Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Optimal anti-emetic dose of granisetron for preventing postoperative nausea and vomiting.
In order to determine the optimal effective dose of granisetron for preventing postoperative nausea and vomiting, the drug was administered in doses of either 20, 40 or 60 micrograms.kg-1. The efficacy of granisetron was evaluated in a randomized, double-blind comparison with placebo in 100 patients undergoing general anaesthesia for major gynaecological surgery. The patients received a single dose of either granisetron or placebo (saline) iv immediately after recovery from anaesthesia. ⋯ The mean scores were 0.7, 0.6, 0.2 and 0.2 after administration of placebo, granisetron 20, 40 and 60 micrograms.kg-1, respectively. Granisetron 40 micrograms.kg-1 was as effective as 60 micrograms.kg-1 and both resulted in reduction of the scores compared with placebo and granisetron 20 micrograms.kg-1 (P < 0.05). In conclusion, granisetron 40 micrograms.kg-1 is considered to be the appropriate dosage for preventing postoperative emesis after anaesthesia.
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Randomized Controlled Trial Clinical Trial
Optimizing sedation following major vascular surgery: a double-blind study of midazolam administered by continuous infusion.
A randomized, double-blind study was undertaken to determine the dose requirements, recovery characteristics, and pharmacokinetic variables of midazolam given by continuous infusion for sedation in patients following abdominal aortic surgery. Thirty subjects, 50-75 yr, scheduled to undergo aortic reconstructive surgery, entered the study. Following a nitrous oxide-isoflurane-opioid anaesthetic technique, patients were randomly allocated to receive one of three loading doses (0.03, 0.06 or 0.1 mg.kg-1) and initial infusion rates (0.5, 1.0 or 1.5 micrograms.kg-1.min-1) of midazolam, corresponding to groups low (L), moderate (M) and high (H). ⋯ Times to awakening were longer in Group H: 3.1 +/- 3.4 hr, than in Group L: 1.1 +/- 0.8 h, P < 0.05. Pharmacokinetic variables were found to be dose-independent over the range of infusion rates. Mean values were t1/2 beta = 4.4 +/- 1.5 hr, CL = 5.94 +/- 1.69 mL.min-1.kg-1, Vd = 3.13 +/- 1.07 L.kg-1.(ABSTRACT TRUNCATED AT 400 WORDS)
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Randomized Controlled Trial Clinical Trial
Does a mid-lumbar block level provide adequate anaesthesia for transurethral prostatectomy?
In this prospective, randomized study, 23 patients having spinal anaesthesia for transurethral prostatectomy (TURP) were evaluated for the adequacy of their block using a visual analog pain score (VAPS). Each patient with a "standard" (> or = T10) block level (n = 5) or "intermediate" (L1 or T12) block level (n = 5) found the block adequate. Sixty-two percent (8/13) of patients with a "low" (< or = L3) block level found their block adequate. ⋯ However, a smaller (P < 0.05) maximum percent decrease in diastolic blood pressure was found in LBPs, than in "intermediate" or "standard" block patients. It is concluded that a spinal block > or = L1 is adequate during TURP when bladder pressure is monitored and kept low. Mid-lumbar block levels should be reserved for patients in whom the benefit of minimizing haemodynamic changes outweighs the risk of a "less complete" anaesthetic.