European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Effect of parecoxib sodium on postoperative shivering: A prospective, randomised, double-blind clinical trial.
Intraoperative parecoxib 40mg reduces postoperative shivering, comparable to tramadol.
pearl -
Preeclampsia continues to be a leading cause of maternal and foetal mortality and morbidity worldwide. It is defined as hypertension and proteinuria after 20 weeks' gestation, which resolves after delivery. It is complicated by intracerebral haemorrhage, pulmonary oedema and respiratory and hepatic failure, which form the commonest causes of death. ⋯ A fluid restriction policy should be used to prevent iatrogenic pulmonary oedema. Effective anaesthetic management relies on neuraxial techniques. Epidural, combined spinal-epidural and single-shot spinal anaesthetic techniques are all perfectly acceptable and should be actively promoted to the mother unless contraindications such as thrombocytopaenia exist.
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Perphenazine is a treatment option in postoperative nausea and vomiting (PONV) prophylaxis. Chronic administration and high dose are known to cause extrapyramidal system (EPS) dysfunction at a frequency of 8%, but the incidence of acute EPS after a single 4 or 8 mg dose is unknown. ⋯ Given the infrequent side effects, this single, low dose of perphenazine should be encouraged as a low-risk adjunct to any multimodal PONV prophylaxis regimen, based on the selection criteria described.