British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering.
Sixty patients who shivered after routine surgery under general anaesthesia were allocated randomly to receive normal saline (n = 20), doxapram 1.5 mg kg-1 (n = 20) or pethidine 0.33 mg kg-1 (n = 20). Both doxapram and pethidine were effective in treating postoperative shivering 2-3 min after i.v. administration. ⋯ In the pethidine group, all patients had stopped shivering by 7 min after treatment. We conclude that both doxapram and pethidine were effective in the treatment of postoperative shivering.
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Randomized Controlled Trial Clinical Trial
Tropisetron for postoperative nausea and vomiting in patients after gynaecological surgery.
In a double-blind study, we have compared the prophylactic antiemetic effect of tropisetron 5 mg (Navoban, a 5-HT3 receptor antagonist) with that of placebo, both given as a short i.v. infusion approximately 15 min before wound closure in patients undergoing gynaecological surgery. Perioperative anaesthetic care was standardized and patients were observed for at least 24 h after operation. ⋯ Vomiting occurred in 26% of tropisetron-treated patients, compared with 59% of placebo-treated patients (P = 0.006); 69% of tropisetron-treated patients suffered nausea, compared with 88% of placebo-treated patients (P = 0.05). In addition, patients judged the antiemetic treatment with tropisetron as more effective than the placebo treatment (visual analogue score 71 vs 51 mm (P = 0.003)).
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Comparative Study
Comparison of propofol with thiopentone for treatment of bupivacaine-induced seizures in rats.
Thirty Sprague-Dawley rats were paralysed with pancuronium and their lungs ventilated mechanically with 70% nitrous oxide and 0.5% halothane in oxygen. Bupivacaine 2 mg kg-1 min-1 was infused continuously i.v. until the animals died. At the onset of seizures, animals were given an i.v. bolus of propofol 1 mg kg-1 (n = 10), thiopentone 2 mg kg-1 (n = 10) or lipid vehicle (n = 10). ⋯ The initial doses of thiopentone and of propofol stopped epileptiform activity in all animals, usually within 6 s after administration. The seizure-free period after the initial administration of thiopentone and of propofol lasted, on average, 0.98 min and 1.72 min, respectively. We conclude that propofol may have value in treating seizures induced by bupivacaine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single-dose, randomized, double-blind, double-dummy cross-over comparison of extradural and i.v. clonidine in chronic pain.
We studied 10 patients with chronic back pain who had claimed benefit with a previous extradural dose of clonidine 150 micrograms combined with local anaesthetic. We compared a single dose of clonidine 150 micrograms given by either the extradural or i.v. route in a double-blind, randomized, double-dummy and cross-over fashion, with 80% power to detect a difference in the analgesic effect of the two routes. ⋯ Clonidine given by either route produced statistically significant sedation and significant decreases in arterial pressure and heart rate. In this study, extradural clonidine had no significant clinical advantages compared with i.v. clonidine; clonidine 150 micrograms by either route produced a high incidence of adverse effects.