Anesthesia and analgesia
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Anesthesia and analgesia · Mar 1994
Randomized Controlled Trial Multicenter Study Clinical TrialAn initial multicenter, randomized controlled trial on the safety and efficacy of acadesine in patients undergoing coronary artery bypass graft surgery. SPI Research Group.
Acadesine (5-amino-4-imidazole carboxamide riboside) is a purine nucleoside analog that has been shown in animals to reduce myocardial ischemic injury by selectively increasing the availability of adenosine in ischemic tissues. Because patients undergoing coronary artery bypass graft (CABG) surgery are especially vulnerable to developing myocardial ischemia, we investigated whether perioperative use of this adenosine-regulating drug with potential anti-ischemic properties could modify the incidence and severity of perioperative myocardial ischemia. The goals of this study were to evaluate safety and the effects of acadesine on myocardial ischemia, left ventricular function, and, secondarily, on adverse clinical outcomes (myocardial infarction, heart failure, life-threatening dysrhythmias, and death) in patients undergoing CABG surgery. ⋯ During prebypass, the incidence of ECG ischemia was similar in all three groups (0%, 3%, 3%, respectively). The incidence of TEE ischemia was numerically lower in the two acadesine groups (high-dose = 6%, low-dose = 15%) than in the control group (19%), but this was not statistically significant (P = 0.22). During postbypass, the incidence of ECG ischemia was 11% in the high-dose group, 22% in the low-dose group, and 18% in the control group (P = 0.42), and TEE ischemia was similar in incidence in all groups (placebo = 29%; low dose = 27%; high-dose = 24%) (P = 0.86).(ABSTRACT TRUNCATED AT 400 WORDS)
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Anesthesia and analgesia · Mar 1994
Randomized Controlled Trial Clinical TrialOndansetron decreases emesis after tonsillectomy in children.
We performed a double-blind, randomized, placebo-controlled trial to investigate the efficacy and safety of ondansetron in preventing vomiting after tonsillectomy with or without adenoidectomy in children. Sixty children were premedicated with 0.5 mg/kg of oral midazolam and underwent inhaled induction and maintenance of anesthesia with halothane and nitrous oxide. Intravenous morphine 0.075 mg/kg, vecuronium 0.1 mg/kg, and either ondansetron 0.15 mg/kg (maximum = 8 mg), or saline placebo were administered after intravenous catheter placement. ⋯ Three children who received ondansetron and one who received placebo complained of abdominal cramping on the night of the surgery. There were no other complaints or complications. Analysis of the 51 children who did not receive dexamethasone revealed similar results.(ABSTRACT TRUNCATED AT 250 WORDS)