European journal of anaesthesiology
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Comment Letter Comparative Study
Comparison of tramadol with morphine for post-operative pain following abdominal surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the effect of intramuscular diclofenac, ketorolac or piroxicam on post-operative pain following laparoscopy.
Sixty patients presenting for in-patient gynaecological laparoscopic surgery were randomly allocated to receive either diclofenac 75 mg (n = 20), ketorolac 30 mg (n = 20) or piroxicam 20 mg (n = 20) as an intramuscular (i.m.) injection immediately after induction of anaesthesia. Post-operative Visual Analogue Scores at rest, over the first 24 h after surgery, using a 10 cm scale, ranged from 3.2-0.5 in the diclofenac group, 2.7-0.85 in the ketorolac group and 2.8-0.5 in the piroxicam group. The scores did not differ significantly between the three groups (P > 0.05). ⋯ Six out of 20 patients in the diclofenac group required further analgesia compared with nine out of 20 in the other two drug groups, this was not significant. There were no reports of increased bleeding, bronchoconstriction, bleeding from the upper gastrointestinal tract, renal impairment or pain from the intramuscular (i.m.) injection site in any of the groups. The administration of a non-steroidal anti-inflammatory drug to patients presenting for laparoscopic surgery reduces post-operative pain and analgesic requirements, and piroxicam 20 mg provides a suitable alternative to 75 mg diclofenac and 20 mg ketorolac.
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Randomized Controlled Trial Clinical Trial
Nitrous oxide reduces the cost of intravenous anaesthesia.
One hundred and one women (ASA grades I and II) were anaesthetized for routine gynaecological surgery using an intravenous (i.v.) anaesthetic technique combining propofol and alfentanil. The patients were allocated randomly into groups. ⋯ There was no significant difference in the incidence of postoperative complications between the two groups. We suggest that nitrous oxide may be used to reduce the cost of total i.v. anesthesia with propofol and alfentanil without causing any increase in post-operative morbidity in patients undergoing routine gynaecological surgery.
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Abnormalities of platelet haemostasis pose increased risk to patients undergoing anaesthesia and surgery. We have investigated the effect of propofol on platelet aggregation in 12 patients undergoing upper and lower abdominal surgery. ⋯ Platelet aggregation measurements were made for adenosine diphosphate (ADP), collagen and adrenaline. The results show that propofol does not affect platelet aggregation in the concentrations used.