Anaesthesia
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Randomized Controlled Trial Clinical Trial
Efficacy of ondansetron and metoclopramide for preventing postoperative emesis following strabismus surgery in children.
A double-blind, randomised, placebo-controlled trial was conducted to compare the efficacy of metoclopramide with the 5-HT3 antagonist, ondansetron, for the prevention of postoperative emesis in children undergoing elective strabismus surgery. None of the children received any premedication and a similar anaesthetic technique was used for all. Ondansetron 0.15 mg.kg-1, metoclopramide 0.25 mg.kg-1 or saline placebo were administered following intravenous catheter placement. ⋯ Recovery room scores were comparable in all the groups. No serious side-effects were observed in the ondansetron group. We conclude that prophylactic ondansetron is effective and superior to metoclopramide in the prevention of postoperative emesis in children following elective strabismus surgery.
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A case of complete uterine rupture during a trial of labour in which epidural analgesia was used is described. The pain of uterine rupture was not masked by the addition of fentanyl 25 micrograms to bupivacaine 0.25% 6 ml but was relieved by bupivacaine 0.375% 6 ml.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of midazolam with trimeprazine as an oral premedicant for children.
The effect of oral premedication was investigated in a double-blind, randomised trial in 85 children undergoing tonsillectomy and/or adenoidectomy. Orally administered midazolam 0.5 mg.kg-1 given 30 min pre-operatively was compared with trimeprazine 2 mg.kg-1 given 90 min pre-operatively and a placebo preparation. Compliance, sedation and ease of induction were assessed as were the duration and quality of recovery. ⋯ More patients were calm and quiet on arrival in the anaesthetic room following midazolam than following trimeprazine, with both premedicant agents comparing favourably with placebo. There was no significant difference between the three groups in the time to recovery or the sedation score on discharge to the ward. Midazolam is a safe and effective oral premedicant for children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single-breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: a feasibility study in adults and comparison with an intravenous bolus of propofol.
The induction characteristics of sevoflurane in nitrous oxide and oxygen were compared with sevoflurane in oxygen alone and a propofol infusion. A vital capacity technique was used for the gaseous induction groups using a Mapleson A system and a 4-litre reservoir bag. Four end-points of anaesthesia were recorded: time to cessation of finger tapping, time to loss of eyelash reflex, time to jaw relaxation and time to regular settled breathing after laryngeal mask airway insertion. ⋯ There were few adverse airway events in any group and none caused oxygen saturation to fall below 96%. There was more excitation in the gaseous induction groups, though this did not interfere with induction. Patient satisfaction with induction was high.
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Clinical Trial Controlled Clinical Trial
Oxygenation of patients undergoing ophthalmic surgery under local anaesthesia.
The oxygenation of 30 patients undergoing elective ophthalmic surgery without sedation whilst breathing air was studied and was compared with two methods of oxygen supplementation. Arterial oxygen saturation, inspired and expired oxygen and carbon dioxide were analysed. The delivery of oxygen at 21.min-1 via nasal cannulae was shown to be superior to a method which directed oxygen from under the surgical drapes.