Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of ondansetron and droperidol in the prevention of postoperative nausea and vomiting after laparoscopic surgery in women. A randomised, double-blind, placebo-controlled trial.
Women undergoing laparoscopic surgery are susceptible to postoperative nausea and vomiting (PONV). Ondansetron and droperidol are useful antiemetics. This study was designed to ascertain primarily the relative difference in efficacy of ondansetron and droperidol and secondarily between these drugs and placebo in the prevention of PONV after laparoscopic surgery. ⋯ The efficacy of prophylactic ondansetron and droperidol in reducing postoperative nausea associated with laparoscopic surgery in female inpatients was similar, but ondansetron appeared to be slightly more efficient than droperidol in preventing vomiting. Ondansetron and droperidol were both significantly better than placebo in the prophylaxis of PONV.
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Acta Anaesthesiol Scand · Nov 1997
Randomized Controlled Trial Clinical TrialEffects of cisatracurium on cerebral and cardiovascular hemodynamics in patients with severe brain injury.
For neuroanesthesia and neurocritical care the use of drugs that do not increase or preferentially decrease intracranial pressure (ICP) or change cerebral perfusion pressure (CPP) and cerebral blood flow (CBF) are preferred. The current study investigates the effects of a single rapid bolus dose of cisatracurium on cerebral blood flow velocity, ICP, CPP, mean arterial pressure (MAP) and heart rate (HR) in 24 mechanically ventilated patients with intracranial hypertension after severe brain trauma (Glasgow coma scale <6) under continuous sedation with sufentanil and midazolam. ⋯ The results from this study suggest that cisatracurium is a safe neuromuscular blocking agent for use in adult severe brain-injured patients with increased ICP under mild hyperventilation and continuous sedation.
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Cardiopulmonary resuscitation (CPR) has the potential to save many lives. Used indiscriminately though, it may be harmful and not in the best interest of the patient. An advance directive to refrain from resuscitation in selected patients is probably not uncommon in Sweden, but guidelines ruling this are still generally lacking. This study was performed to evaluate the use and documentation of do-not-resuscitate orders in a Swedish university hospital. ⋯ We conclude that a decision to refrain from resuscitation is often not made, even when considered medically and ethically justifiable. Also, the use of coded information as a sole indicator for a patient not to be resuscitated is still common practice. The patient or his/her relatives are rarely involved in this decision.
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Acta Anaesthesiol Scand · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effect of intravenous ketoprofen, ketorolac and diclofenac on platelet function in volunteers.
Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis which may result in impaired platelet function. Because NSAIDs have different abilities to inhibit cyclo-oxygenases we compared the effect of intravenous ketoprofen, ketorolac and diclofenac on platelet function in volunteers. ⋯ Ketoprofen, ketorolac and diclofenac caused a reversible platelet dysfunction. Diclofenac had the mildest effect, while platelet dysfunction was still seen 24 h after the beginning of ketorolac.
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Acta Anaesthesiol Scand · Nov 1997
Randomized Controlled Trial Clinical TrialEmergence from isoflurane/N2O or isoflurane anaesthesia.
The first goal of anaesthetic recovery is return of the patient's ability to independently maintain respiratory and circulatory functions. Nitrous oxide remains popular due to minor effects on the cardiovascular and respiratory systems. However, diffusion hypoxaemia can occur during recovery and there is a potential advantage of providing the patient with only a potent vaporised agent. ⋯ Patients anaesthetised with only isoflurane had a longer delay until resumption of spontaneous breathing and extubation in the emergence period. Minute ventilation and carbon dioxide elimination were also significantly more suppressed throughout emergence after anaesthesia with isoflurane as compared with isoflurane/N2O.