Anaesthesia
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Randomized Controlled Trial Multicenter Study Clinical Trial
Single oral dose ondansetron in the prevention of postoperative nausea and emesis. The European and US Study Groups.
In two placebo-controlled, double-blind, multicentre studies, the efficacy and safety of single oral doses of ondansetron 4 mg, 8 mg and 16 mg were evaluated for the prevention of postoperative nausea and vomiting in female inpatients. For the total study populations, 26% (European study) and 32% (US study) of placebo-treated patients experienced no emesis compared with 54% (European study) and 52% (US study) of patients treated with ondansetron 16 mg, the most effective dose. Similarly, 22% (European study) and 19% (US study) of placebo-treated patients experienced no nausea compared with 42% (European study) and 34% (US study) of ondansetron 16 mg-treated patients. ⋯ In the US study, a slightly greater percentage of patients undergoing non-gynaecological surgery had no nausea and no emesis compared with patients undergoing gynaecological surgery in both the placebo and ondansetron treatment groups. Again, ondansetron 16 mg was the most effective dose in both surgery types. Ondansetron was well tolerated, with only headache being reported as a significant problem in both studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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Multicenter Study
The use of the laryngeal mask airway by nurses during cardiopulmonary resuscitation. Results of a multicentre trial.
A multicentre study was undertaken to assess the potential value of the laryngeal mask airway when inserted by ward nurses during resuscitation as a method of airway management, prior to the arrival of the Advanced Life Support Team with tracheal intubation capability. The nurses underwent a training programme agreed by all the participating hospitals and followed an identical protocol and data recording system. One hundred and thirty nurses were trained and 164 cases of cardiac arrest were studied. ⋯ Regurgitation of gastric contents occurred before airway insertion in 20 cases (12%), during the insertion in three cases (2%), but there was clinical evidence of pulmonary aspiration in only one patient, who survived to leave hospital. We conclude that the laryngeal mask airway offers advantages over other methods of airway and ventilation management, such as the bag-valve-mask or mouth-to-mouth methods that are currently used by ward nurses in resuscitating patients with cardiac arrest. In this study, the laryngeal mask airway was not being compared with the tracheal tube.
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Comment Letter Case Reports
Cardiorespiratory arrest and combined spinal/epidural anaesthesia for caesarean section.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Single dose intravenous ondansetron for the 24-hour treatment of postoperative nausea and vomiting.
Postoperative nausea and vomiting is a major concern for patients undergoing outpatient surgery under general anaesthesia, and may complicate and delay discharge from hospital. This paper evaluates the safety and efficacy of ondansetron, a 5-HT3 receptor antagonist, in the treatment of postoperative nausea and vomiting. One thousand patients in 30 centres in the United States who received general anaesthesia and developed postoperative nausea and vomiting were studied. ⋯ Dose comparisons between the three treatment groups showed that ondansetron 4 mg is the optimal dose to treat postoperative nausea and vomiting. Ondansetron is a well tolerated, efficacious antiemetic which has a similar side effect profile to placebo. Intramuscular administration has the same systemic availability as intravenous administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Multicenter Study Clinical Trial
Single dose intravenous ondansetron in the prevention of postoperative nausea and vomiting.
Postoperative nausea and vomiting continues to pose problems for surgical patients. Three studies were undertaken to evaluate the efficacy and safety of prophylactic intravenous ondansetron in male and female patients undergoing outpatient surgery. Studies 1 and 2 included a total of 1169 female patients scheduled to undergo surgery on a day case basis. ⋯ In study 3, ondansetron 4 mg was significantly (p < or = 0.001) more effective than placebo in preventing emesis in males. There were no differences between treatment groups with respect to vital signs, laboratory values, or adverse events. Intravenous ondansetron is safe and effective at preventing postoperative nausea and vomiting in male and female patients undergoing day case surgery.