European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Esomeprazole for the prevention of postoperative nausea and vomiting. A randomized, placebo-controlled trial.
Postoperative nausea and vomiting still represents a major problem after surgery. Although risk factors for postoperative nausea and vomiting and procedures to reduce postoperative nausea and vomiting have been described, the incidence of postoperative nausea and vomiting remains high. The aim of the present study was to investigate the potential role of the proton pump inhibitor esomeprazole to reduce postoperative nausea and vomiting after elective surgery. ⋯ There is no evidence that prophylactic esomeprazole reduces the incidence of postoperative nausea and vomiting or the degree of postoperative nausea.
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Comment Letter Comparative Study
Tracheal intubation with and without muscular relaxation.
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Randomized Controlled Trial Comparative Study
The effects of sufentanil or morphine added to hyperbaric bupivacaine in spinal anaesthesia for caesarean section.
The quality of spinal anaesthesia, often used for Caesarean section, can be improved by adding an opioid to the local anaesthetic. This study compared the quality of anaesthesia, postoperative analgesia, and adverse effects on mother and neonate when either sufentanil 5 microg or morphine 0.2 mg was added to intrathecal hyperbaric bupivacaine for Caesarean section. ⋯ The addition of 5 microg sufentanil or 0.2 mg morphine to hyperbaric bupivacaine for Caesarean section both provided safe and effective anaesthesia. Morphine increased the duration of postoperative analgesia compared with sufentanil without increasing maternal or neonatal side-effects.
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Comparative Study
The effect of a remifentanil bolus on the bispectral index of the EEG (BIS) in anaesthetized patients independently from intubation and surgical stimuli.
Remifentanil boluses are used in different clinical situations and the effects on bispectral index monitoring are unclear. We analysed the effect of a remifentanil bolus on the bispectral index of the electroencephalogram (bispectral index) under total intravenous anaesthesia with propofol and remifentanil. ⋯ There was a significant reduction in the areas under the curve between 90-120 s following the bolus. Heart rate and blood pressure also showed significant reductions. Thus, remifentanil bolus given under total intravenous anaesthesia with propofol and remifentanil decreases bispectral index, an effect independent of intubation and surgical stimuli.
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Comparative Study
Current practice in regional anaesthesia in Germany.
Several new techniques and agents (e.g. ropivacaine) have been introduced in regional anaesthesia to improve patients outcome and safety. The beneficial effects on patient outcome are clear with these techniques, however, no information is available about their pattern and frequency of use in clinical practice. This study presents data concerning the current practice of regional anaesthesia in Germany. ⋯ In small hospitals a majority of board certified anaesthesiologists rely on basic regional anaesthesia techniques. In large departments some consultants provide the entire spectrum of regional anaesthesia, with the majority of cases transferred to the residents responsibility. These results indicate the strong need to improve residency programs with regard to regional anaesthesia.