European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Midazolam for premedication in children: nasal vs. rectal administration.
The authors compared the acceptance and efficacy of rectal and nasal administration of midazolam (MDZ) for premedication. Ninety-five ASA I and II paediatric patients (8 months to 12 years) scheduled for elective surgery were randomly allocated to two groups. Group R received 0.3 mg kg-1 of rectal midazolam (in 5 mL saline). ⋯ Swallowing (nasal midazolam) and concerns about modesty (rectal midazolam) were more frequent in older children. Because of its poor tolerance, nasal premedication should be reversed for cases where there is no alternative. Rectal premedication should be avoided in older children.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Intravenous administration of tenoxicam 40 mg for post-operative analgesia: a double-blind, placebo-controlled multicentre study.
The analgesic efficacy of tenoxicam, a newer injectable non-steroidal anti-inflammatory drug, for post-operative analgesia after abdominal or orthopaedic surgery in ASA Grade I/II patients is reported. Two hundred and fifty-six patients received a single dose of tenoxicam 40 mg intravenous (i.v.) at the end of surgery and this was repeated 24 h later. These patients were compared, with respect to pain or adverse events, with 258 patients that received placebo. ⋯ The cumulative rescue PCA-morphine consumption was always lower in the tenoxicam treated patients and was most marked at 4 and 24 h after the second injection of tenoxicam. This effect was more pronounced after abdominal surgery. The intravenous administration of tenoxicam was associated with a low incidence of adverse events and a high tolerability.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind comparison of alizapride, droperidol and ondansetron in the treatment of post-operative nausea.
To compare the efficacy in the treatment of post-operative nausea and/or vomiting (PONV), 75 patients undergoing gynaecological procedures under general anaesthesia using N2O/enflurane who suffered from PONV in the first hour after surgery were randomly allocated to three groups containing 25 patients each to receive either alizapride 100 mg, droperidol 1 mg or ondansetron 8 mg (i.v.). Patients expressed the severity of their nausea on a Visual Analogue Scale (VAS) ranging from 0 (none) to 10 (as bad as possible). Vomiting was recorded as present or absent, and the number of emetic events was noted. ⋯ However, comparison between the three groups showed no statistically significant differences. There was no statistically significant difference between the three groups in the number of patients receiving rescue medication, the number of emetic events and the time from administration of the study drug until rescue medication was given. It is concluded that alizapride 100 mg, droperidol 1 mg and ondansetron 8 mg intravenously are equally effective in the treatment of PONV after gynaecological procedures and that the newer drugs alizapride and ondansetron offer no advantage over droperidol.
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Randomized Controlled Trial Clinical Trial
Visual evaluation of train-of-four and double burst stimulation, fade at various currents, using a rubber band.
The sensitivity of train-of-four (TOF) or double burst stimulation3,3 (DBS3,3) was examined to detect fade by visual inspection, at varying stimulating currents, using the thumb of the investigated arm maintained abducted by the use of a rubber band. One-hundred adult patients were allocated randomly to (1) train-of-four-rubber band (TOF-RB), (2) train-of-four-control (TOF-control), (3) double burst stimulation-rubber band (DBS-RB), or (4) double burst stimulation-control (DBS-control) group. Each group contained 25 patients. ⋯ In contrast, when measured TOF ratio was 0.51-0.80, at the stimulating current of 50 or 30 mA, the likelihood of visual detection of fade in the DBS-RB group was significantly higher than in the DBS-control group (P < 0.05). With a TOF ratio of 0.61-0.70, in the DBS-RB group the probability of visual detection of fade at 50 or 30 mA was significantly higher than at 20 mA (P < 0.05). This study suggests that when using a rubber band, fade in response to the DBS3,3 is detected by visual inspection more readily at a stimulating current of 50 or 30 mA than without the rubber band.
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Randomized Controlled Trial Clinical Trial
The optimal dose of local anaesthetic in the orthogonal two-needle technique. Extent of sensory block after the injection of 20, 30 and 40 mL of anaesthetic solution.
Ninety patients undergoing scheduled upper limb orthopaedic surgery were studied to determine the optimal anaesthetic dose using the 'orthogonal two-needle technique'. The patients were randomly assigned to one of three groups to receive one of three different volumes (20, 30 and 40 mL) (n = 30) of anaesthetic solution (a mixture of equal parts of 0.5% bupivacaine with adrenaline 1:200,000 and 2% lignocaine). A significant correlation was found between the volume injected and the anaesthetic spread for all tested areas. ⋯ The comparisons between the 20 mL group and the other two groups are significant in all the tested areas, as well as the comparisons between 30 and 40 mL groups in the areas innervated by radial and musculocutaneous nerves. Only the area innervated by the axillary nerve showed a weaker volume-analgesia relation, confirming the elusiveness of this area to anaesthesia in the axillary approaches. The improved results observed using greater amounts of anaesthetic solution might result from a higher intrasheath pressure with disruption of sheath septa, or from a greater availability of drug for all the terminal branches of brachial plexus, or both.