mL) or placebo (1 mL Intralipid) intravenously in the postanesthesia care unit. ⋯ Hemodynamic values remained unchanged in both groups. Pain on injection (7.6%) or dizziness (3.6%) only occurred in the propofol group. We conclude that propofol has significant direct antiemetic properties.
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Anesthesia and analgesia · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparative study of transdermal 10% lidocaine gel with and without glycyrrhetinic acid monohemiphthalate disodium for pain reduction at venous cannulation.
The clinical benefits of transdermal 10% lidocaine base gels with and without 3% glycyrrhetinic acid monohemiphthalate disodium (GAMHPh) for reduction of pain at venous cannulation were compared in a randomized, double-blind fashion in 24 surgical patients. After about 60 min of occlusive transdermal application, the mean pinprick pain score (1.3 +/- 1.5) in the GAMHPh group (n = 12), graded by noting the number of painful pinpricks out of five, was significantly less than that (2.5 +/- 1.7) in the control group (n = 12) (P less than 0.05). ⋯ Erythema observed in 8 of the 24 patients was the only adverse local reaction. Addition of 3% GAMHPh to the lidocaine gel is useful in promoting transdermal lidocaine absorption.