Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of pretreatment with ketorolac on pain during intravenous injection of propofol.
A randomised, double-blind, controlled trial was undertaken to compare three different methods of reducing pain during the intravenous injection of propofol. In 101 patients undergoing daycase surgery, verbal rating scores for pain during injection of propofol were compared immediately after intravenous pretreatment with ketorolac 10 mg, lignocaine 10 mg or saline. Neither pain during injection (p = 0.129), nor venous sequelae at 7 days postoperatively were significantly different between the three treatments. Pain during propofol injection remains a confounding clinical problem.
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Randomized Controlled Trial Clinical Trial
Antiemetic efficacy of ondansetron with patient-controlled analgesia.
A double-blind, randomised, placebo-controlled study was performed to assess the antiemetic efficacy of ondansetron in women receiving morphine from a patient-controlled analgesia system after total abdominal hysterectomy. Sixty-six ASA grade 1 or 2 patients scheduled for total abdominal hysterectomy were randomly allocated into one of two groups. All patients received a standardised anaesthetic and postoperative patient-controlled analgesia regimen. ⋯ Pain scores, nausea scores, episodes of vomiting, use of rescue antiemetics and recollection of nausea and vomiting were not different between the groups. Only 15% of patients who received ondansetron and 30% of patients who received the placebo recorded no nausea or vomiting in the first 24 h. We conclude that ondansetron, in the dose studied, does not reduce nausea and vomiting in women receiving morphine from a patient-controlled analgesia system after total abdominal hysterectomy.
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Randomized Controlled Trial Clinical Trial
An investigation of the potential morphine sparing effect of midazolam.
The effect of a bolus and continuous infusion of midazolam on postoperative morphine consumption was assessed in a placebo-controlled, double-blind, randomly allocated trial of 50 patients undergoing elective abdominal hysterectomy. Patients in the trial group received a bolus dose of midazolam 5 mg.70 kg-1 at induction followed by an infusion at a rate of 1 mg.70 kg-1.h-1 over the next 48 h. Morphine consumption in the midazolam group was significantly lower in the first 12 h postoperatively (p < 0.02) but there was no significant difference between the two groups thereafter. ⋯ Also, a significantly greater number of patients in the midazolam group required no antiemetic medication over the 48 h study period (p < 0.05). Assessment of sedation revealed no significant difference between groups. We conclude that low dose midazolam has a significant, but short-lived, morphine sparing effect.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal administration of morphine for elective Caesarean section. A comparison between 0.1 mg and 0.2 mg.
This study compared the quality of analgesia and incidence of adverse effects with two doses of intrathecal morphine in patients undergoing elective Caesarean section. Fifty patients were randomly allocated to receive either morphine 0.1 mg or 0.2 mg in addition to a standard intrathecal dose of 2.5 ml bupivacaine 0.5% in 8% dextrose. ⋯ Fewer patients in the 0.1 mg morphine group experienced postoperative nausea and vomiting (7 versus 14, p < 0.05). We conclude that the use of 0.1 mg morphine intrathecally produces comparable analgesia to 0.2 mg after Caesarean section with significantly less nausea and vomiting.