European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between ketorolac and diclofenac in laparoscopic sterilization.
We compared ketorolac and diclofenac for the prevention and treatment of post-operative pain in patients undergoing laparoscopic sterilization. Fifty ASA I or II women were allocated randomly to receive either diclofenac 75 mg or ketorolac 30 mg intramuscularly 30-90 min before general anaesthesia. Pain scores were assessed half-hourly in the recovery room and then at 2 h and 4 h in the ward. ⋯ Pain at the injection site was more common after diclofenac than ketorolac (12 vs. 3, P < 0.05). In conclusion, both intramuscular diclofenac and ketorolac were relatively ineffective in controlling the pain after laparoscopic sterilization. The drugs were equally well tolerated, but more patients complained of pain at the injection site after diclofenac.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of a radiant heater on post-operative hypothermia: comparison with a reflective blanket.
Thirty patients with post-operative hypothermia following major surgery (thoracic, abdominal, orthopaedic) were allocated randomly to either active warming with a radiant heater (500 W) or passive rewarming with a reflective blanket. Rectal temperature, mean skin temperature (at four measuring sites), continuous haemoglobin saturation and shivering were measured for 2 h post-operatively. Although post-operative heat supply with a radiant heater resulted in faster rewarming, there were no differences between the two groups with respect to haemoglobin saturation and shivering.
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Randomized Controlled Trial Clinical Trial
The effects of midazolam followed by administration of either vecuronium or atracurium on the QT interval in humans.
Prolongation of the QT interval may produce potentially hazardous dysrhythmias. The effects on the QT interval of midazolam followed by administration of either vecuronium or atracurium have been investigated. Thirty patients, ASA I or II, without cardiovascular problems, electrolyte abnormalities or receiving any medication were studied. ⋯ Midazolam followed by administration of either vecuronium or atracurium did not produce any significant change in QTc interval (QT interval corrected for heart rate). Statistically significant prolongation of QTc was observed in both groups after intubation, although the mean QTc values did not exceed the upper limits of normal. Heart rate and arterial pressure were also increased significantly in both groups after intubation.
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Randomized Controlled Trial Clinical Trial
Optimum time for neostigmine administration to antagonize vecuronium-induced neuromuscular blockade.
We followed the recovery time course in 46 patients antagonized by neostigmine (0.036 mg kg-1) at different levels of vecuronium-induced neuromuscular blockade ranging from post-tetanic count 1 to train-of-four ratio 0.4 and in 15 patients during spontaneous recovery. Non-linear regression curve fit analyses showed that the optimal time for neostigmine administration was when the first twitch in the train of four (T1) was between 1% and 10%. ⋯ To achieve the optimum effect, neostigmine must therefore be given 32.6 min plus the required time for peak effect of neostigmine (5.3-7.1 min), i.e. 37.9-39.7 min, before train-of-four ratio 0.7 is reached. During spontaneous recovery this corresponds to a T1 between 1% and 15%.
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Randomized Controlled Trial Clinical Trial
Pre-emptive versus post-surgical administration of ketorolac for hysterectomy.
Seventy-seven women who underwent routine vaginal or abdominal hysterectomy were randomly allocated to receive intravenous ketorolac 30 mg either 30 min before surgical incision (pre-emptive group, n = 37), or at the end of the surgical procedure (post-surgical group, n = 40). The patients received routine post-operative care, which included morphine by patient-controlled analgesia, 1 mg per demand with a lockout of 6 min and a background infusion of 1 mg h-1. In addition, pain was assessed at 12 and 24 h using a 100 mm visual analogue scale (VAS), both at rest and on coughing. ⋯ There were no significant differences on univariate testing. Subsidiary stepwise multiple regression modelling identified age, weight, type of hysterectomy, and the timing of ketorolac administration as significant explanators of post-operative morphine consumption. A statistically significant pre-emptive analgesic effect was therefore identifiable, but the clinical significance is uncertain in relation to the other influences on post-operative analgesic requirements.