European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Midazolam for premedication in children: nasal vs. rectal administration.
The authors compared the acceptance and efficacy of rectal and nasal administration of midazolam (MDZ) for premedication. Ninety-five ASA I and II paediatric patients (8 months to 12 years) scheduled for elective surgery were randomly allocated to two groups. Group R received 0.3 mg kg-1 of rectal midazolam (in 5 mL saline). ⋯ Swallowing (nasal midazolam) and concerns about modesty (rectal midazolam) were more frequent in older children. Because of its poor tolerance, nasal premedication should be reversed for cases where there is no alternative. Rectal premedication should be avoided in older children.
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Randomized Controlled Trial Clinical Trial
Visual evaluation of train-of-four and double burst stimulation, fade at various currents, using a rubber band.
The sensitivity of train-of-four (TOF) or double burst stimulation3,3 (DBS3,3) was examined to detect fade by visual inspection, at varying stimulating currents, using the thumb of the investigated arm maintained abducted by the use of a rubber band. One-hundred adult patients were allocated randomly to (1) train-of-four-rubber band (TOF-RB), (2) train-of-four-control (TOF-control), (3) double burst stimulation-rubber band (DBS-RB), or (4) double burst stimulation-control (DBS-control) group. Each group contained 25 patients. ⋯ In contrast, when measured TOF ratio was 0.51-0.80, at the stimulating current of 50 or 30 mA, the likelihood of visual detection of fade in the DBS-RB group was significantly higher than in the DBS-control group (P < 0.05). With a TOF ratio of 0.61-0.70, in the DBS-RB group the probability of visual detection of fade at 50 or 30 mA was significantly higher than at 20 mA (P < 0.05). This study suggests that when using a rubber band, fade in response to the DBS3,3 is detected by visual inspection more readily at a stimulating current of 50 or 30 mA than without the rubber band.
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Fifteen patients undergoing elective thoracic surgery were studied in order to investigate the efficacy of high frequency jet ventilation of the non-dependent lung with respect to arterial oxygenation. During the study PaO2, PaCO2, arterial pressures and heart rate were recorded during ventilation of both lungs in the lateral decubitus position during one-lung ventilation and during high frequency jet ventilation of the non-dependent lung. Mean PaO2 was 28 +/- 8.75 kPa and mean PaCO2 was 5.4 +/- 0.7 kPa during control. ⋯ With high frequency jet ventilation to the non-dependent lung, mean PaO2 increased to 25 +/- 6.75 kPa and PaCO2 decreased to 5.16 +/- 0.9 kPa respectively. Arterial pressures and heart rate remained stable during the study period. In conclusion high frequency jet ventilation of the non-dependent lung was effective in providing arterial normoxaemia and normocapnia during one-lung ventilation.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Intravenous administration of tenoxicam 40 mg for post-operative analgesia: a double-blind, placebo-controlled multicentre study.
The analgesic efficacy of tenoxicam, a newer injectable non-steroidal anti-inflammatory drug, for post-operative analgesia after abdominal or orthopaedic surgery in ASA Grade I/II patients is reported. Two hundred and fifty-six patients received a single dose of tenoxicam 40 mg intravenous (i.v.) at the end of surgery and this was repeated 24 h later. These patients were compared, with respect to pain or adverse events, with 258 patients that received placebo. ⋯ The cumulative rescue PCA-morphine consumption was always lower in the tenoxicam treated patients and was most marked at 4 and 24 h after the second injection of tenoxicam. This effect was more pronounced after abdominal surgery. The intravenous administration of tenoxicam was associated with a low incidence of adverse events and a high tolerability.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind comparison of alizapride, droperidol and ondansetron in the treatment of post-operative nausea.
To compare the efficacy in the treatment of post-operative nausea and/or vomiting (PONV), 75 patients undergoing gynaecological procedures under general anaesthesia using N2O/enflurane who suffered from PONV in the first hour after surgery were randomly allocated to three groups containing 25 patients each to receive either alizapride 100 mg, droperidol 1 mg or ondansetron 8 mg (i.v.). Patients expressed the severity of their nausea on a Visual Analogue Scale (VAS) ranging from 0 (none) to 10 (as bad as possible). Vomiting was recorded as present or absent, and the number of emetic events was noted. ⋯ However, comparison between the three groups showed no statistically significant differences. There was no statistically significant difference between the three groups in the number of patients receiving rescue medication, the number of emetic events and the time from administration of the study drug until rescue medication was given. It is concluded that alizapride 100 mg, droperidol 1 mg and ondansetron 8 mg intravenously are equally effective in the treatment of PONV after gynaecological procedures and that the newer drugs alizapride and ondansetron offer no advantage over droperidol.