Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Additional droperidol, not butorphanol, augments epidural fentanyl analgesia following anorectal surgery.
To examine the effects of additional droperidol or butorphanol to epidural fentanyl infusion on postsurgical analgesia. ⋯ In this study population, additional droperidol, not butorphanol, improved postsurgical analgesia accompanied by less incidence of nausea/vomiting during epidural fentanyl administration.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Pooled analysis of three large clinical trials to determine the optimal dose of dolasetron mesylate needed to prevent postoperative nausea and vomiting. The Dolasetron Prophylaxis Study Group.
To identify the maximally effective dolasetron dose (i.e., maximum efficacy with minimum adverse events) for prevention of postoperative nausea and vomiting (PONV) using the statistical power generated in a pooled patient sample from three large, nearly identical clinical trials. ⋯ Dolasetron 12.5 mg, given near the end of anesthesia, is the maximally effective dose studied for preventing postoperative nausea and vomiting.
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Randomized Controlled Trial Comparative Study Clinical Trial
Influence of intravenous clonidine pretreatment on anesthetic requirements during bispectral EEG-guided sevoflurane anesthesia.
To assess the anesthetic effects of clonidine during sevoflurane anesthesia guided by the bispectral index (BIS), which is a processed EEG variable correlated with anesthetic-hypnotic depth. ⋯ Mean sevoflurane requirements were not lower with clonidine pretreatment. There was statistically better perioperative hemodynamic stability (i.e., fewer episodes of hypertension and tachycardia) without clinical relevance. A decreased need for postoperative analgesia was observed.
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Case Reports
An anteromedial internal jugular vein successfully cannulated using the assistance of ultrasonography.
The internal jugular vein usually is found either lateral or anterolateral to the carotid artery when it is cannulated for central vein access using external anatomical landmarks. We report a case in which the carotid artery was inadvertently punctured, but the right internal jugular vein could not be found. ⋯ A figure showing the ultrasound of this rare anatomical variation is provided. The advantages and utility of ultrasound when used for the placement of internal jugular central vein catheters are reviewed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of oral clonidine premedication on side effects of intravenous ketamine anesthesia: a randomized, double-blind, placebo-controlled study.
To determine the effects of oral clonidine premedication on hemodynamic changes during the entire course of ketamine anesthesia and incidence of postoperative adverse reactions. ⋯ Oral clonidine 2.5 micrograms/kg and clonidine 5 micrograms/kg attenuates cardiostimulatory effects, while clonidine 5 micrograms/kg was associated with reduced incidence and severity of nightmare and salivation attributable to i.v. ketamine.