Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Remifentanil induces consistent and sustained controlled hypotension in children during middle ear surgery.
To determine in children whether remifentanil combined with sevoflurane, could induce controlled hypotension, reduce middle ear blood flow (MEBF) measured by laser-Doppler, and provide a satisfactory operative field. ⋯ Remifentanil combined with sevoflurane in children enabled controlled hypotension, reduced MEBF and provided good surgical conditions for middle ear surgery with no need for additional use of a specific hypotensive agent.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled epidural analgesia reduces analgesic requirements compared to continuous epidural infusion after major abdominal surgery.
To compare the quality of pain relief and incidence of side effects between 24-hr postoperative continuous epidural infusion (CEI) and subsequent patient-controlled epidural analgesia (PCEA) with different analgesics after major abdominal surgery. ⋯ PCEA in comparison to preceding CEI provides equivalent analgesia with lower local anesthetic doses and plasma levels, and without motor blocking side effects, irrespective of the applied drug regimen.
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Randomized Controlled Trial Clinical Trial
Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness.
To evaluate the antiemetic effect of iv dexamethasone for preventing postoperative nausea and vomiting (PONV) in women with and without a history of motion sickness. ⋯ Prophylactic administration of dexamethasone is effective in reducing PONV in patients with and without a history of motion sickness. The results of this study were more favourable in patients with a history of motion sickness, demonstrating a higher effectiveness of dexamethasone for preventing PONV in this subgroup of patients.
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Randomized Controlled Trial Clinical Trial
Salbutamol, beclomethasone or sodium chromoglycate suppress coughing induced by iv fentanyl.
Fentanyl, a synthetic opioid, is a popular choice amongst anesthesiologists in the operating room. Preinduction iv fentanyl bolus is associated with coughing in 28-45% of patients. Coughing due to fentanyl is not always benign and at times may be explosive requiring immediate intervention. We have studied the role of aerosol inhalation of salbutamol, beclomethasone and sodium chromoglycate in preventing fentanyl induced coughing and have compared their efficacy. ⋯ The use of salbutamol, beclomethasone or sodium chromoglycate aerosol 15 min prior to iv fentanyl administration minimizes fentanyl-induced coughing.
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Randomized Controlled Trial Clinical Trial
Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia.
Upper respiratory infections (URI) presage perioperative respiratory complications, but thresholds to cancel surgery vary widely. We hypothesized that autonomically-mediated complications seen during emergence from anesthesia would be predicted by capnometry and reduced with preoperative bronchodilator administration. ⋯ Adverse events were neither predicted nor prevented. In afebrile outpatient ASA I and II children with no lung disease or findings, having non-cavitary, non-airway surgery for under three hours, there was no association between either recent URI or active URI and desaturation, wheeze, cough, stridor, or laryngospasm causing desaturation (all P > 0.05). In this highly selected population of afebrile patients, the results suggest that anesthesiologists may proceed with surgery using specific criteria in the presence of a URI.