British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Study of the prophylactic effect of droperidol, alizapride, propofol and promethazine on spinal morphine-induced pruritus.
We have compared the use of alizapride, propofol, droperidol and promethazine for the prevention of spinal morphine-induced pruritus. ⋯ Droperidol, propofol and alizapride, in a decreasing order of effectiveness in the doses used in this study, reduced the incidence of pruritus induced by the use of morphine 0.2 mg intrathecally. On the other hand, promethazine 50 mg was shown to be ineffective.
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A 45% complication rate and a mortality of 20% were reported previously in patients undergoing non-cardiac surgery after coronary artery stenting. Discontinuation of antiplatelet drugs appeared to be of major influence on outcome. Therefore we undertook a prospective, observational multicentre study with predefined heparin therapy and antiplatelet medication in patients undergoing non-cardiac procedures after coronary artery stenting. ⋯ Despite heparin and despite having all patients on intensive/intermediate care units, cardiac events are the major cause for new perioperative morbidity/mortality in patients undergoing non-cardiac surgery after coronary artery stenting. The complication rate exceeds the re-occlusion rate of stents in patients without surgery (usually <1% annually). Patients with coronary artery stenting less than 35 days before surgery are at the greatest risk.
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Emergence delirium in the post-anaesthesia care unit (PACU) is poorly understood. The goal of this prospective study was to determine frequency and risk factors of emergence delirium in adults after general anaesthesia. ⋯ Preoperative benzodiazepines, breast and abdominal surgery and surgery of long duration are risk factors for emergence delirium.
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Randomized Controlled Trial
Gabapentin attenuates the pressor response to direct laryngoscopy and tracheal intubation.
Laryngoscopy and tracheal intubation increase blood pressure and heart rate (HR). The aim of the present study was to investigate the effect of gabapentin when given before operation on the haemodynamic responses to laryngoscopy and intubation. ⋯ Gabapentin, under the present study design attenuates the pressor response but not the tachycardia associated with laryngoscopy and tracheal intubation.