AANA journal
-
Randomized Controlled Trial Clinical Trial
The safety and efficacy of granisetron in postoperative vomiting in pediatric patients undergoing tonsillectomy.
A high incidence of vomiting after tonsillectomy is consistently reported in the literature. Multiple trials with different pharmacological agents and alternative anesthetic techniques have been used in an attempt to decrease this, but results have been inconclusive and adverse effects occur frequently. The purpose of this study was to examine the safety and efficacy of granisetron (Kytril) in the prevention of postoperative vomiting in children undergoing tonsillectomy. ⋯ A reduction in the incidence and severity of vomiting was shown to be significant in the experimental group, both in the hospital and at 24 hours postoperatively. High patient satisfaction was also reported in this group. Clinically, the prophylactic administration of granisetron intraoperatively in pediatric tonsillectomy patients should be considered to reduce the incidence and severity of postoperative vomiting.
-
Randomized Controlled Trial Clinical Trial
Comparison of intubating conditions related to timed dosages and a nerve stimulator based on the measurement of acceleration using mivacurium.
A quantitative method of monitoring neuromuscular blockade has been recently introduced. It has been suggested, when using mivacurium, that a standardized passage of time be used for induction. The purpose of this study was to determine whether a difference existed in intubating conditions when using mivacurium between a timed-dose technique and the ParaGraph (Vital Signs, Inc., Totowa, New Jersey). ⋯ Of the ParaGraph group, 100% had good to excellent intubating conditions, and 85% of the timed-dose group had fair to excellent intubating conditions. Time to intubation was longer in the ParaGraph group, with a mean of 216 seconds compared with 121 seconds in the timed-dose group. The variable time to onset of mivacurium indicates that a timed-dose technique may yield less than optimal intubating conditions despite manufacturer recommendations.
-
Randomized Controlled Trial Clinical Trial
The effect of glycopyrrolate premedication on postoperative sore throat.
Patients given general endotracheal anesthesia commonly experience postoperative sore throat and/or hoarseness. Our study examined whether the occurrence of postoperative sore throat was associated with the use of a glycopyrrolate premedication and found that it was. ⋯ After surgery, an interviewer, unaware of the subject's group assignment, questioned each subject about the presence of a sore throat and, if present, asked the patient to rate its severity. We found that patients who did not receive preoperative glycopyrrolate were significantly less likely to report having a sore throat or reported having a less severe sore throat than patients who did receive glycopyrrolate.
-
Randomized Controlled Trial Clinical Trial
Effect of preemptive acetaminophen on postoperative pain scores and oral fluid intake in pediatric tonsillectomy patients.
Postoperative pain is a significant problem that continues to be undertreated in the pediatric population. Preemptive administration of analgesics has recently emerged as a method to enhance pain management associated with surgery. The purpose of this study was to compare postoperative pain scores, rescue analgesic use, and oral fluid intake in children who received acetaminophen preoperatively to children who received postoperative acetaminophen. ⋯ Incidence of nausea and vomiting was high in both groups (64-78%). These results provide evidence that preemptive acetaminophen may enhance analgesia in pediatric tonsillectomy patients. Preoperative acetaminophen is a safe, quick, and inexpensive intervention that can readily be incorporated into anesthesia practice.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Cost-effective anesthesia: desflurane versus propofol in outpatient surgery.
This study compared the costs of desflurane and propofol as maintenance anesthetic agents in outpatient surgery. Recovery time and related drug expenses were included in the cost comparison. Fifty-three ASA physical status I and II patients were randomly assigned to receive a maintenance anesthetic of either desflurane with 50% nitrous oxide or propofol with 50% nitrous oxide. ⋯ There was no significant difference between the recovery times of the two groups. Desflurane was more cost-effective than propofol. Although desflurane patients experienced more nausea, this did not affect their discharge time.