European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
The effects of sufentanil or morphine added to hyperbaric bupivacaine in spinal anaesthesia for caesarean section.
The quality of spinal anaesthesia, often used for Caesarean section, can be improved by adding an opioid to the local anaesthetic. This study compared the quality of anaesthesia, postoperative analgesia, and adverse effects on mother and neonate when either sufentanil 5 microg or morphine 0.2 mg was added to intrathecal hyperbaric bupivacaine for Caesarean section. ⋯ The addition of 5 microg sufentanil or 0.2 mg morphine to hyperbaric bupivacaine for Caesarean section both provided safe and effective anaesthesia. Morphine increased the duration of postoperative analgesia compared with sufentanil without increasing maternal or neonatal side-effects.
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Randomized Controlled Trial Comparative Study
Double- vs. single-injection infraclavicular plexus block in the emergency setting: higher success rate with lower volume of local anaesthetic.
Infraclavicular plexus block has many advantages of particular interest in the emergency setting. However, the number of nerve stimulations needed to optimize the technique remains unclear. We evaluated both the local anaesthetic requirement and the success rate of Sim's derived infraclavicular plexus block performed with a nerve stimulator when either one or two responses were sought. ⋯ We conclude that only 30 mL of local anaesthetic seems to be sufficient to ensure a high level of success when performing an infraclavicular block with stimulation of both the musculocutaneous nerve and median, ulnar or radial nerve.
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Comparative Study
The effect of a remifentanil bolus on the bispectral index of the EEG (BIS) in anaesthetized patients independently from intubation and surgical stimuli.
Remifentanil boluses are used in different clinical situations and the effects on bispectral index monitoring are unclear. We analysed the effect of a remifentanil bolus on the bispectral index of the electroencephalogram (bispectral index) under total intravenous anaesthesia with propofol and remifentanil. ⋯ There was a significant reduction in the areas under the curve between 90-120 s following the bolus. Heart rate and blood pressure also showed significant reductions. Thus, remifentanil bolus given under total intravenous anaesthesia with propofol and remifentanil decreases bispectral index, an effect independent of intubation and surgical stimuli.
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Randomized Controlled Trial Comparative Study
A randomized, prospective double-blind comparison of the efficacy of generic propofol (sulphite additive) with diprivan.
We compared the dose requirement and side effect profile of total intravenous anaesthesia using Diprivan to generic propofol at a specific anaesthetic target level utilizing the bispectral index monitor to determine efficacy differences between the two products. ⋯ Diprivan and generic propofol have similar efficacy at a specified, bispectral index-defined, depth of anaesthesia.
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Randomized Controlled Trial Comparative Study
Esomeprazole for the prevention of postoperative nausea and vomiting. A randomized, placebo-controlled trial.
Postoperative nausea and vomiting still represents a major problem after surgery. Although risk factors for postoperative nausea and vomiting and procedures to reduce postoperative nausea and vomiting have been described, the incidence of postoperative nausea and vomiting remains high. The aim of the present study was to investigate the potential role of the proton pump inhibitor esomeprazole to reduce postoperative nausea and vomiting after elective surgery. ⋯ There is no evidence that prophylactic esomeprazole reduces the incidence of postoperative nausea and vomiting or the degree of postoperative nausea.