Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialMorphine for postoperative analgesia. A comparison of intramuscular and subcutaneous routes of administration.
Intermittent parenteral bolus doses of morphine are commonly used for postoperative analgesia. Morphine is typically given by intramuscular or intravenous injection but there are theoretical advantages for the subcutaneous route of administration. Fifty-nine patients entered a prospective randomized double-blind cross-over study comparing intermittent intramuscular and subcutaneous morphine boluses. ⋯ The majority of patients indicated a strong preference for the subcutaneous route. There were no significant differences in pain scores, respiratory rate, arterial oxygen saturation, heart rate, mean arterial pressure, sedation or nausea scores between intramuscular and subcutaneous administration of morphine. Postoperative analgesia by subcutaneous morphine bolus injection is as effective as intramuscular injection with a similar side-effect profile but with greater patient acceptance and less risk.
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Anaesth Intensive Care · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of isoflurane, halothane and fentanyl in patients with decreased ejection fraction undergoing coronary surgery.
The aim of the study was to compare three anaesthetic agents in patients with ejection fraction below 0.40 subjected to coronary revascularization surgery. Twenty five elective coronary surgical patients with ejection fraction below 0.40 were prospectively studied. Premedication was pethidine 1 mg/kg and induction was fentanyl 0.03 mg/kg and pancuronium 0.1 mg/kg. ⋯ Neither pressure nor flow decreased in patients receiving fentanyl. Following weaning from cardiopulmonary bypass, systemic vascular resistance decreased significantly in all groups. Cardiac index, however, did not increase above control values and arterial pressure consequently decreased; there was no significant difference between groups.
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Anaesth Intensive Care · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe prophylactic antiemetic efficacy of prochlorperazine and ondansetron in nasal septal surgery: a randomized double-blind comparison.
A prospective, randomized placebo-controlled study was undertaken to compare the effects on heart rate and blood pressure during surgery and on the incidence of nausea, vomiting and headache after surgery of i.m. prochlorperazine 0.2 mg.kg-1, i.v. prochlorperazine 0.1 mg.kg-1 and i.v. ondansetron 0.06 mg.kg-1 given at induction of general anaesthesia to patients undergoing septorhinoplasty. The effects of the test drugs after administration on heart rate and blood pressure were similar, as were the incidences of retching and vomiting in the recovery ward after each test drug. Postoperatively, compared with placebo (7%), nausea per se was most frequent in those given i.v. prochlorperazine (25%, P < 0.01), and less frequent in those given i.m. prochlorperazine (2%) and i.v. ondansetron (15%). ⋯ I.m. prochlorperazine and i.v. ondansetron increased the frequency (from 35% to 64%, P < 0.0005 and to 71%, P < 0.0005, respectively) of those experiencing no PONV and delayed the onset of PONV, but only i.m. prochlorperazine reduced the severity of postoperative vomiting. Headache was frequent in the control (69%), i.v. prochlorperazine (62%) and i.v. ondansetron (69%) groups, and least frequent after i.m. prochlorperazine (53%; P < 0.05 versus i.v. ondansetron). It is concluded that these drugs have no adverse cardiovascular effects within 10 minutes of administration, i.m. prochlorperazine and i.v. ondansetron reduce PONV more effectively than i.v. prochlorperazine and postoperative headache after septorhinoplasty occurs less frequently in those given i.m. prochlorperazine than in those given i.v. ondansetron.