European journal of anaesthesiology
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Meta Analysis Comparative Study
A meta-analysis of nausea and vomiting following maintenance of anaesthesia with propofol or inhalational agents.
A number of prospective randomized comparator studies have suggested that there is a reduction in post-operative nausea and vomiting following maintenance of anaesthesia with propofol compared with inhalational agents. We analysed these studies in more detail by examining the effects of induction agent, choice of inhalation agent, presence/absence of nitrous oxide, age of patient or use of opiate on the incidence of emesis. ⋯ These were examined individually and independently by two of the authors and log-odds ratios, calculated from the incidence data of each individual trial, were determined and combined using a fixed-effects meta-analysis approach. Patients who received maintenance of anaesthesia with propofol had a significantly lower incidence of post-operative nausea and vomiting in comparison with inhalational agents regardless of induction agent, choice of inhalation agent, presence/absence of nitrous oxide, age of patient or use of opiate.
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We report a case of post-operative rhabdomyolysis following transmandibular buccopharyngectomy without reconstruction in a patient remaining in the supine position throughout the procedure. Muscle compression induced by a cushion used during the procedure had probably contributed to the rhabdomyolysis. Outcome was favourable without acute renal failure. Prevention, early diagnosis and treatment are the keys to a successful recovery.
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The physical compatibility of thiopentone and propofol mixtures was investigated. The investigations used were macroscopic and microscopic observations, zeta potential and oil droplet size measurements. There was no evidence of instability in the mixtures. The thiopentone-propofol mixture has the potential advantage of reducing the pain on injection, provides synergistic interaction, does not prolong recovery when used for induction of anaesthesia, may reduce the incidence of convulsions and is cost-effective.