Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialParacetamol 1 g given rectally at the end of minor gynaecological surgery is not efficacious in reducing postoperative pain.
We studied the analgesic effects of 1 g paracetamol given rectally at the end of surgery in a prospective, randomised, double-blind study. ⋯ The routine use of 1 g paracetamol given rectally at the end of surgery after termination of pregnancy seems not to be justified.
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Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialEffect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery.
Acupuncture and acupressure have previously been reported to possess antiemetic effect. We wanted to investigate the "true" and placebo effect of acupressure in prevention of postoperative nausea and vomiting (PONV). ⋯ In patients undergoing brief gynaecological surgery, placebo effect of acupressure decreased nausea after 24 h but vomiting and need of rescue antiemetics was reduced only by acupressure with the correct P6 point stimulation.
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Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialIntra-articular morphine for pain relief after knee arthroscopy.
Peripheral opioid analgesia is well documented. But the clinical usefulness of intra-articular morphine after surgery is uncertain. The aim of the present study was to evaluate the analgesic effects of intra-articular morphine after knee arthroscopy. ⋯ Postoperative analgesic effect of intra-articular morphine was found only in a subgroup of patients with higher pain intensity in the immediate postanaesthetic period. Possible reasons for our overall negative findings include low study sensitivity due to weak pain stimulus, lack of inflammation that may be a prerequisite for peripheral opioid analgesia, and the local anaesthetic, which impedes local inflammatory reaction and expression of peripheral opioid receptors. These factors may also explain the conflicting results in other studies.
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Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialPositive end-expiratory pressure prevents atelectasis during general anaesthesia even in the presence of a high inspired oxygen concentration.
General anaesthesia impairs the gas exchange in the lungs, and moderate desaturation (SaO2 86-90%) occurred in 50% of anaesthetised patients in a blinded pulse oximetry study. A high FiO2 might reduce the risk of hypoxaemia, but can also promote atelectasis. We hypothesised that a moderate positive end-expiratory pressure (PEEP) level of 10 cmH2O can prevent atelectasis during ventilation with an FiO2 = 1.0. ⋯ PEEP = 10 cmH2O reduced atelectasis formation after a VCM, when FiO2 = 1.0 was used. Thus, a VCM followed by PEEP = 10 cmH2O should be considered when patients are ventilated with a high FiO2 and gas exchange is impaired.
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Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialContinuous interscalene brachial plexus block for postoperative analgesia following shoulder surgery.
Severe postoperative pain is a well-known problem following shoulder surgery. This study evaluates the clinical efficacy of continuous interscalene brachial plexus block, patient-controlled analgesia, and morphine (i.v. and i.m.) for postoperative analgesia in this setting. ⋯ Successful continuous interscalene brachial plexus block provides very good pain relief following shoulder surgery and is superior to the other methods studied. However, we were unable to demonstrate a correlation between VAS pain scores and stress indicators in metabolic, circulatory and respiratory parameters.