Anesthesia and analgesia
-
Anesthesia and analgesia · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialMetoclopramide reduces the incidence of vomiting after tonsillectomy in children.
The efficacy of intravenous metoclopramide in controlling vomiting in children after tonsillectomy was determined in a prospective randomized, double-blind investigation. One hundred two unpremedicated, ASA physical status I or II children between the ages of 1 and 15 yr who were undergoing surgical removal of the tonsils, with or without adenoidectomy, were studied. Anesthesia was induced either with halothane, nitrous oxide, and oxygen by mask or by intravenous thiopental and was maintained with halothane, nitrous oxide, oxygen, and intravenous morphine (0.1 mg/kg). ⋯ All episodes of vomiting were recorded for 24 h after completion of surgery. The incidence of vomiting in the saline solution group was 70%, compared with 47% in the metoclopramide group (P = 0.026). The authors conclude that the administration of intravenous metoclopramide in a dose of 0.15 mg/kg on arrival in the postanesthesia care unit significantly decreases the incidence of vomiting in children after tonsillectomy.
-
Anesthesia and analgesia · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparative effects of laryngeal mask airway and endotracheal tube insertion on intraocular pressure in children.
Intraocular pressure (IOP) measurements in children are frequently performed under halothane-nitrous oxide anesthesia; however, anesthesia face masks may limit access to the eyes, and tracheal intubation is associated with transient increases in IOP. Use of the laryngeal mask airway (LMA) permits the maintenance of a patent airway without the need for laryngoscopy and tracheal intubation. In a randomized study of 41 children, we compared the IOP, hemoglobin oxygen saturation, and hemodynamic responses to the insertion of an LMA or tracheal tube during a standardized steady-state anesthetic technique consisting of 1 MAC halothane and 66% nitrous oxide. ⋯ The LMA did not increase IOP, heart rate, or arterial blood pressure above baseline values. In contrast, tracheal intubation was associated with significant increases of IOP, heart rate, and arterial blood pressure. We concluded that the laryngeal mask offers advantages over tracheal intubation and the face mask for airway management in patients undergoing IOP measurements.
-
Anesthesia and analgesia · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialEpidural test dose and intravascular injection in obstetrics: sensitivity, specificity, and lowest effective dose.
The authors studied the sensitivity and specificity of several epidural test doses as markers of intravascular injection in laboring patients in a prospective double-blind, randomized study. Fifty-nine parturients were assigned randomly to receive an intravenous injection of either normal saline solution (3 mL, NS group) or 1.5% lidocaine with epinephrine 1:200,000 (1 mL, EPI-5 group; 2 mL, EPI-10 group; or 3 mL, EPI-15 group). The EPI-5 and EPI-10 doses were diluted to 3 mL volume with normal saline solution. ⋯ In the other groups, the increase was 21 +/- 8 (EPI-5 group), 31.5 +/- 13 (EPI-10 group), and 29 +/- 9 beats/min (EPI-15 group). A baseline-to-peak criterion of greater than 10 beats/min identified all intravascular injections in the EPI-15 (by design) and EPI-10 groups (15 of 15 and 14 of 14, respectively) with a sensitivity of 100%. Specificity was 73% (11 of 15 true negatives).(ABSTRACT TRUNCATED AT 250 WORDS)
-
Anesthesia and analgesia · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialHeadache after spinal anesthesia for cesarean section: a comparison of the 27-gauge Quincke and 24-gauge Sprotte needles.
A high incidence of postdural puncture headache (PDPH) occurs after spinal anesthesia for cesarean section. To examine this problem, a study was conducted with the recently developed 24-gauge Sprotte and 27-gauge Quincke needles in patients undergoing elective and emergency cesarean section (n = 298). The needle to be used was assigned in a random manner: group I, 27-gauge Quincke (n = 147); group II, 24-gauge Sprotte (n = 151). ⋯ Five headaches were classified as mild, and only one was moderate to severe. All headaches resolved quickly with conservative management and without blood patch. The authors conclude that the choice between a 27-gauge Quincke and a 24-gauge Sprotte needle does not influence the incidence of PDPH after spinal anesthesia for cesarean section.