Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1999
Randomized Controlled Trial Clinical TrialPostoperative nausea and vomiting in children using patient-controlled analgesia: the effect of prophylactic intravenous dixyrazine.
Although patient-controlled analgesia (PCA) with morphine provides a high degree of satisfactory postoperative analgesia in children, it is often associated with a high incidence of postoperative nausea and vomiting (PONV). Our aim in this study was to evaluate the prophylactic effect of dixyrazine, a phenothiazine with proven anti-emetic properties. ⋯ A significant number of children using PCA with morphine after major surgery experience PONV. Although prophylactic dixyrazine reduces the incidence and severity of vomiting, the incidence still remains high.
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Acta Anaesthesiol Scand · Feb 1999
Randomized Controlled Trial Clinical TrialTopical wound anaesthesia in children--a temporary postoperative pain relief.
Administration of local anaesthetics into the surgical wound may modulate pain at the peripheral level. A previous study in adults has shown good analgesic effects of topical lidocaine in wounds after herniorrhaphy. ⋯ A very short and clinically insignificant pain relief is obtained following the administration of a lidocaine aerosol in the surgical wound. A low pain level in this model may limit the possibility to detect an effect of lidocaine.
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Acta Anaesthesiol Scand · Feb 1999
Randomized Controlled Trial Clinical TrialLack of pre-emptive analgesic effect of (R)-ketamine in laparoscopic cholecystectomy.
This study evaluated the pre-emptive analgesic effect of intravenous (i.v.) (R)-ketamine in laparoscopic cholecystectomy. (R)-ketamine was used due to the lower incidence of side-effects. ⋯ In this study a 1 mg/kg dose of (R)-ketamine given at the end of surgery exerted a short-lasting hypnotic and analgesic effect. The same dose given preoperatively did not show postoperative analgesic effect or pre-emptive effect.
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Acta Anaesthesiol Scand · Feb 1999
Randomized Controlled Trial Clinical TrialThe effect of ketamine on clinical endpoints of hypnosis and EEG variables during propofol infusion.
We studied the effect of variable doses of ketamine on the endpoints of hypnosis, e.g., unresponsiveness to verbal commands (UVC), loss of eyelash reflex (LER), and inhibition of body movement response with or without sneezing to nasal membrane stimulation (INBMR), and processed EEG variables, e.g., bispectral index (BIS), 95% spectral edge frequency (SEF) and median frequency (MF) during propofol infusion. ⋯ Our results suggest additive interaction between propofol and ketamine (Groups PK0.5 and PK0.75) for achieving the hypnotic endpoints; however, ketamine did not depress the EEG variables in proportion to its hypnotic effect. The paradoxically higher BIS and 95% SEF values at the hypnotic endpoints may be due to lower propofol concentrations and/or no effect of ketamine on the EEG variables.
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Acta Anaesthesiol Scand · Feb 1999
Clinical TrialPerioperative ST-segment depression and troponin T release. Identification of patients with highest risk for myocardial damage.
Patients undergoing major vascular surgery are at constant risk of developing perioperative myocardial complications, especially myocardial infarction. The following study was performed to answer the question whether ST segment changes, analysed by Holter monitoring and ST segment analysis, are accompanied by release of cardiac troponin T, a highly specific marker of myocardial damage. ⋯ Haemodynamic changes, oxygen imbalance and stress during major vascular surgery frequently lead to an ischaemic burden, which is indicated by ST segment changes during ECG ST analysis. Longlasting ST depression reaching an individual critical cut-off limit followed by structural myocardial damage may be verified by elevated levels of cardiac troponin T. Prolonged periods of ST depression should be followed by determination of cardiac troponin T.