European journal of anaesthesiology
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Clinical sedation assessment becomes insufficient in deeply sedated patients. Bispectral index as a processed electroencephalogram parameter provides a continuous and observer-independent value reported to change with sedation. The aim of this prospective observational study was to determine the reliability and possible confounding factors of the bispectral index to assess sedation in surgical intensive care patients. ⋯ Only under certain conditions, such as low muscular activity and body temperature stability, may the bispectral index be a useful addition to clinical scoring in the sedation assessment of critically ill patients.
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Randomized Controlled Trial Clinical Trial
The prevention of propofol injection pain by tramadol or ondansetron.
To compare the efficacy of tramadol and ondansetron in minimizing the pain due to injection of propofol in 100 patients. ⋯ Tramadol or ondansetron are equally effective in preventing pain from propofol injection. The added benefit of a reduction in nausea and vomiting after operation in the ondansetron group may be a reason to prefer this drug.
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Both the numbers of children undergoing day case surgery and the type of procedures performed in this way are increasing. This expansion will only be beneficial if anaesthesia and surgery are provided with minimal post-operative morbidity e.g. postoperative delirium or nausea and vomiting. The choice of anaesthetic technique is considered critical to optimizing the service provided to patients and for this reason much research has addressed this question. ⋯ The outcome measures reviewed by this article are induction of anaesthesia, effects on the cardiovascular system, recovery from anaesthesia and postoperative nausea and vomiting. In each section both quantitative and qualitative outcome measures are discussed. Comparisons are made between sevoflurane and halothane, sevoflurane and propofol, propofol and halothane, desflurane and halothane and the presence or absence of nitrous oxide.
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Randomized Controlled Trial Clinical Trial
Magnesium infusion reduces perioperative pain.
Magnesium has antinociceptive effects in animal and human models of pain. These effects are primarily based on the regulation of calcium influx into the cell. The aim of this study was to determine whether perioperative infusion of magnesium would reduce postoperative pain and anxiety. ⋯ Continuous magnesium infusion, including the pre-, intra-, and postoperative periods reduces analgesic requirements. These results demonstrate that magnesium can be an adjuvant for perioperative analgesic management.
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Randomized Controlled Trial Clinical Trial
Prophylactic intravenous bolus ephedrine for elective Caesarean section under spinal anaesthesia.
To evaluate the efficacy and optimal dose of prophylactic intravenous ephedrine for the prevention of maternal hypotension associated with spinal anaesthesia for Caesarean section. ⋯ A prophylactic bolus of ephedrine 12 mg intravenously given at the time of intrathecal block, plus rescue boluses, leads to a lower incidence of hypotension following spinal anaesthesia for elective Caesarean section compared to intravenous rescue boluses alone.