British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting.
This study compares the cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting (PONV). ⋯ Ondansetron+droperidol is cheaper and at least as effective as ondansetron+ dexamethasone, and it is more effective than dexamethasone+droperidol with a reasonable extra cost.
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Randomized Controlled Trial Clinical Trial
Intra-atrial ECG is not a reliable method for positioning left internal jugular vein catheters.
ECG guidance is widely used for positioning central venous catheters (CVCs) in the superior vena cava. We noticed a higher incidence of a more perpendicular angle between the catheter tip and the vessel wall after left-sided ECG-guided catheter positioning. To investigate the value of left-sided ECG guidance, we performed this prospective study. ⋯ Intra-atrial ECG does not detect the junction between the superior vena cava and right atrium. It is not a reliable method for confirming position of left-sided CVCs. Post-procedural CXRs are recommended for left-sided, but not right-sided CVCs.
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Randomized Controlled Trial Clinical Trial
Influence of thoracic epidural analgesia on cardiovascular autonomic control after thoracic surgery.
Thoracic epidural analgesia (TEA) is effective in alleviating pain after major thoracoabdominal surgery and may also reduce postoperative mortality and morbidity. This study investigated cardiovascular autonomic control in patients undergoing elective thoracic surgery and its modulation by continuous TEA. ⋯ In contrast with PCA management, TEA using low concentrations of bupivacaine and fentanyl blunted cardiac sympathetic neural drive, resulting in vagal predominance, while HRV variables were better restored after surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Early recovery after remifentanil-pronounced compared with propofol-pronounced total intravenous anaesthesia for short painful procedures.
We compared recovery from high-dose propofol/low-dose remifentanil ('propofol-pronounced') compared with high-dose remifentanil/low-dose propofol ('remifentanil-pronounced') anaesthesia. ⋯ In patients having short painful surgery, less propofol does not give faster recovery as long as the same anaesthetic level (as indicated by BIS and clinical signs) is maintained by more remifentanil. However, recovery times were less variable following remifentanil-pronounced anaesthesia suggesting a more predictable recovery.
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Randomized Controlled Trial Clinical Trial
Effect of intrathecal tramadol administration on postoperative pain after transurethral resection of prostate.
Tramadol administered epidurally has been demonstrated to decrease postoperative analgesic requirements. However, its effect on postoperative analgesia after intrathecal administration has not yet been studied. In this double-blind, placebo-controlled study, the effect of intrathecal tramadol administration on pain control after transurethral resection of the prostate (TURP) was studied. ⋯ Intrathecal tramadol was not different from saline in its effect on postoperative morphine requirements after TURP.