Yonsei medical journal
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Yonsei medical journal · Jun 2006
Randomized Controlled TrialEffects of metoclopramide and ranitidine on preoperative gastric contents in day-case surgery.
This prospective, randomized, double-blinded study was performed to evaluate the effects of intravenous metoclopramide and ranitidine on preoperative gastric contents in outpatients receiving intravenous anesthesia for laparoscopic gynecologic surgery. Fifteen minutes before the induction of anesthesia, the Z-M group (n=20) received 50 mg ranitidine and 10 mg metoclopramide intravenously and the control group (n=20) received the same volume of normal saline. Before the surgery, a 14-F multiorifice nasogastric tube was inserted to aspirate the gastric contents of patients under sedation with propofol and midazolam. ⋯ The mean aspirated volumes (mL) were 15.3 +/- 10.4 (SD) [median 11.0 (range: 5.0-44.0)] in the control group, and 6.9 +/- 10.0 (SD) [median 4.5 (range: 0-38.0)] in the Z-M group. There were significantly more high-risk (gastric fluid volumes > 25 mL and pH < 2.5) patients in the control group (4/20, 20%) than in the Z-M group (1/20, 5%). In conclusion, intravenous prophylactic ranitidine and metoclopramide may be an easy and useful method to decrease the volume while increasing the pH of gastric contents, and therefore may reduce the number of patients at risk for aspiration pneumonitis in ambulatory laparoscopic procedures who receive an anesthesia.
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Yonsei medical journal · Dec 2005
Randomized Controlled TrialThe effect of pretreatment with thiopental on reducing pain induced by rocuronium injection.
We examined whether pretreatment with a small dose of thiopental was effective in reducing pain induced by the intravenous injection of rocuronium. Withdrawal movement was used to assess pain reduction. Ninety patients were randomly assigned to one of two groups: patients in the control group were pretreated with 2 mL saline, and those in the thiopental group were pretreated with 2 mL (50 mg) thiopental. ⋯ Withdrawal movement was assessed using a four-grade scale: no movement, movement limited to the wrist, to the elbow or to the shoulder. The frequency of withdrawal movement in the group pretreated with thiopental was lower than in the control group (34 vs. 13, p < 0.05). We concluded that pretreatment with 2 mL (50 mg) thiopental is effective in reducing pain caused by the intravenous injection of rocuronium.
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Yonsei medical journal · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural and intravenous analgesia for postoperative pain control in pediatric lower extremity surgery.
In recent years epidural anesthesia and analgesia techniques were used in pediatric surgery owing to the development of pediatric epidural catheter needles. And the need of postoperative pain control in pediatric patients is also increasing. We compared combined general-epidural anesthesia and analgesia technique with intravenous fentanyl analgesia after general anesthesia for postoperative analgesic effect and complications in these pediatric patients. ⋯ There was no significant difference in the incidence of postoperative nausea and vomiting. A combined general-epidural anesthesia technique significantly reduces intraoperative end-tidal sevoflurane concentration compared to general anesthesia alone. And continuous patient-controlled epidural analgesia reduces postoperative pain scores significantly more than continuous patient-controlled IV fentanyl analgesia without any serious complications in pediatric lower extremity surgery.
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Yonsei medical journal · Oct 2004
Randomized Controlled Trial Clinical TrialThe effects of urokinase instillation therapy via percutaneous transthoracic catheter in loculated tuberculous pleural effusion: a randomized prospective study.
The purpose of this study was to propose that intrapleural urokinase (UK) instillation could reduce pleural thickening in the treatment of loculated tuberculous pleural effusion. Forty- three patients who were initially diagnosed as having loculated tuberculous pleural effusion were assigned at random to receive either the combined treatment of UK instillation including anti-tuberculosis agents (UK group, 21 patients) or strictly the unaccompanied anti-tuberculous agents (control group, 22 patients). The UK group received 100,000 IU of UK dissolved in 150 ml of normal saline daily, introduced into the pleural cavity via a pig-tail catheter. ⋯ The interval of symptoms observed prior to treatment of patients with RPT > or = 10 mm (6.0 +/- 3.4 wks) was detected to be significantly longer than in those with RPT < 10 mm (2.1 +/- 1.2 wks) in the control group (p < 0.05). However, there were no discernible differences were seen in the pleural fluid parameter in patients with RPT > or = 10 mm, as compared to patients with RPT < 10 mm in the UK group. These results indicate that the treatment of loculated tuberculous pleural effusion with UK instillation via percutaneous transthoracic catheter can cause a successful reduction in pleural thickening.
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Yonsei medical journal · Oct 2002
Randomized Controlled Trial Clinical TrialInstillation of normal saline before suctioning in patients with pneumonia.
This study was conducted to investigate the effects of a no saline, a 2 ml and a 5 ml saline instillation prior to endotracheal suctioning on oxygen saturation in patients with pneumonia. The subjects in this study were 16 pneumonic patients with a tracheotomy tube, who had been admitted to the neuro-surgical intensive care unit at a university hospital in Seoul Korea. All three (0, 2 and 5 ml) saline instillation methods were applied to the 16 patients. ⋯ The oxygen saturation was evaluated using pulse oximetry. The recovery times for oxygen saturation to return to baseline levels following suctioning were, just after suctioning, 45 seconds after suctioning and in excess of 5 minutes with 0, 2 and 5 ml saline instillations, respectively. Instillation of normal saline before suctioning could have an adverse effect on oxygen saturation, and should be used carefully as a routine intervention in patients who have pneumonia.