British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Propofol sedation for outpatient upper gastrointestinal endoscopy: comparison with midazolam.
The objectives of this study were to assess midazolam and propofol as sedative agents for outpatient gastrointestinal endoscopy, with particular reference to recovery profile, amnesic effects, and haemodynamic state and oxygenation during the procedure. Forty consecutive patients were allocated randomly to two groups. Patients in group I (n = 19) received midazolam 81 (SEM 32) micrograms kg-1; those in group II (n = 21) received propofol 950 (400) micrograms kg-1. ⋯ Oxygen desaturation from baseline was similar in both groups (P less than 0.01). An increase in heart rate and decrease in mean arterial pressure were noted in both groups. Propofol provided more rapid recovery compared with midazolam, but was associated with pain on injection, a short amnesia span, and reduced patient acceptance.
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Randomized Controlled Trial Clinical Trial
Effect of P6 acupressure on postoperative vomiting in children undergoing outpatient strabismus correction.
A prospective, double-blind study was conducted to compare the effect of pressure at the P6 (Neikuan) point with placebo as an antiemetic in children. Sixty-six patients, ages 3-12 yr, undergoing outpatient surgery for correction of strabismus, were allocated randomly to receive either bilateral P6 acupressure or placebo during the perioperative period. ⋯ The corresponding results for the acupressure group were 58% before discharge, 71% at home and 94% in the first 24 h. These differences were not significant; P6 acupressure did not reduce the incidence of postoperative vomiting in children undergoing strabismus surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antagonism of intense atracurium-induced neuromuscular block in children.
Antagonism of intense neuromuscular block induced by atracurium 0.5 mg kg-1 was attempted in four groups of six children using one of two doses of neostigmine (0.05 mg kg-1 and 0.1 mg kg-1) or of edrophonium (0.5 mg kg-1 and 1.0 mg kg-1) when the first twitch of the post-tetanic count (PTC1) was 10% of control. For comparison with normal practice, a fifth group received neostigmine 0.05 mg kg-1 when the first twitch of the train-of-four was 10% of control. ⋯ Doubling the doses of the anticholinesterases did not reduce the recovery time and had the effect of increasing variability. We conclude that there is no clinical advantage in attempting to antagonize intense neuromuscular block in children using normal or increased doses of neostigmine or edrophonium.
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We have studied the effect of thiopentone, etomidate and propofol on systemic vascular resistance (SVR) during cardiopulmonary bypass with constant pump flow in 30 patients undergoing elective coronary artery bypass surgery. SVR decreased to 78% of control values after thiopentone 4 mg kg-1, to 72% of control after etomidate 0.3 mg kg-1, and to 68% of control after propofol 2 mg kg-1; it returned to control values 10 min after administration of thiopentone and propofol and 7 min after administration of etomidate. Analysis of variance showed that there were no significant differences in the changes in SVR between the groups.