Anaesthesia
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Randomized Controlled Trial Clinical Trial
The anti-emetic efficacy of a combination of ondansetron and droperidol.
The anti-emetic efficacy of a combination of ondansetron 8 mg with either droperidol 0.75 mg or 1.25 mg given prophylactically was studied in a randomised blinded trial of 94 female inpatients with a previous history of postoperative nausea and vomiting and scheduled to have laparoscopic surgery. A standardised general anaesthetic technique was used for all patients. The mean estimated risk of postoperative sickness according to predictive patient characteristics was 65% for both treatment groups. ⋯ No serious adverse events were observed. Ondansetron in combination with droperidol 0.75 mg resulted in less drowsiness than in combination with 1.25 mg (p = 0.03). In conclusion, a prophylactic combination treatment of ondansetron 8 mg with a small dose of droperidol was clinically effective and well tolerated for the prevention of postoperative nausea and vomiting after laparoscopic surgery in patients with a high probability of nausea and vomiting.
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We report a case where two consecutive blood patches failed to relieve postdural puncture headache and hearing loss following inadvertent dural puncture. Initial conservative therapy with analgesics, fluids and later two blood patches had no effect and the patient's symptoms only resolved after an epidural dextran 40 patch performed 8 weeks after the dural tap. Two months later, the patient is still asymptomatic.
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Randomized Controlled Trial Clinical Trial
Addition of adrenaline to pethidine for epidural analgesia after caesarean section.
We have investigated the addition of adrenaline to epidural pethidine for postoperative analgesia in 40 patients after Caesarean section. In a randomised, double-blind study, patients received pethidine 25 mg with adrenaline 50 micrograms (adrenaline group, n = 20) or pethidine 25 mg without adrenaline (plain group, n = 18) epidurally at the first request for postoperative analgesia. ⋯ Visual analogue scale pain scores in the first 30 min after injection and onset of analgesia, defined by the time for pain scores to decrease by 50%, were similar between groups. Addition of adrenaline to epidural pethidine has advantages for analgesia after Caesarean section.