Anaesthesia
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Randomized Controlled Trial Clinical Trial
The antiemetic effectiveness of droperidol during morphine patient-controlled analgesia.
This prospective, double-blind study examined the antiemetic effectiveness of the addition of droperidol to a morphine solution for use in patient-controlled analgesia in a group of 50 patients undergoing elective lumbar laminectomy. The addition of 20 mg droperidol to 120 mg morphine in 60 ml saline given by a Baxter 'Infusor' patient-controlled analgesia device reduced the incidence of vomiting as compared to the addition of sodium chloride from 42.8% to 12.5% (p = 0.028) and of nausea from 71.4% to 29.2% (p = 0.005). The proportion of patients requiring rescue antiemetic therapy was reduced from 47.6% to 16.7% (p = 0.025) and the time interval to the first use of rescue antiemetic agent was significantly prolonged (p = 0.029). The use of droperidol was associated with an increased degree of sedation during the first 12 h after operation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Propofol and postanaesthetic shivering.
Sixty ASA grade 1 unpremedicated patients scheduled for minor elective surgery were randomly allocated to receive general anaesthesia consisting of either propofol-nitrous oxide in oxygen or a conventional technique of thiopentone-isoflurane-nitrous oxide-oxygen. Baseline axillary temperature readings, duration of operation and intra-operative decrease in axillary temperature were similar in both groups. The patients who received propofol-nitrous oxide-oxygen anaesthesia had a significantly lower incidence of postanaesthetic shivering than the control group. A propofol-nitrous oxide-oxygen technique may be preferable when postanaesthetic shivering is deemed undesirable.
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Randomized Controlled Trial Clinical Trial
Dose-responses for edrophonium during antagonism of vecuronium block in young and older adult patients.
The dose-response relationship for edrophonium during antagonism of vecuronium-induced neuromuscular blockade was studied in two groups of adult patients of mean (SD) age 35 (10.0) years (n = 42) and 77 (5.4) years (n = 42) respectively. Neuromuscular block was monitored by recording the force of contraction of the adductor pollicis muscle following train-of-four stimulation. ⋯ The dose-response curves showed no significant difference between the two age groups except at 10 min. The estimated dose of edrophonium required for attaining a train-of-four ratio of 0.7 at 10 min was 0.9 and 1.3 mg.kg-1 in the younger and older groups, respectively (p < 0.05).
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of direct blood pressure measurement at the radial and dorsalis pedis arteries during surgery in the horizontal and reverse Trendelenburg positions.
The differences in simultaneous arterial pressure measurements from the radial and dorsalis pedis arteries were studied in anaesthetised adult patients in either the horizontal or reverse Trendelenburg position. Significantly higher pressures were measured from the dorsalis pedis artery than from the radial artery in both positions, even allowing for the hydrostatic effect on the dorsalis pedis arterial pressure in the non-horizontal group. If the dorsalis pedis artery is to be used to measure direct arterial blood pressure, we recommend that readings be compared with an arm sphygmomanometer to avoid potentially dangerous hypotension being missed.