Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Effective dose of granisetron for preventing postoperative emesis in children.
This study was to identify the minimum effective dose of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, to prevent postoperative vomiting in children who have undergone strabismus repair, tonsillectomy or tonsillectomy with adenoidectomy. ⋯ Granisetron 40 micrograms.kg-1 is an effective antiemetic for preventing retching and vomiting following strabismus repair and tonsillectomy in children. Increasing the dose to 80 micrograms.kg-1 provided no demonstrable benefit in reducing postoperative emesis.
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This report describes an episode of malignant hyperthermia (MH) in a ten year old boy receiving desflurane anaesthesia. ⋯ Onset of tachycardia in a patient receiving desflurane may initially be attributed to desflurane-induced sympathetic hyperactivity. This poses a clinical challenge in the diagnosis of MH during desflurane anaesthesia.
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Randomized Controlled Trial Clinical Trial
Patient controlled oral analgesia with morphine.
When using strong oral opioids for postoperative pain management, demand titration is desirable. A device for patient controlled oral analgesia (PCORA) and first results of its use for oral titration of morphine are presented. ⋯ Patient controlled oral analgesia is an effective and non-invasive mode of postoperative pain management. The PCORA-device is reliable and easy to use.
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This study compares the effects of stored red cells, freshly donated blood and ultrapurified polymerized bovine haemoglobin (HBOC) on haemodynamic variables, oxygen transport capacity and muscular tissue oxygenation after acute and almost complete isovolaemic haemodilution in a canine model. ⋯ The results show a higher oxygenation potential of HBOC than with autologous stored red cells because of a more pronounced oxygen extraction.
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Randomized Controlled Trial Clinical Trial
Prostaglandin E1 attenuates the hypertensive response to tracheal extubation.
Tracheal extubation causes hypertension and tachycardia, which may cause imbalance between myocardial oxygen demand and supply in patients at risk of coronary artery disease. We conducted a randomized, controlled study to evaluate the effects of 0.05 or 0.1 microgram.kg-1.min-1 prostaglandin E1 (PGE1) iv on haemodynamic variables occurring during tracheal extubation and emergence from anaesthesia and compared them in patients receiving either lidocaine or saline. ⋯ The intravenous infusion of 0.1 microgram.kg-1.min-1 PGE1 given during emergence from anaesthesia and tracheal extubation is a useful method for attenuating the hypertension associated with noxious stimuli during this period.