Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 1995
Randomized Controlled Trial Clinical TrialCorrection of splanchnic oxygen deficit in the intensive care unit: dopexamine and colloid versus placebo.
Correction of the splanchnic oxygen deficit indicated by low gastric intramucosal pH (pHi < 7.35) appears to reduce ICU mortality. Dopexamine hydrochloride is in clinical use for this purpose but its efficacy has not been fully investigated. We report the results of a prospective, randomized, placebo-controlled study with a crossover design to assess the efficacy of dopexamine in correcting low pHi. ⋯ There was no difference in pHi between treatments despite cardiovascular effects during dopexamine infusion. There was, however, a time-related increase in pHi suggesting a beneficial effect of conventional therapy. Dopexamine hydrochloride at 4-6 micrograms/kg/min in conjunction with colloid is not a clinically useful therapy to correct the splanchnic oxygen deficit indicated by low pHi.
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Anaesth Intensive Care · Dec 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of patient-controlled analgesia and nurse-controlled infusion analgesia after cardiac surgery.
A randomized, controlled clinical trial was conducted on 72 patients undergoing elective cardiac surgery to compare patient-controlled analgesia (PCA) to nurse-titrated infusion of morphine. Pain and nausea scores were assessed at 5, 20, 32 and 44 hours after cardiopulmonary bypass. Serum cortisol estimations were performed at 24 and 48 hours, and morphine consumption was measured at 0-24 and 24-48 hours. ⋯ There was a significant association between pain and serum cortisol at 48 hours (P = 0.023). This study also found a tenfold difference in the amount of morphine used (range = 11 to 108 mg), with no significant association with patient age or sex. We could find no significant benefit from the routine use of PCA in cardiac surgical patients.
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Anaesth Intensive Care · Dec 1994
Randomized Controlled Trial Clinical TrialPeritonsillar infiltration with bupivacaine for paediatric tonsillectomy.
In a double-blind study forty-two children scheduled for elective adenotonsillectomy were randomized to receive peritonsillar infiltration, following induction of anaesthesia, with either 0.25% plain bupivacaine or 0.9% saline, 0.5 ml/kg to a maximum of 10 ml. The children were assessed on awakening, and then 10 minutes, 1 hour, 4 hours and 24 hours later. ⋯ Thereafter there was no difference between the groups. The authors conclude that peritonsillar infiltration with bupivacaine is only moderately useful as analgesia for children having tonsillectomy.
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Anaesth Intensive Care · Dec 1994
Randomized Controlled Trial Clinical TrialP6 acupressure and nausea and vomiting after gynaecological surgery.
We studied the effect of P6 acupressure on 46 women undergoing laparotomy for major gynaecological surgery who received patient-controlled analgesia. Half the patients received acupressure at the P6 site, the remainder received acupressure at a "sham" site. There was a reduction in the requests for anti-emetic therapy in the group receiving P6 acupressure but there was no difference in the incidence of nausea and vomiting. There was no difference in total morphine consumption between the two groups.
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Anaesth Intensive Care · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of vecuronium administered by the Springfusor infusion device to vecuronium by intermittent bolus injection in critically ill adult patients.
To evaluate the Springfusor infusion device for clinical use in an Intensive Care Unit and to compare the technique of intermittent bolus and constant infusion of muscle relaxants, we undertook a prospective double-blind randomized placebo-controlled study. Twenty critically ill ventilated patients requiring muscle paralysis were investigated. ⋯ The device is robust, easy to use and reduces nursing workload. This may translate into cost-saving improvement in patient care if the Springfusor is used to provide muscle relaxation, sedation and analgesia.