Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A double-blind, randomized study comparing postoperative pain management using epidural ropivacaine with intravenous ketorolac or intravenous ketorolac alone following transabdominal hysterectomy.
The aim of this study is to compare the effect on postoperative pain of epidural ropivacaine in combination with intravenous ketorolac with intravenous ketorolac alone following transabdominal hysterectomy. ⋯ We demonstrated that epidural infusion of ropivacaine in addition with intravenous ketorolac gave superior pain relief at rest and on coughing in patients undergoing transabdominal hysterectomy when compared to the group receiving intravenous ketorolac alone.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Remifentanil vs morphine for patients in intensive care unit who need short-term mechanical ventilation.
This randomized, double-blind study compared the safety and efficacy of remifentanil (9 microg/ kg/h) with morphine (0.045 mg/kg/h plus a bolus dose of 0.025 mg/kg). One hundred and eighty nine Intensive Care Unit (ICU) patients with normal renal function or mild renal impairment requiring mechanical ventilation were included in this study. A pre-defined dosing algorithm permitted initial titration of the opioids to predetermine the optimal level of sedation and pain score. ⋯ The dosing algorithm facilitated rapid extubation in both groups. Remifentanil provided comparable hemodynamic stability to morphine, and was not associated with an increase in cardiovascular adverse event. Remifentanil is therefore considered to be effective and well tolerated in ICU patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A multicenter randomized double-blind comparison of remifentanil and alfentanil during total intravenous anaesthesia for out-patient laparoscopic gynaecological procedures.
We compared Remifentanil, an esterase-metabolized opioid, with Alfentanil as part of the total intravenous anesthesia with propofol and atracurium for out-patient laparoscopic gynaecological procedures in a multicenter randomized, double-blind study. We chose Remifentanil 1 mg./kg.for bolus injection and a continuous infusion of 0.25-0.5 microg./kg./min, compared to Alfentanil 20 microg./kg. For bolus injection and a continuous infusion of 0.5-1 microg./kg./min. ⋯ The incidence of intraoperative bradycardia was significantly higher with Remifentanil. Other incidences of nausea, emesis, urinary retention and postural hypotension were similar. All patients were ready to be discharged from the hospital within two hours after extubation except for one patient in the Alfentanil group who needed five hours of hospital stay because of urinary retention, nausea and severe emesis.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of ondansetron and placebo for preventing postoperative nausea and emesis in gastrointestinal tract surgery: a multicenter randomized controlled trial.
Nausea and emesis are undesirable events that may cause discomfort and suffering in the postoperative period. This study was carried out to evaluate the efficacy and safety of ondansetron for preventing postoperative nausea and vomiting in patients undergoing gastrointestinal tract surgery. ⋯ Ondansetron 4 mg given intravenously before surgery is safe and effective for preventing postoperative nausea and emesis following gastrointestinal tract surgery.
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Multicenter Study
Universal precautions: knowledge, compliance and attitudes of doctors and nurses in Thailand.
A study on the knowledge, compliance and attitudes of doctors and nurses on "universal precautions" (U. P.) was done by questionnaire in April 1993. Four hundred and sixty-nine doctors and 4,554 nurses from 35 hospitals throughout Thailand responded. ⋯ They supported the application of U. P. as a safety measure. Welfare support for health-care workers who have contacted HIV at work is also expected.