European journal of anaesthesiology
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Ondansetron is more effective than metoclopramide for the treatment of opioid-induced emesis in post-surgical adult patients. Ondansetron OIE Post-Surgical Study Group.
Nausea and vomiting are common side effects of opioids administered for pain control. This double-blind, randomized, parallel-group study evaluated the anti-emetic efficacy and tolerability of single intravenous (i.v.) doses of ondansetron 8 mg, ondansetron 16 mg and metoclopramide 10 mg in the treatment of opioid-induced emesis. Adult patients undergoing low emetogenic surgical procedures, using a standardized anaesthesia regimen were assessed for 24 h following administration of study anti-emetic to treat established post-surgical opioid-induced emesis. ⋯ There were no significant differences between the two ondansetron groups. All three treatments were well tolerated. In conclusion, this large, multicentre study demonstrates that ondansetron is more effective than metoclopramide in the treatment of opioid-induced emesis following administration of post-surgical opioids to control pain.
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Randomized Controlled Trial Clinical Trial
Prevention of post-operative nausea and vomiting with combined granisetron and droperidol in women undergoing thyroidectomy.
We have compared the efficacy and safety of combined granisetron and droperidol with each anti-emetic alone for preventing post-operative nausea and vomiting after thyroidectomy. In a prospective, randomized, double-blind study, 180 women received granisetron 40 micrograms kg-1, droperidol 20 micrograms kg-1, or granisetron 40 micrograms kg-1 plus droperidol 20 micrograms kg-1 (n = 60 of each) intravenously immediately before induction of anaesthesia. ⋯ No clinically important adverse events due to the drugs were observed in any of the groups. In summary, prophylactic use of combined granisetron and droperidol is more effective than each drug alone for the prevention of post-operative nausea and vomiting in female patients undergoing thyroidectomy.
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Comment Letter Randomized Controlled Trial Clinical Trial
Tropisetron or ondansetron for the prevention of post-operative nausea and vomiting (PONV)
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Optimal control of long-term sedation during therapy in the intensive care unit is difficult to achieve in a number of patients when based on commonly used clinical sedation scores alone. We therefore used the median frequency of the EEG power spectrum as a quantitative measure for closed-loop administration of propofol in 21 artificially ventilated patients (nine trauma, 12 non-trauma). ⋯ Non-trauma patients required sedation with an EEG median frequency between 2 and 3 Hz (propofol consumption: 1.4 +/- 0.8 mg kg-1 h-1) and sedation seemed to follow some circadian patterns, whereas trauma patients needed significantly deeper sedation (EEG median frequency: 1-2 Hz; propofol consumption: 2.6 +/- 0.8 mg kg-1 h-1). We conclude that the EEG closed-loop system could safely and reliably administer propofol to maintain a predetermined level of sedation for patients in intensive care unit over a protracted time.
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We compared the performance of the size 5 laryngeal mask airway in 20 paralysed anaesthetized male patients and 20 male cadavers (6-24 h post-mortem). Groups were matched for height and weight. Airway sealing pressure, in vivo intracuff pressure and anatomical position (judged fibre-optically) were documented at zero volume and after each additional 10 mL up to 40 mL. ⋯ There were no differences in airway sealing pressure, in vivo intracuff pressure or fibre-optic position between the groups. We conclude that the performance of the laryngeal mask airway is similar for fresh cadavers and paralysed anaesthetized patients. This may have implications for laryngeal mask airway research and training.