Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Gastric fluid volume and pH in elective inpatients. Part II: Coffee or orange juice with ranitidine.
In order to assess the effect of preoperative oral fluids, with and without ranitidine, on gastric fluid volume and pH 300 elective surgical inpatients, ASA physical status I and II, were randomly allocated to one of six groups. The three ranitidine groups (Groups 4, 5, and 6) are discussed in this paper (Part II), and the three placebo groups (Groups 1, 2, and 3) in Part I. Between two and three hours before the scheduled time of surgery, patients received 150 ml coffee with oral ranitidine 150 mg (Group 4), 150 ml orange juice with oral ranitidine 150 mg (Group 5), or oral ranitidine alone (Group 6). ⋯ The volume of residual gastric fluid, which was aspirated into a 60 ml syringe, was recorded, and its pH was measured. There were no statistically significant differences between groups with respect to volume (Group 4: 14.3 +/- 15.4; Group 5: 14.8 +/- 17.0; Group 6: 9.7 +/- 12.6 ml). The mean pH in all groups was greater than 5.40 (Group 4: 5.65 +/- 2.12; Group 5: 5.41 +/- 2.12; Group 6: 6.21 +/- 1.51).
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Randomized Controlled Trial Clinical Trial
Priming with nondepolarizing relaxants for rapid tracheal intubation: a double-blind evaluation.
Results of a series of controlled, randomized, double-blind trials investigating intubation conditions with priming sequences of nondepolarizing relaxants are reported. In Phase I of the study the groups received: Group A, tubocurarine (DTC) 3 mg + succinylcholine 1.5 mg.kg-1, Group B, atracurium 0.05 mg.kg-1 + 0.35 mg.kg-1, Group C, vecuronium, 0.01 mg.kg-1 + 0.07 mg.kg-1; in Phase II: Group D, no relaxant, Group E, DTC 0.05 mg.kg-1 + vecuronium 0.07 mg.kg-1, Group F, vecuronium 0.01 mg.kg-1 + vecuronium 0.12 mg.kg-1; in Phase III, Group G, DTC 3 mg + succinylcholine 1.5 mg.kg-1, Group H, vecuronium 0.01 mg.kg-1 + 0.09 mg.kg-1, Group I vecuronium 0.1 mg.kg-1 as a single bolus. Intubation conditions were assessed at 60 seconds. ⋯ Priming produced significantly better intubating conditions than an equivalent single bolus; however, intubating conditions with priming did not appear to match the uniformly excellent conditions produced by succinylcholine. The data suggest that a four-minute priming interval is as effective as a seven-minute interval. The results of this study differed substantially from previous unblinded studies; therefore, it is suggested that a randomized, double-blind design with simultaneous succinylcholine controls be considered a prerequisite for future studies of intubation conditions.
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Randomized Controlled Trial Clinical Trial
Gastric fluid volume and pH in elective inpatients. Part I: Coffee or orange juice versus overnight fast.
In order to assess the effect of preoperative oral fluids, with and without ranitidine, on gastric fluid volume and pH, 300 elective surgical inpatients, ASA physical status I or II, were randomly assigned to one of six groups. The three groups that received placebo are discussed in this paper, Part I, and the three that received ranitidine in Part II. Between two and three hours before the scheduled time of surgery patients received either 150 ml coffee (Group 1), or 150 ml orange juice (Group 2), while the control group continued their overnight fast (Group 3). ⋯ Immediately following induction of anaesthesia the residual gastric fluid was obtained by suction on a nasogastric tube and its volume and pH measured. Residual gastric fluid volumes showed no statistically significant differences among the groups (Group 1: 24.5 +/- 21.6 ml; Group 2: 23.7 +/- 18.4 ml; Group 3: 23.2 +/- 17.3 ml; p greater than 0.1). Values for pH among the groups were also similar (Group 1: 2.18 +/- 1.58; Group 2: 1.95 +/- 1.24; Group 3: 1.95 +/- 1.62; p greater than 0.1).
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Clinical Trial Controlled Clinical Trial
Priming with anti-cholinesterases--the effect of different combinations of anti-cholinesterases and different priming intervals.
This study was designed to investigate the effect of different combinations of neostigmine and edrophonium when administered in divided doses and the effect of different intervals (priming intervals) between the doses. Seventy-two patients divided into 12 groups (n = 6 in each) were included in the study. An initial dose of neostigmine 0.012 mg.kg-1 or edrophonium 0.2 mg.kg-1 was administered, followed at different priming intervals (1, 2 or 3 min) by either edrophonium 0.8 mg.kg-1 or neostigmine 0.048 mg.kg-1 for antagonism of atracurium-induced neuromuscular blockade. ⋯ Recovery indices and reversal times were found to be significantly shorter (p less than 0.05) with a 1 min priming interval. In two additional groups of patients premedicated and anaesthetized as the others equipotent mixtures of the antagonists were administered as a single bolus dose. Reversal times were significantly longer (p less than 0.05) when compared to those given the same amounts of the combination but in divided doses with a 1 min priming interval.(ABSTRACT TRUNCATED AT 250 WORDS)