European journal of anaesthesiology
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Comparative Study Clinical Trial Controlled Clinical Trial
Assessment of accelerography with the TOF-GUARD: a comparison with electromyography.
The TOF-GUARD is a new device for monitoring the neuromuscular function using acceleration measurement. It is quick and easy to apply and does not require a rigid support for the arm. ⋯ The levels at intubation as well as at full recovery of the patients can be assessed equally by the two monitors. Thus, the TOF-GUARD is a reliable clinical monitor in daily anaesthesia practice.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal sufentanil compared with epidural bupivacaine analgesia in labour.
Epidural analgesia for pain relief during labour has certain disadvantages including slow onset. However, intrathecal sufentanil provides rapid onset and well-controlled analgesia lasting 1-4 h. The aim of this study was to compare the analgesia and the side effects of intrathecal sufentanil with epidural bupivacaine during labour. ⋯ Pain scores were significantly lower between 5 and 90 min after injection in patients receiving intrathecal sufentanil. Pruritus was significantly more frequent among those receiving intrathecal sufentanil. The rapid onset and effective analgesia of intrathecal sufentanil may in certain situations be advantageous.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ondansetron is not superior to moderate dose metoclopramide in the prevention of post-operative nausea and vomiting after minor gynaecological surgery.
Peri-operative nausea and vomiting (PONV), remain a considerable problem. Ondansetron is being promoted currently as the drug of choice for the prevention and treatment of PONV. Experiments to investigate efficacy of ondansetron in PONV have been made with placebo or single doses of other drugs, e.g. metoclopramide, and often with different anaesthetic regimes with different emetic potential. ⋯ Nausea scores were similar between the groups in the recovery ward and 24-h follow-ups but there were higher post-operative nausea scores in the ondansetron group in the day ward (P = 0.001). There were no significant side effects due to either drug. We conclude that moderate dose metoclopramide is an effective alternative to ondansetron in the control of PONV.
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Randomized Controlled Trial Clinical Trial
The influence of timing of ketorolac administration on post-operative analgesic requirements following total abdominal hysterectomy.
One hundred and thirty-seven patients were studied to assess whether the timing of a dose of ketorolac affected cumulative morphine requirements during the first 12 post-operative hours. Pain, sedation and nausea scores, respiratory rate and degree of operative blood loss were also recorded. Thirty-six patients (group A) were given placebo injections pre- and intra-operatively. ⋯ Thus, the timing of ketorolac administration made no difference to overall morphine consumption. Pain, nausea, sedation and respiratory rate scores were similar in all four groups. There was a significantly greater blood loss in patients receiving ketorolac (groups B, C and D) compared with those receiving placebo alone (group A).
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Case Reports
Pneumopericardium associated with high-frequency jet ventilation during laser surgery of the hypopharynx in a child.
A case of pneumopericardium, without concomitant pneumothorax, resulting from high frequency jet ventilation during laser surgery of the hypopharynx is described. The patient, a four-year-old boy, suffered cardiac arrest as a consequence of the incident. The pneumopericardium was likely to have been caused by obstruction to the expiratory flow during surgery. Other possible explanations for the incident are discussed.