Anesthesia and analgesia
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Anesthesia and analgesia · Mar 1994
Randomized Controlled Trial Clinical TrialOndansetron decreases emesis after tonsillectomy in children.
We performed a double-blind, randomized, placebo-controlled trial to investigate the efficacy and safety of ondansetron in preventing vomiting after tonsillectomy with or without adenoidectomy in children. Sixty children were premedicated with 0.5 mg/kg of oral midazolam and underwent inhaled induction and maintenance of anesthesia with halothane and nitrous oxide. Intravenous morphine 0.075 mg/kg, vecuronium 0.1 mg/kg, and either ondansetron 0.15 mg/kg (maximum = 8 mg), or saline placebo were administered after intravenous catheter placement. ⋯ Three children who received ondansetron and one who received placebo complained of abdominal cramping on the night of the surgery. There were no other complaints or complications. Analysis of the 51 children who did not receive dexamethasone revealed similar results.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Mar 1994
Low plasma lidocaine concentration does not affect oxygen uptake at awakening from isoflurane anesthesia.
To clarify the effects of lidocaine in plasma after epidural administration on oxygen uptake (VO2) at awakening from isoflurane anesthesia, we measured VO2 in 45 patients undergoing abdominal hysterectomy under four conditions: control group, intravenous normal saline; epidural group, 3 mg/kg of 1.5% lidocaine epidurally as a bolus; and groups CIV-A and CIV-B, continuous intravenous infusion of 2% lidocaine, 0.5 and 1 mg/kg, respectively, for 5 min followed by 30 micrograms.kg-1 x min-1. VO2 at both periods of steady state during anesthesia before lidocaine administration and awakening from anesthesia were measured using a mass spectrometer system during spontaneous breathing. ⋯ These results indicate that epidural lidocaine prevents the increase in VO2 associated with arousal from isoflurane anesthesia. This effect is not due to the absorbed plasma lidocaine but due to the epidural neural block.
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Anesthesia and analgesia · Mar 1994
Randomized Controlled Trial Comparative Study Clinical TrialUse of mivacurium during laparoscopic surgery: effect of reversal drugs on postoperative recovery.
We studied the influence of mivacurium on the recovery profile following outpatient laparoscopic tubal ligation in 60 healthy, nonpregnant women. After administration of midazolam 2 mg intravenously (IV), anesthesia was induced with fentanyl, 2 micrograms/kg, and thiopental, 4 mg/kg, IV. When the patient became unresponsive (loss of eyelid reflex), either succinylcholine 1 mg/kg, IV (Group I), or mivacurium 0.2 mg/kg, IV (Groups II and III), was administered to facilitate tracheal intubation. ⋯ In addition, a comparable number of patients in each treatment group required analgesic medication for postoperative pain. Although patients who received succinylcholine complained of significantly more neck pain during the 24-h period after discharge, nausea, vomiting, and shoulder pain were similar in all three groups during this period. We conclude that neostigmine and glycopyrrolate may contribute to the development of postoperative emesis when used for reversal of residual neuromuscular block.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Mar 1994
Comparative StudyComparison of propofol and thiopental for rapid anesthesia induction in infants.
We compared the hemodynamic response to laryngoscopy and intubation, as well as emergence and recovery times, when propofol or thiopental were used for rapid intravenous induction of anesthesia in 59 infants undergoing repair of inguinal hernia. An intravenous catheter was inserted under N2O analgesia and atropine 0.01 mg/kg was administered to all patients. Subsequent induction with propofol (3 mg/kg), thiopental (5 mg/kg), or halothane (2%) was followed with succinylcholine (2 mg/kg) and tracheal intubation. ⋯ Infants who received thiopental induction had a higher incidence of perioperative airway complications than all others. There was no significant difference in the recovery and discharge times among the three groups. We conclude that when rapid intravenous induction is required for infants, propofol is more effective than thiopental in obtunding the hypertensive response to intubation, and in young infants (1-6 mo) it results in more prompt emergence after short surgical procedures.