Anaesthesia
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Randomized Controlled Trial Clinical Trial
The effect of intravenous tenoxicam on pruritus in patients receiving epidural fentanyl.
In this prospective randomised study, pruritus and pain were evaluated in patients undergoing abdominal surgery during which epidural fentanyl was administered. All patients had an epidural catheter inserted at the time of surgery. Epidural fentanyl 100 micrograms was administered intra-operatively and infused at a concentration of 2 micrograms.ml-1 for 48 h postoperatively. ⋯ Patients receiving tenoxicam demonstrated significantly lower pruritus and pain scores at 30 min, 2, 4, 8 and 24 h postoperatively as well as reduced pethidine requirements for breakthrough pain in the first 24 h. In conclusion, tenoxicam 20 mg significantly reduces the incidence and severity of postoperative pruritus in patients who received peri-operative epidural fentanyl. In addition, it significantly reduces pain and further analgesic requirements postoperatively.
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Randomized Controlled Trial Clinical Trial
Propofol auto-co-induction as an alternative to midazolam co-induction for ambulatory surgery.
We propose the use of an intravenous propofol/propofol auto-co-induction technique as an alternative to propofol/midazolam for induction of anaesthesia. We have studied 54 unpremedicated ASA 1 or 2 patients undergoing day-stay anaesthesia for minor orthopaedic surgery. All received 10 micrograms.kg-1 or alfentanil before induction, followed by either midazolam 0.05 mg.kg-1, propofol 0.4 mg.kg-1 or saline, and 2 min later, a propofol infusion at a rate of 50 mg.kg-1.h-1 until loss of eyelash reflex. ⋯ Both co-induction techniques showed less postinduction hypotension and significant reduction of the total induction dose of propofol when compared to the control group. In the propofol/propofol group there was a decreased incidence of apnoea during induction of anaesthesia. These patients were discharged from hospital 2 h after the end of anaesthesia whereas patients in the midazolam/propofol group were discharged after 2 1/2 h (p < 0.001).
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Randomized Controlled Trial Clinical Trial
Safe pre-operative fasting times after milk or clear fluid in children. A preliminary study using real-time ultrasound.
Gastric emptying of orange-flavoured glucose (group I), low-fat milk (group II) and breast milk (group III) was evaluated in 45 ASA grade I children of < or = 5 years of age by using real-time ultrasonography and residual gastric volume and pH was then measured. In 15 more children, residual gastric volume and pH was measured after a midnight fast (group IV). Mean (SD) gastric emptying time in group I was 1.53 (0.25) h (range 1.00-1.75), group II 2.32 (0.31) h (range 1.75-2.75) and group III 2.43 (0.27) h (range 2.00-2.75). ⋯ The incidence of 'at risk' children in group IV was 33.3%. It was concluded that 3% fat milk or 17.5% glucose in a volume of 10 ml.kg-1 (maximum volume of 100 ml) can be given in children safely 3 h and 2 h, respectively, before anaesthesia. More real-time studies are required on breast milk to establish guidelines for its potential use as a pre-operative feed 3 h before anaesthesia.