European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of the antiemetic efficacy of ondansetron, propofol and midazolam in the early postoperative period.
To compare the antiemetic efficacy of ondansetron with two different hypnotic drugs (propofol 15 mg, midazolam 1 and 2 mg) for the treatment of established postoperative nausea and vomiting (PONV). ⋯ Propofol and midazolam used in subhypnotic doses were as effective as ondansetron in treating PONV in patients undergoing abdominal or gynaecological surgery without untoward sedative or cardiovascular effects.
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To evaluate the effects of pneumoperitoneum and the reverse Trendelenburg position on respiratory mechanics and blood-gases in morbid obese patients with chronic obstructive pulmonary disease and hypertension. ⋯ In morbid obese patients with chronic obstructive pulmonary disease and hypertension, a 20 degrees reverse Trendelenburg position improved respiratory mechanics and oxygenation without any apparent adverse effects on haemodynamics during laparoscopic gastric banding surgery.
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Since reports have shown that outpatient preoperative evaluation increases the quality of care and cost-effectiveness, an increasing number of patients are being evaluated purely on an outpatient basis. To improve cost-effectiveness, it would be appealing if those patients who are healthy and ready for surgery without additional testing could be easily distinguished from those who require more extensive evaluation. This paper examines whether published studies provide sufficient data to determine how detailed preoperative history taking and physical examination need to be in order to assess the health of surgical patients and to meet the objective of easy and early distinction. ⋯ The amount of detail of preoperative patient history and the value of physical examination to obtain a reasonable estimate of perioperative risk remains unclear. Although not evidence based, a thorough history taking and physical examination of all patients before surgery seems important until more evidence-based guidelines become available. Diagnostic and prognostic prediction studies may provide this necessary evidence.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bispectral index-guided administration of anaesthesia: comparison between remifentanil/propofol and remifentanil/isoflurane.
The bispectral index of the electroencephalogram is a measure of the hypnotic component of anaesthesia and can be used to guide the administration of anaesthesia. This study compares bispectral index-guided anaesthesia with remifentanil and either propofol or isoflurane. ⋯ Bispectral index-guided anaesthesia with remifentanil plus propofol or isoflurane results in the absence of postoperative recall and a fast recovery with both drug combinations. In our patients, at comparable bispectral index-levels, haemodynamic control requires higher doses of remifentanil with propofol than with isoflurane.
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Randomized Controlled Trial Comparative Study Clinical Trial
General anaesthesia or spinal anaesthesia for outpatient urological surgery.
A variety of drugs and techniques have been introduced into ambulatory anaesthesia. The technique as well as the drugs used may hasten or delay home discharge. We compared recovery profiles and side-effects of spinal anaesthesia and total intravenous anaesthesia. ⋯ In healthy unpremedicated men undergoing minor urological operations, total intravenous anaesthesia with remifentanil and propofol provided as safe and effective anaesthesia as spinal block with the advantage of earlier home readiness.