AANA journal
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effects of propofol versus thiopental induction on postoperative outcomes following surgical procedures longer than 2 hours.
The use of propofol as an induction agent for surgeries lasting less than 2 hours has been shown to result in a faster emergence from anesthesia. Our study was performed to analyze the impact of propofol on surgical procedures lasting longer than 2 hours. A convenience sample of 84 men and women undergoing nonemergency laparoscopic procedures scheduled for longer than 2 hours were enrolled in this prospective study and randomly assigned to receive a standardized induction with thiopental or propofol. ⋯ No differences were found between the propofol and thiopental groups in demographics, total surgical time, anesthesia time, recovery times, postoperative analgesic and emetic requirements, satisfaction scores, or incidence of nausea and vomiting. Discharge times from the postanesthesia care unit and to home were similar between groups. Based on the results, we concluded that propofol offered no advantages over thiopental in postoperative outcomes in laparoscopic surgical procedures longer than 2 hours.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea.
Postoperative nausea, a common complication in patients receiving general anesthesia, was studied in this randomized investigation to compare the efficacy of 70% inhaled isopropyl alcohol and intravenous ondansetron. For the study, 100 healthy women, ASA physical status I or II, scheduled for outpatient gynecologic laparoscopic procedures randomly received 4 mg of intravenous ondansetron or isopropyl alcohol for the treatment of postoperative nausea. Nausea was measured on arrival to the postanesthesia care unit, at first complaint of nausea, every 5 minutes after initiation of therapy until nausea resolution, and every 15 minutes thereafter using a 0 to 10 verbal numerical rating scale. ⋯ No statistically significant differences were found at any other time interval. Mean times from initiation of therapy to a 50% reduction in nausea between the ondansetron and alcohol groups were 6.3 minutes and 27.7 minutes, respectively (P = 0.022). Based on this study, it seems postoperative nausea can be resolved quicker using 70% inhaled isopropyl alcohol compared with intravenous ondansetron in women undergoing outpatient gynecologic laparoscopic procedures.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of tubocurarine, rocuronium, and cisatracurium in the prevention and reduction of succinylcholine-induced muscle fasciculations.
Fasciculations are a common side effect of the use of succinylcholine for tracheal intubation. Many anesthesia care providers prefer to prevent them due to a possible association between fasciculations and increased intracranial and intraocular pressures. The purpose of this study was to compare the effectiveness of tubocurarine, rocuronium, and cisatracurium in the prevention and reduction of succinylcholine-induced muscle fasciculations. ⋯ Therefore, rocuronium is a valid alternative to tubocurarine for defasciculation. Cisatracurium is inferior to rocuronium and tubocurarine for defasciculation. Therefore, the use of cisatracurium is not recommended for defasciculation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of rocuronium and lidocaine for the prevention of postoperative myalgia after succinylcholine administration.
The incidence of postoperative myalgia (POM) after succinylcholine administration has been reported to range from 5% to 83%. The administration of small doses of nondepolarizing muscle relaxants or lidocaine before the administration of succinylcholine has been shown to decrease the incidence and severity of POM experienced by patients. The purpose of this investigation was to compare the severity of POM in subjects receiving pretreatment with rocuronium or lidocaine. ⋯ Of the lidocaine group, 21 (72%) of 29 reported no myalgia at 48 hours compared with only 9 (38%) of 24 in the rocuronium group (P = 0.023). Satisfaction was similar between the groups. Based on the results of this study, pretreatment with lidocaine may provide better relief from myalgia than rocuronium at 48 hours after surgery.
-
Randomized Controlled Trial Clinical Trial
Use of a simple forearm tourniquet as an adjunct to an intravenous regional block.
Intravenous regional anesthesia (IVRA) is a well-recognized technique for producing anesthesia during surgical procedures of the extremities. It has been suggested that the application of a tourniquet to the forearm may improve the quality of the block. The purpose of this investigation was to determine whether the application of a forearm tourniquet would accelerate onset time and improve the density and quality of an intravenous regional block. ⋯ Paired t tests were used to examine differences between groups on the variables studied. It was noted that the arm with the tourniquet had a shorter time for the onset of anesthesia (P = .0008) and had lower 10-minute VAS tolerance (P = .0469). This investigation suggests that the application of a simple forearm tourniquet as an adjunct to IVRA provides a more rapid onset of anesthesia than when no tourniquet is applied and may improve the density and quality of the block.