European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of the antiemetic efficacy of ondansetron, propofol and midazolam in the early postoperative period.
To compare the antiemetic efficacy of ondansetron with two different hypnotic drugs (propofol 15 mg, midazolam 1 and 2 mg) for the treatment of established postoperative nausea and vomiting (PONV). ⋯ Propofol and midazolam used in subhypnotic doses were as effective as ondansetron in treating PONV in patients undergoing abdominal or gynaecological surgery without untoward sedative or cardiovascular effects.
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Comparative Study Clinical Trial
EEG-based indices of anaesthesia: correlation between bispectral index and patient state index?
Both the bispectral and the patient state indices are derived from the electroencephalogram and have been proposed as a measure of the same clinical target, the hypnotic component of anaesthesia. The present study evaluated whether there is concordance between the bispectral and the patient state indices with regard to end-points measured simultaneously in patients undergoing surgery under general anaesthesia. ⋯ Concordance between the bispectral and patient state indices is relatively weak, whereas both are thought to reflect the same clinical target, the hypnotic component of anaesthesia. As a consequence, further studies are required to compare reliability of both indices as indicators of different levels of hypnosis.
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Perioperative brain protection refers to prophylactic measures instituted during the perioperative period to prevent or reduce ischaemic damage and to improve neurological outcome. In that context, strategies for protecting the brain rely on the control of physiological variables, anaesthesia, administration of non-anaesthetic pharmacological agents and preconditioning. Avoiding hyperthermia, hyperglycaemia and arterial hypotension are passive neuroprotective measures acknowledged in human beings. ⋯ Laboratory studies investigating pharmacological neuroprotection have shown interesting results but most clinical trials have been disappointing except for a few drugs in specific settings. Preconditioning which results in the induction of some resistance to ischaemia appears as a promising strategy. Up to now, the translation of beneficial experimental results into clinical success is considered an entirely permissible hope but remains an unachieved objective.
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Randomized Controlled Trial Clinical Trial
Sub-Tenon's block reduces both intraoperative and postoperative analgesia requirement in vitreo-retinal surgery under general anaesthesia.
We compared the effects of sub-Tenon's local anaesthetic block and placebo on peri-operative opioid requirement and cardiovascular stability and on postoperative pain, nausea and vomiting in patients undergoing vitreo-retinal surgery under general anaesthesia. ⋯ This local anaesthetic technique is effective in vitreo-retinal surgery and can be safely applied to this population of patients regardless of axial length.
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Letter Randomized Controlled Trial Clinical Trial
Morphine-sparing effect of nefopam by continuous intravenous injection after abdominal surgery by laparotomy.