British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Effects of intraoperative i.v. acetaminophen vs i.m. meperidine on post-tonsillectomy pain in children.
Enteral acetaminophen, when used alone, is not very effective for postoperative analgesia because of delayed absorption and sub-therapeutic plasma concentrations. In contrast, i.v. acetaminophen is devoid of these shortcomings and could potentially provide adequate postoperative analgesia as a single agent. This randomized double-blind study compared the analgesic effects of i.v. acetaminophen and i.m. meperidine in paediatric patients undergoing tonsillectomy. ⋯ Compared with i.m. meperidine, i.v. acetaminophen provided adequate analgesia, less sedation and earlier readiness for recovery room discharge among paediatric patients undergoing tonsillectomy.
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Randomized Controlled Trial
Preconditioning effects of levosimendan in coronary artery bypass grafting--a pilot study.
The calcium sensitizer levosimendan protects against myocardial ischaemia and reperfusion injury in animal models. ⋯ Patients receiving a short infusion of levosimendan before CABG showed evidence of less myocardial damage, suggestive of a preconditioning effect. Larger outcome studies are thus indicated to confirm benefit.
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To investigate the relationship between the depression of spinal motor neuronal excitability and the sedative level induced by propofol infusion, we simultaneously analysed the suppressive effect of propofol on the F wave and the sedative level during propofol infusion. ⋯ We demonstrated that the excitability of spinal motor neurones was suppressed during sedation by propofol TCI, but this suppressive effect vanished at return of consciousness by mild physical stimulation even at a constant Cpt. Our data suggested that the effect of propofol on the excitability of spinal motor neurones might be affected by consciousness level rather than propofol Cpt in humans.
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Randomized Controlled Trial Comparative Study
Prospective comparison of sevoflurane and desflurane in formerly premature infants undergoing inguinal herniotomy.
Formerly premature infants having inguinal herniotomy have been at a high risk of postoperative apnoea, newer less soluble anaesthetic agents may reduce this risk. ⋯ Infants wake faster from general anaesthesia when maintained with desflurane as compared with sevoflurane, but no difference in postoperative respiratory events was demonstrated between the groups.
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Randomized Controlled Trial
Nitrous oxide does not change the incidence of postoperative delirium or cognitive decline in elderly surgical patients.
Postoperative delirium and cognitive decline are common in elderly surgical patients after non-cardiac surgery. Despite this prevalence and clinical importance, no specific aetiological factor has been identified for postoperative delirium and cognitive decline. In experimental setting in a rat model, nitrous oxide (N(2)O) produces neurotoxic effect at high concentrations and in an age-dependent manner. Whether this neurotoxic response may be observed clinically has not been previously determined. We hypothesized that in the elderly patients undergoing non-cardiac surgery, exposure to N(2)O resulted in an increased incidence of postoperative delirium than would be expected for patients not receiving N(2)O. ⋯ Exposure to N(2)O resulted in an equal incidence of postoperative delirium when compared with no exposure to N(2)O.