Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Pressure support improves efficiency of spontaneous breathing during inhalation anesthesia.
To determine if reducing respiratory muscle load or increasing tidal volume (VT) with pressure support (PS) would improve ventilatory efficiency by reducing respiratory rate (RR) and resting PaCO2. ⋯ PS titrated to produce a near normal VT improves the efficiency of spontaneous breathing by lowering RR and PaCO2 while preserving hemodynamic homeostasis in patients undergoing inhalation anesthesia. Lesser PS levels will unload the respiratory muscles, but have no effect on RR or PaCO2.
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Randomized Controlled Trial Clinical Trial
Time to peak effect of neostigmine at antagonism of atracurium- or vecuronium-induced neuromuscular block.
(1) To determine the time to peak effect of neostigmine (time to peak antagonism) during atracurium- or vecuronium-induced neuromuscular block; and (2) to determine the effect on time to peak effect of neostigmine during atracurium-induced neuromuscular block, when the dose of neostigmine is increased from 35 micrograms/kg to 70 micrograms/kg. ⋯ The time to peak effect of neostigmine 35 micrograms/kg is about 6 to 10 minutes when antagonizing a constant degree of atracurium- or vecuronium-induced neuromuscular block at a twitch height at a point between 4% and 11%. Even though the time to peak effect was longer with atracurium than with vecuronium, clinically significant differences between the antagonizing effect of atracurium versus vecuronium block were not demonstrated. The time to peak effect during atracurium-induced block decreased when the dose of neostigmine was increased from 35 micrograms/kg to 70 micrograms/kg.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ketorolac for early postoperative analgesia.
To determine the efficacy and speed of onset of analgesia of a single dose of intravenous (IV) or intramuscular (IM) ketorolac tromethamine following major orthopedic surgery. ⋯ Despite high patient acceptability compared with placebo, the use of ketorolac as the sole analgesic failed to control postoperative pain following major orthopedic surgery. IV administration of ketorolac conferred no advantages over the IM route with regard to efficacy or speed of onset.
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Randomized Controlled Trial Comparative Study Clinical Trial
Doxacurium block is not influenced by age.
To determine the influence of aging on the efficacy and safety of doxacurium. ⋯ The use of doxacurium in elderly patients is possible with no need for dose adjustment. Doxacurium might be a good choice for patients with cardiac disease who are scheduled for long surgical procedures.
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Randomized Controlled Trial Clinical Trial
Epidural scopolamine administration in preventing nausea after epidural morphine.
To determine the effectiveness of epidural scopolamine in preventing nausea and vomiting in patients receiving epidural morphine. ⋯ Epidural scopolamine can be used as an adjunct to epidural morphine in effectively reducing the incidence of postoperative nausea and vomiting.