The Laryngoscope
-
Randomized Controlled Trial Clinical Trial
Effects of atropine and scopolamine on bradycardia and emetic symptoms in otoplasty.
To assess the effects of unilateral or bilateral otoplasty on bradycardia and postoperative nausea and vomiting (PONV) and the efficiency of transdermal scopolamine in the prophylaxis of PONV. ⋯ TTS-scopolamine offers effective prophylaxis against PONV (auriculoemetic reflex), but does not protect from bradycardia (auriculocardiac reflex) in otoplasty. Cutting of the TTS-scopolamine patch may lead to undesirable side effects.
-
Randomized Controlled Trial Clinical Trial
Tube placement: a prospective, randomized double-blind study.
Bilateral myringotomy with tympanostomy tube placement is the second most frequently performed pediatric surgical procedure, next to circumcision. Postoperative pain relief for children undergoing this procedure has been an ongoing concern. The authors undertook a prospective, randomized, double-blind, placebo-controlled clinical study in 200 consecutive children to investigate the efficacy of oral acetaminophen, acetaminophen with codeine, ibuprofen, and placebo administered preoperatively in relieving postoperative pain in children undergoing this procedure. ⋯ There was no significant difference in postoperative pain score between the four groups (P > 0.4447). Thus it is likely that the intraoperative administration of antibiotic eardrops mixed with 4% lidocaine is all that is required to alleviate postoperative pain in children undergoing myringotomy with tympanostomy tube placement. Preoperative oral analgesics are apparently of little added benefit.
-
Randomized Controlled Trial Clinical Trial
Sphenopalatine blocks in the treatment of pain in fibromyalgia and myofascial pain syndrome.
Sphenopalatine blocks have been used to treat pain for more than 80 years. Anecdotal support for sphenopalatine ganglion blocks has been very strong in those who believe in the technique, but the research results have been inconclusive. Therefore, a double blind, placebo-controlled study was performed on 61 patients, 42 with fibromyalgia and 19 with myofascial pain syndrome. ⋯ Headaches were evaluated in frequency and location prior to and after treatment. Sphenopalatine ganglion blocks were performed under direct vision using 4% lidocaine and sterile water as a placebo. Analysis of the results showed no statistical differences between the lidocaine and the placebo groups.
-
Randomized Controlled Trial Clinical Trial
Middle ear pressure variation: effect of nitrous oxide.
Previous studies examining middle ear pressure changes due to inhalant anesthesia, including nitrous oxide, have cited equivocal results. An investigation was performed to closely monitor changes in middle ear pressure during middle ear surgery. Baseline tympanometry was performed before anesthesia, and middle ear pressure was then documented in 1-min time intervals. ⋯ There were no effects for time of surgery, type of fluid, or baseline. Pressure fluctuation was attributed to eustachian tube function. Case studies are presented to demonstrate subject variability, and suggestions for validation study procedures are presented.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Bupivacaine for postoperative analgesia following endoscopic sinus surgery.
This prospective study was conducted to examine pain after endoscopic sinus surgery (ESS). The hypothesis was that a long-acting anesthetic agent would result in patients experiencing less pain in the 24-hour postoperative period and therefore needing fewer oral analgesics. We randomized 100 patients undergoing ESS to receive either lidocaine (1% or 2%) with epinephrine or bupivacaine (0.25% or 0.5%) with epinephrine as an anesthetic and for a sphenopalatine block. ⋯ We further found that the type of anesthetic used did not significantly affect postoperative pain; pain score changes and use of analgesics were similar between the two anesthesia groups. Postoperative pain was also similar between the "packing" and "no packing" groups. Although patients receiving packing had consistently lower increases in pain (and in fact many patients in this group had decreases in pain from baseline), none of the differences between group means was statistically significant.