Anaesthesia
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Randomized Controlled Trial Multicenter Study Clinical Trial
The effect of oral ondansetron in the prevention of postoperative nausea and vomiting after major gynaecological surgery performed under general anaesthesia.
The efficacy and safety of ondansetron in preventing postoperative nausea and vomiting following major gynaecological surgery was evaluated in this multicentre, double-blind study. A total of 243 patients were randomised to receive three doses of oral ondansetron 8 mg or matching placebo at 8-hourly intervals, with the first dose being given an hour before surgery. A standard general anaesthetic technique was employed throughout. ⋯ Of the 237 patients evaluated for efficacy, significantly fewer ondansetron 8 mg treated patients (65/117; 56%) experienced postoperative nausea and/or vomiting compared with placebo-treated patients (94/120; 78%) during the study period (p < 0.001). In addition, ondansetron 8 mg reduced the severity of nausea (p < 0.001) and the total number of vomiting episodes experienced (p < 0.001). Overall, ondansetron 8 mg was well tolerated and effective in preventing postoperative nausea and vomiting in this surgical setting.
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Two groups of adult patients (55 each) were visited pre-operatively by an anaesthetist who was dressed either formally or casually. Their response to this visit, their opinions regarding anaesthetists and their knowledge of anaesthetic work were elicited afterwards by means of a questionnaire. ⋯ The anaesthetist was awarded a high level of prestige and the length of his/her training was recognised to be comparable to that of other professionals; 81.8% of patients thought that anaesthetists held a medical degree but only 35.4% thought that they worked in the intensive care unit. Patients expressed a preference for doctors to wear name tags, white coats and short hair but disapproved of clogs, jeans, trainers and earrings.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the laryngeal mask airway and Guedel airway, bag and facemask for manual ventilation following formal training.
Ten volunteers, with no previous experience of resuscitation, were formally trained in the use of the laryngeal mask airway and the oropharyngeal airway (Guedel), bag and facemask for manual ventilation of the lungs in 104 fit, anaesthetised adults. They then used both airways in turn. ⋯ Success rates for the laryngeal mask airway and the Guedel airway, bag and facemask were 87% and 43% respectively (p < 0.001) and the average insertion times were 27.4 s (SEM 1.5) and 15.8 s (SEM 0.50) (no significant difference), respectively. The laryngeal mask airway proved to be easier to use for manual ventilation than the Guedel airway, bag and mask for inexperienced personnel who had received a period of formal training in both techniques.