British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of preoperative with postoperative lignocaine infiltration on postoperative analgesic requirements.
Ninety patients undergoing appendicectomy were allocated randomly to receive 1.5% lignocaine 15 ml with adrenaline infiltrated into the proposed wound line 3 min before incision, lignocaine 15 ml with adrenaline infiltrated into the wound on closure or no wound infiltration. After operation, all patients received pethidine by patient-controlled analgesia. ⋯ There were no significant differences in the cumulative dose of pethidine required or pain scores between the three groups at any time point after operation. We conclude that pre-incisional infiltration with 1.5% lignocaine had no advantage compared with infiltration at wound closure or no wound infiltration in reducing postoperative analgesic requirements or pain scores after appendicectomy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind comparison of ondansetron, droperidol and saline in the prevention of postoperative nausea and vomiting.
We have compared the efficacy of ondansetron with droperidol and saline in the prevention of postoperative nausea and vomiting (PONV) in 120 ASA I and II patients undergoing hip and knee replacements and femoral resections. They received a standardized combined extradural and general anaesthetic and at the end of surgery were allocated randomly to receive droperidol 1.25 mg, ondansetron 4 mg or 0.9% saline in a 25-ml bag. An extradural mixture containing 0.5% plain bupivacaine 10 ml, fentanyl 500 micrograms and saline 30 ml was infused and PONV assessed for 24 h. ⋯ The incidence of vomiting was 17% for ondansetron, 18% for droperidol and 45% for saline. There was no significant difference in the incidence of nausea between the groups. Metoclopramide, the rescue antiemetric, was demanded by 38%, 34% and 17% of patients receiving saline, droperidol and ondansetron, respectively (ondansetron vs droperidol P < 0.05).
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of patient-controlled analgesia in children by i.v. and s.c. routes of administration.
Sixty children undergoing appendicectomy were allocated randomly to receive one of two PCA regimens with morphine. Group IV received standard i.v. PCA with a bolus dose of morphine 20 micrograms kg-1 and a background infusion of 4 micrograms kg-1 h-1 while group SC received PCA by the s.c. route with a bolus dose of morphine 20 micrograms kg-1 and a background infusion of 5 micrograms kg-1 h-1. ⋯ PCA. By giving patients feedback on the occurrence of valid demands for analgesia, s.c. PCA may produce more appropriate and effective use of PCA.
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Randomized Controlled Trial Clinical Trial
Reduction in postoperative vomiting after surgical correction of prominent ears.
There is a high incidence of postoperative nausea and vomiting after surgical correction of prominent ears. A prospective, randomized study was performed to determine if the method of dressing the ears influenced the incidence of postoperative vomiting. Avoidance of packing the external auditory meatus and concha produced a significant reduction in postoperative nausea (83% vs 30%; P < 0.005) and vomiting (63% vs 22%; P < 0.01).
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Randomized Controlled Trial Clinical Trial
Addition of oral clonidine to postoperative patient-controlled analgesia with i.v. morphine.
Using a randomized, double-blind, placebo-controlled design, we have investigated, in 40 patients undergoing major abdominal surgery, the effect of oral clonidine 300 micrograms, 1 h before and 12 h after surgery on postoperative morphine requirements (evaluated by PCA). During the 24 h of the study, pain scores measured every 6 h did not differ significantly. ⋯ Heart rate was significantly lower until 18 h after surgery and sedation was significantly more pronounced in patients receiving clonidine. We cannot recommend routine oral administration of clonidine before surgery to improve postoperative analgesia.