The Journal of international medical research
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Editorial Randomized Controlled Trial Comparative Study
A randomized, double-blind trial of palonosetron compared with ondansetron in preventing postoperative nausea and vomiting after gynaecological laparoscopic surgery.
This randomized, double-blind study evaluated the relative efficacy of palonosetron (a new, selective 5-hydroxytryptamine type 3 [5-HT(3)] receptor antagonist) and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing gynaecological laparoscopic surgery. Patients received either palonosetron 0.075 mg (n = 45) or ondansetron 8 mg (n = 45), intravenously, immediately before induction of general anaesthesia. ⋯ There were no significant statistical differences in the visual analogue scale for nausea. In conclusion, palonosetron 0.075 mg was more effective than ondansetron 8 mg in preventing PONV.
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Randomized Controlled Trial
Intravenous lidocaine for effective pain relief after inguinal herniorrhaphy: a prospective, randomized, double-blind, placebo-controlled study.
This prospective, randomized, double-blind, placebo-controlled study evaluated the effectiveness of intravenous lidocaine to reduce post-operative pain in 64 inguinal herniorrhaphy patients. Intravenous bolus injection of 1.5 mg/kg lidocaine followed by a continuous lidocaine infusion of 2 mg/kg per h was randomly assigned to 32 patients (lidocaine group) and intravenous normal saline bolus injection followed by infusion of normal saline was assigned to 32 other patients (control group). ⋯ Total fentanyl consumption (patient-controlled plus investigator-controlled rescue administration) and the total number of button pushes were significantly lower in the lidocaine group than in the control group. It is concluded that intravenous lidocaine injection reduced post-operative pain after inguinal herniorrhaphy, is easy to administer and may have potential to become routine practice for this type of surgery.
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This study investigated 151 patients undergoing cardiac surgery to determine whether measurement of regional cerebral oxygen saturation (rS(c)O(2)) using near-infrared spectroscopy (NIRS) can indicate a low haematocrit after initiation of hypothermic cardiopulmonary bypass (CPB). Haematocrit, rS(c)O(2), haemoglobin level, arterial partial pressures of carbon dioxide and oxygen, systemic blood pressure, and nasopharyngeal and rectal temperatures were determined 5 min after the initial administration of heparin for CPB and 90 s after completion of the first cardioplegic solution injection. ⋯ No significant correlations were found between the change in haematocrit and changes in left, right and mean rS(c)O(2); thus, changes in rS(c)O(2) before and after initiation of hypothermic CPB did not reflect changes in haematocrit values. This indicates that NIRS cannot provide early warning of a low haematocrit immediately after initiation of hypothermic CPB in cardiac surgery.
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Randomized Controlled Trial
Effects of a priming dose of fentanyl during anaesthesia on the incidence and severity of fentanyl-induced cough in current, former and non-smokers.
Fentanyl is commonly used during anaesthesia and can cause fentanyl-induced cough (FIC). This study investigated whether a priming dose of fentanyl reduced FIC, and determined the factors associated with increased risk of FIC. Subjects undergoing elective surgery under general anaesthesia (n = 800) were randomized into four groups: group 1 received 2 μg/kg fentanyl bolus; groups 2, 3 and 4 received a priming dose of fentanyl 0.5 μg/kg followed by 1.5 μg/kg after 1, 2 or 3 min, respectively. ⋯ Former smokers were 2.91 times more likely than current smokers to experience cough. A fentanyl priming dose did not reduce the incidence and severity of FIC. Former smokers were hyper-reactive to fentanyl compared with current smokers.
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Little is known about the impact of early invasive treatment in patients following out-of-hospital cardiac arrest (OHCA). The present study investigated the clinical characteristics and long-term prognosis of 1254 patients with suspected acute coronary syndrome, including 65 with OHCA who underwent successful cardiopulmonary resuscitation (CPR) and 1189 patients who did not require CRP. All patients underwent immediate coronary angiography even if clear signs of myocardial infarction (MI) were absent. ⋯ Cardiac biomarkers were significantly higher in CPR patients despite a shorter period from symptom onset to admission. The 6-month mortality rate was 29% in the CPR group and 4% in the non-CPR group, with > 90% of fatalities occurring ≤ 3 weeks after admission. In summary, early invasive treatment leads to a considerably reduced mortality and improved prognosis in patients after OHCA.