European journal of anaesthesiology
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Randomized Controlled Trial
Premedication with oral midazolam with or without parental presence.
In this study, we aimed to investigate whether the combination of low-dose (0.25 mg kg(-1)) midazolam premedication with parental presence can effectively reduce anxiety at induction as well as provide a smoother emergence. ⋯ Preoperative administration of midazolam 0.5 mg kg(-1) for premedication alone, without parental presence at induction, and that of low-dose midazolam 0.25 mg kg(-1) for premedication with parental presence at induction are both equally effective in reducing separation anxiety and providing a smooth emergence. However, parental presence alone, without midazolam for premedication, is not an adequate approach for this outcome. If the environment for parental presence is convenient, the dose of midazolam may be reduced and induction and emergence conditions may still be of high quality.
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Randomized Controlled Trial Comparative Study
Volatile induction/maintenance of anaesthesia with sevoflurane increases jugular venous oxygen saturation and lumbar cerebrospinal fluid pressure in patients undergoing craniotomy.
Sevoflurane is a widely used volatile agent in neuroanaesthesia, and its nonirritant properties on the respiratory tract make sevoflurane suitable for volatile induction/maintenance of anaesthesia (VIMA). In the current trial, we investigate the effects of sevoflurane VIMA on lumbar cerebral fluid pressure (LCSFP) and jugular venous oxygen partial pressure in patients undergoing craniotomy for supratentorial intracranial surgery under bispectral index monitoring, determine jugular bulb venous oxygen saturation (SjvO2) and calculate cerebral perfusion pressure (CPP), arteriojugular venous oxygen content difference and cerebral oxygen extraction rate (COER) at different time points during the operation. Moreover, we compare these with total intravenous anaesthesia (TIVA) in patients receiving remifentanil and propofol continuous infusion. ⋯ Sevoflurane VIMA increases SjvO2, lumbar CSF pressure and CPP, and decreases COER, which suggested that VIMA could be a better choice for patients with the risk of cerebral hypoperfusion or insufficient oxygen delivery. Propofol-based TIVA is associated with decreased SjvO2, LCSFP and CPP, and increased COER, and it might be suitable for patients with increased intracranial pressure.
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Randomized Controlled Trial
Multimodal analgesia with gabapentin, ketamine and dexamethasone in combination with paracetamol and ketorolac after hip arthroplasty: a preliminary study.
It has been hypothesized that combinations of analgesics with different mechanisms of action may reduce or even prevent postoperative pain. We, therefore, investigated the analgesic effect of gabapentin, dexamethasone and low-dose ketamine in combination with paracetamol and ketorolac as compared with paracetamol and ketorolac alone after hip arthroplasty. ⋯ Preoperative gabapentin, dexamethasone and ketamine combined with paracetamol and ketorolac reduced overall pain scores in patients after hip arthroplasty as compared with paracetamol and ketorolac alone. Morphine consumption was not reduced.
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Randomized Controlled Trial
Effectiveness of premedication agents administered prior to nitrous oxide/oxygen.
In paediatric dentistry, when anxiety, fear of dental procedures or behavioural impairment precludes the conduct of dental treatments, sedation procedures are required. However, sedation at the desired level might not be achieved despite administration of various agents. The present study aimed to evaluate the effectiveness of oral premedication with different agents on children scheduled for dental treatment under nitrous oxide/oxygen (N2O/O2) sedation. ⋯ It is concluded that 0.7 mg kg(-1) midazolam is more effective than 0.25 mg kg(-1) midazolam with 3 mg kg(-1) ketamine and 1 mg kg(-1) hydroxyzine hydrochloride in terms of oral premedication prior to N2O/O2 sedation in children scheduled for dental treatments.