Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Epidural ketamine reduces post-operative epidural PCA consumption of fentanyl/bupivacaine.
To study the analgesic effect of epidural ketamine on postoperative pain and epidural PCA consumption after total abdominal hysterectomy. ⋯ Epidural ketamine 30 mg reduces post hysterectomy pain as evidenced by prolongation of time to first analgesia request and reduction in postoperative epidural PCA consumption. This effect is manifest whether ketamine is given before induction or 20 min after skin incision.
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Randomized Controlled Trial Clinical Trial
Prevention of PONV with granisetron, droperidol or metoclopramide in patients with postoperative emesis.
A high incidence of postoperative nausea and vomiting (PONV) has been noted in patients with a history of postoperative emesis. This study was undertaken to compare the efficacy of granisetron, droperidol and metoclopramide, in the prevention of PONV in such patients undergoing general anaesthesia for major gynaecological surgery. ⋯ Granisetron is more effective than droperidol or metoclopramide in preventing PONV in female patients with a history of postoperative emesis.
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Randomized Controlled Trial Clinical Trial
Awake removal of the laryngeal mask airway is safe in paediatric patients.
It has been suggested that it is safer to remove the Laryngeal Mask Airway (LMA) in paediatric patients when they are deeply anaesthetised than when they are awake. However, the evidence regarding this recommendation is contradictory. The purpose of the study was to compare the incidence of complications (laryngeal spasm, bronchospasm, coughing, retching, excessive salivation and oxygen desaturation) associated with removal of the LMA in children. ⋯ There was no difference in the incidence of airway complications whether the LMA was removed in the anaesthetised or the awake child.
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To measure the haemodynamic effects of rocuronium in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ The haemodynamic profile for a 0.6 mg.kg-1 bolus of rocuronium is acceptable for patients with cardiovascular disease.
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Case Reports
Long-term epidural ketamine, morphine and bupivacaine attenuate reflex sympathetic dystrophy neuralgia.
There is considerable evidence that NMDA receptor antagonists can abolish nociceptor hypersensitivity in animals. In the present case report, two patients with reflex sympathetic dystrophy were treated with ketamine, a NMDA antagonist, morphine and bupivacaine. ⋯ Epidural coadministration of low doses of morphine, ketamine and bupivacaine provided effective pain relief in two patients. This suggests synergy from this combination that provides an alternative treatment for reflex sympathetic dystrophy.