European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Post-operative effects of tramadol administered at wound closure.
The aim of this prospective, randomized and double-blind study was to assess the effects of a high dose of the analgesic tramadol administered at the conclusion of surgery on extubation time, sedation, and post-anaesthetic shivering. Forty adult patients, ASA physical status I or II, underwent laparoscopic surgery of about 1 h duration and received a standardized anaesthesia that was maintained with isoflurane in O2/N2O. Tramadol 3 mg kg-1 (n = 20) was administered intravenously at the beginning of wound closure, and was compared with saline (n = 20). ⋯ There were no adverse effects on time to extubation and sedation, and discharge-ready time was shorter in the tramadol group (P < 0.05 compared with control). Pain scores in the post-anaesthesia care unit (PACU) were statistically not different between the two groups, but significantly more supplemental medication was administered in the control group to treat shivering and/or pain. In conclusion, administration of a high dose of tramadol at the end of surgery prevents post-anaesthetic shivering without prolongation of extubation time, and shortens the PACU/discharge-ready time.
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Randomized Controlled Trial Clinical Trial
Reducing the incidence of sore throat with the laryngeal mask airway.
The incidence of sore throat after the use of the laryngeal mask was assessed with a randomized trial in 839 patients. Sore throat occurred more often in women, older patients or after multiple insertion attempts. It was found that the frequency in women, but not in men, was lowered from 11.9% to 3.9% (P = 0.012) by reducing intracuff pressure to the minimum required for an effective seal.
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Randomized Controlled Trial Clinical Trial
Anti-emetic efficacy of prophylactic granisetron, droperidol and metoclopramide in the prevention of nausea and vomiting after laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled trial.
This study evaluates the prophylactic anti-emetic efficacy of granisetron, droperidol and metoclopramide, for the prevention of post-operative nausea and vomiting in female patients undergoing elective laparoscopic cholecystectomy. The patients were randomly assigned to one of four groups (n = 30 for each group): granisetron 3 mg, droperidol 1.25 mg, metoclopramide 10 mg and placebo (saline). ⋯ No clinically important adverse effects were observed in either group. Our results suggest that granisetron is a better anti-emetic than droperidol or metoclopramide for the prevention of post-operative nausea and vomiting after laparoscopic cholecystectomy when compared with a placebo.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of caudal bupivacaine, bupivacaine-morphine and bupivacaine-midazolam mixtures for post-operative analgesia in children.
Sixty children undergoing inguinal or urogenital surgery were allocated randomly to three groups to receive a caudal injection of either 0.125% bupivacaine 0.75 mL kg-1 with 0.5% midazolam 50 micrograms kg-1 (n = 20) or with 1% morphine chlorhydrate 0.05 mg kg-1 (n = 20), or bupivacaine alone (n = 20) after surgery under general anaesthesia. There were no significant changes in heart rate, blood pressure, respiratory rate or oxygen haemoglobin saturation values in all groups, and there were no significant differences in the incidence of vomiting and pruritus between the groups (P > 0.05). ⋯ Differences between the bupivacaine-midazolam group and the bupivacaine group (P < 0.001), the bupivacaine-midazolam group and the bupivacaine-morphine group (P < 0.01), and the bupivacaine-morphine group and the bupivacaine group (P < 0.01) were significant. It is suggested that caudal administration of a bupivacaine-midazolam mixture produces a longer duration of post-operative analgesia than a bupivacaine-morphine mixture and bupivacaine alone with sedation for 8-12 h post-operatively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intra-operative evaluation of a continuous versus intermittent bolus thermodilution technique of cardiac output measurement in cardiac surgical patients.
The purpose of this study was to analyse the clinical agreement between cardiac output measurements, obtained using a newly available continuous thermodilution technique, and the conventional intermittent bolus technique. Twenty-four cardiac surgical patients were intra-operatively monitored using both techniques. Additionally, two different averaging modes for the continuous thermodilution technique, either the previous 6 min (group 1) or 3 min (group 2) were compared. ⋯ There were significant differences at any time point between the groups. The relative error between continuous thermodilution and intermittent bolus techniques was < 15% for the majority of measurements and was significantly higher in group 1 compared with group 2 just prior to cardiopulmonary bypass. Thus, the continuous thermodilution technique produced a clinically acceptable level of accuracy compared with the intermittent bolus technique measurements, especially when using an averaging mode for the previous 3 min.