European journal of anaesthesiology
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Randomized Controlled Trial
Combination of low doses of intrathecal ketamine and midazolam with bupivacaine improves postoperative analgesia in orthopaedic surgery.
Intrathecal ketamine produces a short period of analgesia with stable haemodynamics. Midazolam with bupivacaine prolongs the duration of analgesia when administered intrathecally but does not prevent hypotension. The objective of this study was to assess the effect of a combination of intrathecal bupivacaine, ketamine and midazolam on the duration of analgesia and haemodynamic parameters. ⋯ A low dose of midazolam and ketamine with bupivacaine intrathecally results in prolonged analgesia and less haemodynamic fluctuations. However, the safety of this combination needs to be proved before its use in clinical practice.
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Randomized Controlled Trial
Topical ketamine and morphine for post-tonsillectomy pain.
Tonsillectomy is frequently associated with postoperative pain of considerable duration, which is usually accompanied by the substantial consumption of both opioid and non-opioid analgesics. Despite the use of different surgical and anaesthetic techniques in the search for safe and effective post-tonsillectomy pain relief, this problem remains a clinical dilemma. The aim of the current study was to evaluate the potential effects of topically administered ketamine and morphine by an oral rinse into the tonsillar fossae. ⋯ Topical ketamine and morphine seems to be a safe and easy analgesic approach for decreasing adenotonsillectomy pain.
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Randomized Controlled Trial Multicenter Study Comparative Study
The influence of epidural volume extension on spinal block with hyperbaric or plain bupivacaine for Caesarean delivery.
Epidural volume extension via a combined spinal-epidural is the enhancement of a small-dose intrathecal block by an epidural injection of physiological saline solution. We evaluated the effect of epidural volume extension on the combined spinal-epidural technique of providing spinal anaesthesia for Caesarean section with hyperbaric or plain 0.5% bupivacaine. ⋯ There was no effect of epidural volume extension on the profile of spinal anaesthesia with the combined spinal-epidural technique for Caesarean section using hyperbaric or plain bupivacaine.
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Randomized Controlled Trial Comparative Study
Flexible laryngeal mask as an alternative to reinforced tracheal tube for upper chest, head and neck oncoplastic surgery.
The flexible laryngeal mask airway has been mostly used in spontaneous ventilated children during short procedures to avoid the risk of kinking; little information has been reported about its airway morbidity. The aim of the study was to compare this airway device with the reinforced tracheal tube in mechanically ventilated adult patients. ⋯ During anaesthesia in mechanically ventilated adult patients, both devices function adequately, are stable and protect the airway. Flexible laryngeal mask airway results in less postoperative morbidity than reinforced tracheal tube.
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Randomized Controlled Trial
Renal function after cardiopulmonary bypass surgery in patients with impaired renal function. A randomized study of the effect of nifedipine.
Postoperative acute renal failure predicts morbidity and mortality. We investigated the effect of nifedipine infusion on glomerular filtration rate in patients with impaired renal function undergoing cardiopulmonary bypass surgery. ⋯ Renal function was well preserved after cardiopulmonary bypass surgery in patients with impaired renal function when maintaining thorough intensive care surveillance. Nifedipine did not influence early postoperative renal function.