Journal of clinical anesthesia
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Randomized Controlled Trial Multicenter Study Clinical Trial
A double-blind, parallel-group, placebo-controlled, dose-ranging, multicenter study of intravenous granisetron in the treatment of postoperative nausea and vomiting in patients undergoing surgery with general anesthesia.
To compare the effectiveness of granisetron with placebo in the treatment of established postoperative nausea and vomiting (PONV). ⋯ Granisetron was significantly more effective than placebo in all groups. Further studies in specific subgroups may be warranted.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural block for obstetrics: comparison of bolus injection of local anesthetic with gravity flow technique.
To test the hypothesis that slow administration of local anesthetic into the epidural space by gravity flow reduces the incidence of signs and symptoms of unintended injection. ⋯ Gravity flow administration of local anesthetic-opioid solution during epidural block for obstetrics was associated with fewer signs of systemic drug absorption and cardiovascular perturbations than was the traditional bolus injection. This study supports the current opinion that slow administration of local anesthetic during epidural block contributes to fewer adverse events.
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Randomized Controlled Trial Clinical Trial
Combined hemodilution and hypotension monitored with jugular bulb oxygen saturation, EEG, and ECG decreases transfusion volume and length of ICU stay for major orthopedic surgery.
To assess the efficacy and safety of hemodilution combined with induced hypotension during surgery. ⋯ Hemodilution combined with induced hypotension was safe and may reduce the need for transfusion and ICU admission.
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Randomized Controlled Trial Clinical Trial
Total-body oxygen consumption after isoflurane anesthesia: effects of mild hypothermia and combined epidural-general anesthesia.
To determine the effects of epidural anesthesia and avoidance of intraoperative heat loss on the increase in total-body oxygen consumption in the immediate postoperative period after major intraabdominal surgery. ⋯ Total-body VO2 was increased in the immediate postoperative period. After general anesthesia, the magnitude of the increase in VO2 was significantly less in normothermic patients than in hypothermic patients. After combined epidural-general anesthesia, VO2 was increased in normothermic and in hypothermic patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil versus alfentanil in a balanced anesthetic technique for total abdominal hysterectomy.
To compare the intraoperative effects and recovery characteristics of remifentanil hydrochloride and alfentanil when administered as part of balanced anesthesia, and to assess the effects of an additional remifentanil infusion administered as analgesic pretreatment before removal of the uterus. ⋯ A mean remifentanil infusion of 0.49 microgram/kg/min is as effective as a mean alfentanil infusion of 1.99 micrograms/kg/min in suppressing intraoperative responses. Doubling of the remifentanil infusion to 0.5 microgram/kg/min before the major stress event improves suppression of responses and lowers intraoperative use of remifentanil without prolonging recovery times. Remifentanil allows faster awakening times than alfentanil, but preemptive administration of postoperative analgesics is recommended to facilitate discharge.