European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of tramadol versus meperidine for pain relief and safe recovery after adenotonsillectomy.
Adequate relief of pain after tonsillectomy is a common problem. We compared meperidine and tramadol when given at induction of anaesthesia with respect to their effects on postoperative pain relief and emergence characteristics after adenotonsillectomy in children. ⋯ Meperidine was more effective for pain relief and provides better emergence characteristics than tramadol after tonsillectomy in children.
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Randomized Controlled Trial Clinical Trial
Intraperitoneal application of bupivacaine plus morphine for pain relief after laparoscopic cholecystectomy.
Intraperitoneal administration of a local anaesthetic in combination with an opioid, for the relief of postoperative pain, has already been reported except after laparoscopic cholecystectomy. This study was aimed at assessing the analgesic effect of the intraperitoneal administration of bupivacaine and morphine in patients undergoing laparoscopic cholecystectomy. ⋯ In patients undergoing laparoscopic cholecystectomy, the intraperitoneal administration of morphine plus bupivacaine 0.25% reduced the analgesic requirements during the first 6 postoperative hours compared with the control group. However, the combination of intraperitoneal bupivacaine 0.25% and i.v. morphine was more effective for treatment of pain after laparoscopic cholecystectomy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anaesthesia with ketamine-midazolam versus halothane-nitrous oxide-oxygen anaesthesia for prolonged abdominal surgery.
Total intravenous anaesthesia (TIVA) with ketamine-midazolam (KM) can be used for prolonged abdominal surgery. We compared this technique with halothane-nitrous oxide-oxygen anaesthesia using haemodynamic and endocrine stress responses as primary outcomes and adequacy of operating conditions and recovery profile as secondary outcomes. ⋯ The stress responses during KM anaesthesia for prolonged abdominal surgery were comparable to those during halothane-nitrous oxide-oxygen anaesthesia. However, KM anaesthesia provided better surgical conditions and better recovery.
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Randomized Controlled Trial Clinical Trial
Implications of the use of neuromuscular transmission monitoring on immediate postoperative extubation in off-pump coronary artery bypass surgery.
When continuous infusions of neuromuscular blocking drugs are administered during lengthy interventions and no routine antagonism of their effects is applied, there is a dramatic incidence of residual curarization. We have examined whether the use of neuromuscular transmission monitoring results in differences in the incidence of postoperative residual curarization, the use of antagonist agents, and the endotracheal extubation rate and outcome after continuous infusion of rocuronium in patients undergoing off-pump coronary artery bypass surgery. ⋯ Although we found no additional benefit of using neuromuscular transmission monitoring, it seems an absolute necessity for safety reasons. Pharmacological antagonism was mandatory. However, in our opinion, it is not wise routinely to perform immediate postoperative extubation in off-pump coronary artery bypass surgery.