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 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.
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There is compelling evidence that preconditioning occurs in humans. Experimental studies with potential clinical implications as well as clinical studies evaluating ischaemic, pharmacological and anaesthetic cardiac preconditioning in the perioperative setting are reviewed. These studies reveal promising results. ⋯ In addition, many anaesthetics and a significant number of perioperatively administered drugs affect the activity of cardiac sarcolemmal and mitochondrial K(ATP) channels, the end-effectors of cardiac preconditioning, and thereby markedly modulate preconditioning effects in myocardial tissue. Although these modulatory effects on K(ATP) channels have been investigated almost exclusively in laboratory investigations, they may have potential implications in clinical medicine. Important questions regarding the clinical utility and applicability of perioperative cardiac preconditioning remain unresolved and need more experimental work and randomized controlled clinical trials.