Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
A lidocaine/metoclopramide combination decreases pain on injection of propofol.
Injection pain is a well-known adverse effect of propofol which distresses patients. Lidocaine pretreatment is the most popular method for reducing this pain but this drug cannot entirely eliminate the problem. The purpose of this study was to examine the analgesic effect of lidocaine/metoclopramide combination, compared with lidocaine alone, during propofol injection. ⋯ A lidocaine/metoclopramide combination is more effective than lidocaine alone for reducing pain on injection of propofol in a peripheral vein.
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Randomized Controlled Trial Clinical Trial
Prospective application of a simplified risk score to prevent postoperative nausea and vomiting.
To compare the risk-adapted approach with ondansetron against ondansetron plus dexamethasone to prevent postoperative nausea and vomiting (PONV) in a randomized clinical trial. ⋯ Ondansetron plus dexamethasone prevents PONV more effectively than ondansetron alone in patients at high risk for PONV.
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Methadone, an opioid traditionally associated with the management of opioid addictive disorders, has been prescribed increasingly as an analgesic for the management of various chronic pain conditions. Despite the increasing popularity of methadone, most anesthesiologists are not familiar with its complex pharmacology. The purpose of this article is to review the pharmacology of methadone and to suggest a management algorithm for the perioperative care of methadone patients. ⋯ Methadone is an opioid with complex properties, and a patient that is taking methadone can represent a unique challenge to the anesthesiologist. A good understanding of the pharmacology of methadone and of the type of patients on this medication will help to improve their perioperative care.
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Randomized Controlled Trial Clinical Trial
The ankle clonus test is not a clinically useful measure of spinal cord integrity in children.
Bilateral flexion-induced ankle clonus has been proposed as a test of spinal cord integrity during anesthesia for scoliosis surgery. The purpose of this study was to establish the reliability of this test in normal children emerging from volatile anesthesia. A secondary objective was to determine if there was a difference in the validity of this test with either sevoflurane or isoflurane anesthesia. ⋯ We conclude that the specificity of the ankle clonus test is too low to be clinically useful as a measure of spinal cord integrity in children, both when isoflurane and sevoflurane are used as the primary anesthetic agent.