Journal of the Medical Association of Thailand = Chotmaihet thangphaet
-
Randomized Controlled Trial Comparative Study Clinical Trial
Hypotension in spinal anesthesia for cesarean section: a comparison of 0.5% hyperbaric bupivacaine and 5% hyperbaric lidocaine.
Hypotension is a common side effect associated with spinal anesthesia. However, there is no previous report comparing the incidence of hypotension between two commonly used local anesthetic agents, bupivacaine and lidocaine. The objective of this study was to compare the incidence of spinal hypotension induced by bupivacaine and lidocaine in parturients undergoing cesarean section. ⋯ Delayed onset hypotension occurring after delivery was noted and these events have never been described. However, the mechanism of late onset hypotension remains unidentified. Thus, bupivacaine and lidocaine can be used interchangeably for spinal anesthesia for elective cesarean section without significant difference in the incidence of hypotension.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative nausea and vomiting in out-patient gynecologic laparoscopy: a comparison of thiopental-nitrous oxide, propofol-nitrous oxide and total intravenous anesthesia using propofol.
An intravenous anesthetic drug, propofol was considered to pose antiemetic action. A randomized controlled trial was conducted to evaluate whether propofol could effectively reduce post-operative nausea and vomiting (PONV) compared to thiopental-nitrous oxide (N2O). One-hundred and eight patients undergoing outpatient gynecologic laparoscopy were assigned to receive 3 techniques of anesthesia; thiopental-N2O (T/N), propofol-N2O (P/N) and total intravenous anesthesia (TIVA) using propofol (P/P). ⋯ Two patients in the T/N group were admitted because of severe nausea and vomiting. In conclusion, TIVA using propofol and propofol-N2O anesthesia can significantly reduce the incidence of PONV in the early period. Concerning the economic crisis of the country as well as the quality of care, propofol-N2O would be the most appropriate anesthetic of choice.
-
Randomized Controlled Trial Clinical Trial
Randomized double blind, placebo-controlled study of pilocarpine administered during head and neck irradiation to reduce xerostomia.
Pilocarpine hydrochloride administered during head and neck irradiation was evaluated for its ability to relieve xerostomia and its adverse effects. ⋯ It was concluded that pilocarpine hydrochloride administered during head and neck irradiation produced subjectively insignificant benefit in relieving xerostomia with acceptable side effects.
-
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.
-
Randomized Controlled Trial Clinical Trial
The effects of patellar resurfacing in total knee arthroplasty on position sense: a prospective randomized study.
To find out the improvement of joint position sense after total knee arthroplasty with patellar resurfacing compared to total knee arthoplasty without patellar resurfacing, the study was carried out as a randomised parallel trial in patients who had stage III and IV primary osteoarthrosis of only 1 side of the knee with a 2 year follow-up. Twenty-one patients underwent patellar resurfacing and 26 patients had no patellar resurfacing. Joint position sense was evaluated by the average absolute different angle of the operated knees from the non operated knees which was the asymptomatic knee and acted as the reference knee. ⋯ However, the patients without patellar resurfacing had better improvement. The patients with patellar resurfacing had better results in terms of anterior knee pain and tenderness. Patellar resurfacing should be used in severe articular cartilage damage, not as a routine operation.