Articles: hypnotics-sedatives.
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Randomized Controlled Trial Comparative Study Clinical Trial
Incidence of emesis and postanesthetic recovery after strabismus surgery in children: a comparison of droperidol and lidocaine.
The authors sought to compare the antiemetic and sedative postanesthetic effects of droperidol versus lidocaine given intravenously. One hundred and fifty children, ASA physical status I or II, ages 2-15 yr, were studied. Each child was randomly assigned to receive either droperidol, 0.075 mg/kg; lidocaine, 1.5 mg/kg; or a combination of lidocaine, 1.5 mg/kg, and a reduced dose of droperidol, 0.025 mg/kg, immediately after induction of anesthesia, which was with thiopental, atropine, and succinylcholine. ⋯ However, the mean time intervals from completion of surgery to recovery of full alertness and to discharge from the hospital did not differ significantly among the three groups. In summary, the authors found that intravenous droperidol is significantly more effective than lidocaine in reducing the incidence of vomiting in unpremedicated children after strabismus surgery. Furthermore, droperidol did not delay either the time to recovery of full alertness or the time to discharge from hospital compared to lidocaine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Nalbuphine combined with midazolam for outpatient sedation. An assessment in fibreoptic bronchoscopy patients.
Forty patients who required day case fibreoptic bronchoscopy were sedated with either nalbuphine 0.2 mg/kg and midazolam 0.05 mg/kg (n = 20), or midazolam 0.05 mg/kg alone (n = 20). Extra midazolam was administered when required. ⋯ Patients who received nalbuphine had slightly higher carbon dioxide levels but respiratory rate and cardiovascular changes were similar in both groups. The addition of nalbuphine to midazolam improves the quality of sedation but prolongs the recovery time and increases the incidence of side effects.
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Br Med J (Clin Res Ed) · Feb 1987
Randomized Controlled Trial Comparative Study Clinical TrialPropofol infusion for sedation in the intensive care unit: preliminary report.
Propofol (2,6,di-isopropylphenol) was given by continuous intravenous infusion to provide sedation after cardiac surgery in 30 patients and its effects compared with those of midazolam given to a further 30 patients. Propofol infusion allowed rapid and accurate control of the level of sedation, which was satisfactory for longer than with midazolam. ⋯ Both medical and nursing staff considered the propofol infusion to be superior to midazolam in these patients. These findings suggest that propofol is a suitable replacement for etomidate and alphaxalone-alphadolone for sedating patients receiving intensive care.
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Int J Clin Pharmacol Ther Toxicol · May 1986
Randomized Controlled Trial Comparative Study Clinical TrialSaccadic eye movements in determination of the residual effects of the benzodiazepines.
Saccadic eye movements and the volunteers' subjective assessments were used in the determination of the residual effects of a single high evening dose of flunitrazepam 2 mg, midazolam 30 mg, and lorazepam 2.5 mg as well as in that of placebo. Sleep inducing and maintaining effects were subjectively assessed, too. Both flunitrazepam 2 mg, midazolam 30 mg, and lorazepam 2.5 mg possessed sleep inducing and increasing effects (n = 9), but in the number of nocturnal awakenings and quality of sleep no significant differences between placebo and the active medications were reported. ⋯ After three repeated 2 mg evening doses, flunitrazepam accumulated in the serum of the volunteers (n = 6), but the effect on saccadic eye movements as well as subjective side effects began to decrease already after one day's treatment. Thus, saccadic eye movement recording proved to be a useful tool in determining the residual effects and development of tolerance of benzodiazepines. No correlation was detected between the serum levels (radioreceptor assay) and saccadic eye movement recordings or subjective residual sequelae.
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Acta Anaesthesiol Belg · Jan 1986
Randomized Controlled Trial Clinical TrialEfficacy of lorazepam and lormetazepam as intravenous premedicants for anesthesia and surgery.
Lorazepam 4 mg and lormetazepam 2 mg were compared as intravenous premedicants by assessing their effects on the level of consciousness and anxiety, sensory and motor functions, neuromuscular function and vital parameters in sixty surgical patients in a randomized study. Lormetazepam exerted a marked sedative-hypnotic effect maximal at 10 min. Lorazepam had a slower onset of action with a peak effect at 40 min on the different neurobehavioral functions but seemed to induce a longer duration of sedation and a more consistently obtunded awareness of perisurgical events than lormetazepam. ⋯ All hemodynamic changes remained clinically acceptable in both groups and no side effects were seen. The clinical anesthesiologists rated the quality of premedication as unsatisfactory in 7% of the patients treated with lorazepam and in 27% of those receiving lormetazepam. Together with its milder neurobehavioral effects and highly effective anxiolytic action, these factors favor the use of lorazepam for anesthetic premedication despite a relatively slow onset of action.