Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Clinical TrialThe effect, on injection pain, of adding lignocaine to propofol.
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Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Clinical TrialGastric aspiration at the end of anaesthesia does not decrease postoperative nausea and vomiting.
Two hundred and one women undergoing elective abdominal hysterectomy were anaesthetised with isoflurane in nitrous oxide and oxygen. At the end of anaesthesia the stomach was aspirated in half of the patients, selected in random order. In the other half no aspiration was performed. ⋯ Emesis was similar after the operation regardless of aspiration of the stomach (overall emesis, 79% and 70% for those whose stomach had and had not been aspirated, respectively). The incidence at all times during the 24 hours was similar in both groups. The results suggest that gastric aspiration at the end of anaesthesia has no major effect on the incidence or severity of postoperative emesis in patients undergoing abdominal hysterectomy.
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Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialThe perioperative effects of oral premedication in children.
The pre- and postoperative effects of oral diazepam (0.5 mg/kg), trimeprazine (4 mg/kg), pentobarbitone (3 mg/kg) and a placebo were compared in a randomized double-blind clinical trial in 149 children, aged one to ten years, undergoing adenotonsillectomy. The anaesthetic was standardised and each patient received intraoperative intramuscular papaveretum (0.3 mg/kg). ⋯ There were no differences in waking times between the diazepam, pentobarbitone and placebo groups, but the trimeprazine group's waking times were significantly prolonged (P less than 0.001). However, the trimeprazine group exhibited significantly less distress in the recovery unit (P = 0.02) and had half the incidence of vomiting (P less than 0.001) than did the other premedication groups.
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Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Clinical TrialDouble-blind study of the reversal of midazolam-induced sedation in the intensive care unit with flumazenil (Ro 15-1788): effect on weaning from ventilation.
Midazolam (0.1-0.2 mg/kg/hr) and morphine (2 mg/hr) were given by carefully regulated continuous intravenous infusions to thirty patients who required sedation, analgesia and ventilation for between twelve and twenty-four hours in the Intensive Care Unit. The midazolam and morphine infusions were stopped at the end of the period of sedation required and the efficacy of placebo of flumazenil in reversing the sedative effects of midazolam was compared in this double-blind randomised parallel group study. Patients receiving flumazenil were less sedated (P less than 0.05), able to obey commands (P less than 0.05), weaned from ventilation (P less than 0.05) and extubated (P less than 0.05) significantly earlier than those receiving placebo.
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Severe life-threatening hyperkalaemia may occur following administration of suxamethonium during certain periods after burns, neurological injuries, and in certain other conditions. Although this response is well-known, there is disagreement about when it may occur. This review describes the normal hyperkalaemic response to suxamethonium, the factors affecting it, the conditions in which it may be exaggerated, and the periods of high risk.