The Journal of international medical research
-
Randomized Controlled Trial Clinical Trial
Effectiveness of hyperbaric oxygen therapy in the treatment of complex regional pain syndrome.
In this double-blind, randomized, placebo-controlled study we aimed to assess the effectiveness of hyperbaric oxygen (HBO) therapy for treating patients with complex regional pain syndrome (CRPS). Of the 71 patients, 37 were allocated to the HBO group and 34 to the control (normal air) group. Both groups received 15 therapy sessions in a hyperbaric chamber. ⋯ In the HBO group there was a significant decrease in pain and oedema and a significant increase in the ROM of the wrist. When we compared the two groups, the HBO group had significantly better results with the exception of wrist extension. In conclusion, HBO is an effective and well-tolerated method for decreasing pain and oedema and increasing the ROM in patients with CRPS.
-
Randomized Controlled Trial Clinical Trial
Efficacy of prophylactic ondansetron in a patient-controlled analgesia environment.
We conducted a prospective, randomized, double-blind, placebo-controlled trial to examine the efficacy of prophylactic ondansetron on post-operative nausea and vomiting (PONV) during opioid patient-controlled analgesia (PCA). In total, 374 patients using opioid PCA, but otherwise considered to be low risk for PONV, were randomly allocated to ondansetron (4 mg given intravenously and 16 mg added into the PCA pump) or saline (control group). ⋯ The only difference between the two groups was the higher number of headaches in the ondansetron group. In patients using opioid PCA, but with no other high risk factors for PONV, prophylactic ondansetron does not have any clinical benefit.
-
We investigated the haemodynamic and respiratory effects of propofol target-controlled infusion (TCI) during spontaneous ventilation. We studied 20 patients scheduled for elective orthopaedic surgery who were classified as American Society of Anesthesiologists physical status I. During spontaneous ventilation, haemodynamic, respiratory and electroencephalographic variables were measured. ⋯ Changes in Bispectral Index Score, systolic blood pressure, diastolic blood pressure, end tidal carbon dioxide tension and heart rate were negatively correlated with propofol effect-site concentrations. Despite maintaining oxygen saturation (> or = 99%), apnoea and blood pressure reductions were abruptly induced as the propofol effect-site concentration increased. We therefore recommend careful monitoring of haemodynamic and respiratory function during spontaneous ventilation using propofol TCI.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of prophylactic anti-emetic effects of ondansetron and dexamethasone in women undergoing day-case gynaecological laparoscopic surgery.
We aimed to determine the effect of ondansetron and dexamethasone on preventing post-operative nausea and vomiting (PONV). Sixty women undergoing laparoscopic gynaecological surgery were randomized to receive ondansetron 4 mg, dexamethasone 8 mg or saline. Drugs were administered 2 min before induction of anaesthesia, and anaesthesia and post-operative analgesic regimens were standardized. ⋯ In this period, ondansetron was significantly more effective than dexamethasone and saline, but no differences were seen between dexamethasone and saline. In all treatment groups, post-operative visual analogue scale scores, sedation scores and usage of analgesics were similar. In conclusion, ondansetron, but not dexamethasone, prevented PONV in the first 3 h after gynaecological laparoscopic surgery.
-
Randomized Controlled Trial Clinical Trial
The effect of caudal bupivacaine versus tramadol in post-operative analgesia for paediatric patients.
In this study 20 paediatric surgical patients were randomized to two groups after induction of general anaesthesia. Group 1 received 0.25% bupivacaine (2 mg/kg) and group 2 received 5% tramadol (2 mg/kg) both as a caudal block. Heart rate, mean arterial pressure, arterial oxygen saturation, respiratory rate and pain and sedation scores were recorded at 1, 2, 4, 6, 12 and 24 h post-operatively. ⋯ The pain and sedation scores in group 2 were significantly lower compared with group 1. There were no significant differences in heart rate, mean arterial pressure, arterial oxygen saturation and respiratory rate between the two groups. In conclusion, caudal tramadol was superior to bupivacaine in analgesic efficacy and in reducing the need for additional analgesia during the post-operative period in paediatric patients.