Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyEffect of 3 g of intravenous paracetamol on post-operative analgesia, platelet function and liver enzymes in patients undergoing tonsillectomy under local anaesthesia.
Paracetamol is often given as an adjunctive analgesic to reduce opioid-related adverse effects but its optimal dose is unknown. We studied the analgesic effect and safety of a single 3-g intravenous (i.v.) dose of paracetamol in adults. ⋯ During the initial hours after tonsillectomy, the administration of 3 g of i.v. paracetamol and 75 mg of diclofenac reduced the consumption of morphine. Both drugs also reduced the release of thromboxane B(2) from activated platelets but only diclofenac had a negative effect on platelet aggregation. In sensitive individuals, large doses of paracetamol may disturb the hepatocellular integrity. We do not recommend the use of i.v. doses of paracetamol higher than 1 g.
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyDetection of tracheal malpositioning of nasogastric tubes using endotracheal cuff pressure measurement.
Insertion of a gastric tube (GT) in anaesthetized, paralyzed and intubated patients may be difficult. Tracheobronchial malposition of a GT may result in deleterious consequences. The purpose of this study was to determine the reliability of tracheal cuff pressure measurement to detect endobronchial malposition of GTs. We compared this new method with the measurement of exhaled CO(2) through the GT. ⋯ In intubated patients, cuff pressure measurement during insertion of a gastric tube is a new, simple and reliable bedside method to detect endotracheal malpositioning of a GT.
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyPrevention of withdrawal movement associated with injection of rocuronium in children: comparison of remifentanil, alfentanil and fentanyl.
We compared the efficacy of remifentanil, alfentanil and fentanyl in reducing withdrawal movement associated with the injection of rocuronium in children. ⋯ Remifentanil, alfentanil and fentanyl all reduced the incidence of withdrawal movement when administered 90 s before the injection of rocuronium compared with saline. Remifentanil was the most effective, followed by alfentanil. Fentanyl was less effective but significantly different from the saline in reducing withdrawal movement in children.
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyMethylprednisolone and ketorolac rapidly reduce hyperalgesia around a skin burn injury and increase pressure pain thresholds.
Glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) decrease acute postoperative pain and hyperalgesia. The objectives of this study were to investigate the effects of methylprednisolone and ketorolac on hyperalgesia around a skin burn injury and on pressure pain thresholds. ⋯ Methylprednisolone and ketorolac increased PPTT attenuated secondary hyperalgesia around a skin burn injury. PPTT increased after both methylprednisolone and ketorolac. The present study demonstrates analgesic and anti-hyperalgesic properties of a glucocorticoid and a non-selective NSAID that have not been demonstrated previously in human subjects.
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled TrialBowel function after bowel surgery: morphine with ketamine or placebo; a randomized controlled trial pilot study.
Morphine decreases gut peristalsis, and ketamine decreases morphine use after surgery, and does not slow peristalsis. Thus, the combination should result in faster return of bowel function after surgery than morphine alone. ⋯ Low-dose ketamine was not efficacious for hastening return of bowel function, or for decreasing post-operative pain after surgery for bowel resection. It resulted in hallucinations in some patients. Those reporting hallucinations all wished to remain in the study.