European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Haloperidol vs. ondansetron for the prevention of postoperative nausea and vomiting following gynaecological surgery.
Ondansetron is widely used for the prophylaxis of postoperative nausea and vomiting, while haloperidol is an antiemetic that lacks recent data on efficacy and adverse effects. ⋯ The prophylactic administration of 1 mg intravenous haloperidol or 4 mg ondansetron, in female patients undergoing gynaecological surgery, did not improve the overall incidence of nausea and/or vomiting vs. placebo. However, haloperidol 1 mg proved to be an effective antiemetic in the early observation period without significant adverse effects.
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The use of inhalation sedation with sub-anaesthetic concentrations of sevoflurane and nitrous oxide mixture is expected to reduce amounts of intravenous sedative drugs needed to produce a balanced sedation with the benefits of having reduced side-effects. ⋯ The use of titrated doses of intravenous sedative drugs for induction of conscious sedation followed by the use of low concentrations (0.1-0.3%) of sevoflurane combined with 40% nitrous oxide for maintenance of conscious sedation in patients requiring endoscopic and/or surgical procedures under local anaesthesia, has the potential advantages of reducing amounts of intravenous sedative drugs, less likelihood of problems from drug side-effects and fast recovery and discharge time. Further investigations to establish the technique are currently in progress.
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Randomized Controlled Trial
Early postoperative cognitive recovery after remifentanil-propofol or sufentanil-propofol anaesthesia for supratentorial craniotomy: a randomized trial.
This study was designed to evaluate early postoperative cognitive recovery after total intravenous anaesthesia with remifentanil-propofol or sufentanil-propofol in patients undergoing craniotomy for supratentorial expanding lesions. ⋯ In conclusion, propofol-remifentanil and propofol-sufentanil are both suitable for fast-track neuroanaesthesia and provide similar intraoperative haemodynamics, awakening and extubation times. Despite a higher risk of treatable postoperative hypertension propofol-remifentanil allows earlier cognitive recovery.
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Randomized Controlled Trial Comparative Study
Effect of intraoperative intravenous acetaminophen vs. intramuscular meperidine on pain and discharge time after paediatric dental restoration.
Enteral acetaminophen (paracetamol) has limited analgesic efficacy due to its delayed absorption and sub-therapeutic plasma concentration. Intravenous (i.v.) acetaminophen solves this issue and could thus provide adequate analgesia as a single agent. We compared intraoperative i.v. acetaminophen with intramuscular (i.m.) meperidine with regard to postoperative analgesia and readiness for discharge in paediatric patients undergoing day care dental restoration. ⋯ Compared with i.m. meperidine, intraoperative i.v. acetaminophen resulted in slightly higher pain scores but earlier readiness for recovery room discharge in paediatric patients undergoing dental restoration. The potential economic benefit of early recovery room discharge needs to be further explored.
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Randomized Controlled Trial Comparative Study
Comparison of LMA Unique, Ambu laryngeal mask and Soft Seal laryngeal mask during routine surgical procedures.
This study was performed to compare three disposable airway devices, the LMA Unique (LMA-U), the Ambu laryngeal mask (Ambu LM) and the Soft Seal laryngeal mask (Soft Seal LM) for elective general anaesthesia during controlled ventilation in non-paralysed patients. ⋯ All three disposable devices were clinically suitable with respect to insertion times, success rates, oxygenation, airway and leak pressures, as well as to subjective handling and postoperative airway morbidity.