Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialPostspinal headache in Taylor's approach: a comparison between 21- and 25-gauge needles in orthopaedic patients.
A randomized study was carried out on 160 patients aged 30-60 years with the aim of finding a method of preventing postdural puncture headache (PDPH). In Taylor's lumbosacral approach to the subarachnoid space, two different needle sizes were used (21-gauge versus 25-gauge) for injecting the anaesthetic solution. ⋯ Patients with PDPH showed mild symptoms which disappeared in a short time and none needed epidural blood patching. The possibility of using larger needles, facilitating the execution of the block without increasing PDPH incidence, renders this technique particularly attractive in patients where the midline approach is not feasible, or when pencil-point needles are not available.
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Anaesth Intensive Care · Oct 1995
Randomized Controlled Trial Clinical TrialEffect of propofol infusion on the endocrine response to cardiac surgery.
The effect of propofol infusion on the stress response was studied in patients undergoing coronary artery bypass graft (CABG). Ten patients received propofol infusion during cardiopulmonary bypass (CPB) and ten controls received diazepam. ⋯ There was a significant reduction in all three hormones (P < 0.05) in the study group. In addition, the amount of sodium nitroprusside used during CPB was significantly reduced (P < 0.05).
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Anaesth Intensive Care · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of total intravenous, balanced inhalational and combined intravenous-inhalational anaesthesia for tympanoplasty, septorhinoplasty and adenotonsillectomy.
Two hundred and thirty-five consecutive Saudi patients aged between two and fifty-three years undergoing elective tympanoplasty (n = 32), septorhinoplasty (n = 68) or adenotonsillectomy (n = 135) were studied. They were randomized to receive either a total intravenous anaesthetic (10 ears, 23 noses, 44 throats) consisting of propofol for induction of anaesthesia followed by a propofol infusion, a combined intravenous-inhalational anaesthetic (11 ears, 22 noses, 46 throats) consisting of the above with isoflurane in oxygen-enriched air, or a balanced inhalational anaesthetic (11 ears, 23 noses, 45 throats) consisting of thiopentone for induction of anaesthesia and oxygen in nitrous oxide with isoflurane for maintenance. During tympanoplasty, all three anaesthetic techniques produced stable heart rates and arterial pressures. ⋯ During adenotonsillectomy, total intravenous anaesthesia produced a rise in both heart rate and blood pressure, the combined technique produced a rise in heart rate alone while balanced anaesthesia produced haemodynamic stability. Postoperatively, vomiting, pain scores and analgesic requirements were similar following all three types of anaesthetic within each surgical site subgroup. Our findings support the choice of balanced inhalational anaesthesia for all three types of ENT surgery and, where cost and facilities permit, total intravenous anaesthesia for tympanoplasty and combined intravenous-inhalational anaesthesia for septorhinoplasty.
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Anaesth Intensive Care · Aug 1995
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind randomized prospective study comparing ondansetron with droperidol in the prevention of emesis following strabismus surgery.
A prospective double-blind study was conducted to compare the anti-emetic efficacy of ondansetron and droperidol in preventing postoperative emesis following strabismus surgery. A sample size of 213 patients was divided into three equal groups to receive ondansetron 150 micrograms/kg (Group A), ondansetron 75 micrograms/kg (Group B), or droperidol 75 micrograms/kg (Group C). All patients received a standardized anaesthetic technique. ⋯ Mean time to discharge from the recovery room was 75.3 minutes (Group A), 44.4 minutes (Group B), and 41.0 minutes (Group C). The mean time to tolerating oral fluids was 356.5 minutes (Group A), 402.8 minutes (Group B), and 378.1 minutes (Group C). There was no statistical difference in discharge times from recovery or time to tolerating oral fluids in any of the three groups.
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Anaesth Intensive Care · Aug 1995
Randomized Controlled Trial Clinical TrialA double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting.
The efficacy of ginger for the prevention of postoperative nausea and vomiting was studied in a double-blind, randomized, controlled trial in 108 ASA 1 or 2 patients undergoing gynaecological laparoscopic surgery under general anaesthesia. Patients received oral placebo, ginger BP 0.5g or ginger BP 1.0g, all with oral diazepam premedication, one hour prior to surgery. Patients were assessed at three hours postoperatively. ⋯ The incidence of moderate or severe nausea was 22, 33 and 36%, while the incidence of vomiting was 17, 14 and 31% in groups receiving 0, 0.5 and 1.0g ginger, respectively (odds ratio per 0.5g ginger 1.39 for nausea and 1.55 for vomiting). These results were essentially unchanged when adjustment was made for concomitant risk factors. We conclude that ginger BP in doses of 0.5 or 1.0 gram is ineffective in reducing the incidence of postoperative nausea and vomiting.