Anesthesia and analgesia
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Anesthesia and analgesia · Jul 1996
Randomized Controlled Trial Clinical TrialCombination of ondansetron and droperidol in the prophylaxis of postoperative nausea and vomiting.
The aim of this study was to compare the efficacy and safety of ondansetron plus droperidol with each drug alone or placebo in the prevention of postoperative nausea and vomiting (PONV). One hundred females, aged 18-65 yr, ASA physical status I-II, undergoing general anesthesia for elective abdominal surgery were included in a prospective, double-blind, placebo-controlled, randomized study. A standardized anesthetic technique and postoperative analgesia (ketorolac plus patient-controlled analgesia [PCA] with morphine) were used in all patients. ⋯ A complete response, defined as no PONV in 48 h, occurred in 28% of patients in Group 1, 60% in Group 2 (P < 0.05 vs Group 1), 56% in Group 3 (P < 0.05 vs Group 1), and 92% in Group 4 (P < 0.01 vs Groups 1, 2, and 3). Sedation was significantly greater with droperidol (Groups 2 and 4) for 12 h postoperatively. In conclusion, the combination of ondansetron plus droperidol was more effective than each antiemetic alone or placebo in the prevention of PONV in women undergoing elective abdominal surgery.
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Anesthesia and analgesia · Jul 1996
Case ReportsTransient compartment syndrome of the forearm after attempted radial artery cannulation.
Radial artery cannulation for continuous intraoperative monitoring of arterial blood pressure is considered a safe procedure. One complication of arterial cannulation is hematoma formation at the time of insertion or removal of the catheter. Bleeding is usually self-limited or will stop with compression without significant sequelae, even in the anticoagulated patient. We describe a case of hematoma with a transient compartment syndrome of the forearm after attempts to cannulate the radial artery for intraoperative monitoring purposes.
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Anesthesia and analgesia · Jul 1996
Preoperative fasting time: is the traditional policy changing? Results of a national survey.
Several papers in the 1980s questioned the wisdom of withholding clear liquids for more than 3 h before elective surgery. Furthermore, recent papers have suggested relaxing the current NPO after midnight (Latin: Nulla per os; or "nothing by mouth") practice in children and adults. To see whether the policy and practice regarding NPO status before elective surgery have changed in the United States, we performed a national survey. ⋯ In conclusion, our survey revealed that 69% of anesthesiologists in the United States have either changed their NPO policy or are flexible in their practice in allowing clear liquids before elective operation in children and 41% have done so for adult patients. The most frequently allowed clear liquids in the adult and pediatric population were water and apple juice. None of the respondents reported any medical adverse event associated with the institution of a flexible NPO policy.
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Anesthesia and analgesia · Jul 1996
Case ReportsGastropleural fistula: an unusual cause of intractable postoperative nausea and vomiting.
Gastropleural fistula is an uncommon finding (1). Gastropleural fistulae have been reported after pulmonary resection (1), perforated paraesophageal hernia (2), perforated malignant gastric ulcer at the fundus, and gastric bypass operation for morbid obesity. We present a case of gastropleural fistula that resulted acutely from intractable postoperative nausea and vomiting after ambulatory knee arthroscopic surgery under general anesthesia.