British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Tropisetron for postoperative nausea and vomiting in patients after gynaecological surgery.
In a double-blind study, we have compared the prophylactic antiemetic effect of tropisetron 5 mg (Navoban, a 5-HT3 receptor antagonist) with that of placebo, both given as a short i.v. infusion approximately 15 min before wound closure in patients undergoing gynaecological surgery. Perioperative anaesthetic care was standardized and patients were observed for at least 24 h after operation. ⋯ Vomiting occurred in 26% of tropisetron-treated patients, compared with 59% of placebo-treated patients (P = 0.006); 69% of tropisetron-treated patients suffered nausea, compared with 88% of placebo-treated patients (P = 0.05). In addition, patients judged the antiemetic treatment with tropisetron as more effective than the placebo treatment (visual analogue score 71 vs 51 mm (P = 0.003)).
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Randomized Controlled Trial Clinical Trial
Effects of increasing doses of alfentanil, fentanyl and morphine on mid-latency auditory evoked potentials.
We have studied dose-dependent effects of alfentanil, fentanyl and morphine on mid-latency auditory evoked potentials (MLAEP). Anaesthesia was induced with alfentanil 100 micrograms kg-1 every 5 min to a total dose of 500 micrograms kg-1 (group I, n = 10), fentanyl 10 micrograms kg-1 every 7 min to a total dose of 50 micrograms kg-1 (group II, n = 10) or morphine 1 mg kg-1 for induction and 0.5 mg kg-1 every 15 min to a total dose of 3 mg kg-1 (group III, n = 10). MLAEP were recorded before and 3-15 min after every opioid dose on vertex (positive) and mastoids on both sides (negative). ⋯ There was a marked increase only in latency and decrease in amplitude of P1. In contrast, for the early cortical potentials Na and Pa, only small increases in latencies and decreases in amplitudes were observed. After the largest doses of alfentanil (500 micrograms kg-1), fentanyl (50 micrograms kg-1) and morphine (3 mg kg-1), Na, Pa and Nb showed a similar pattern as in awake patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comment Letter Case Reports
Postdural puncture headache and extradural blood patch.
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We studied mid-latency auditory evoked potentials (MLAEP) during induction of general anaesthesia with ketamine 2 mg kg-1. MLAEP were recorded before, during and after induction of general anaesthesia on the vertex (positive) and mastoid (negative) positions. Latencies of the peak V, Na, Pa, Nb, P1 and amplitudes Na/Pa, Pa/Nb and Nb/P1 were measured. ⋯ Amplitudes and latencies of MLAEP did not change during induction of general anaesthesia with ketamine. Primary processing of auditory stimuli in the primary auditory cortex seemed to be preserved under ketamine. Suppression of sensory (auditory) information processing must take place at a higher cortical level in a dissociative manner.