Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Acupuncture versus ondansetron in the prevention of postoperative vomiting. A study of children undergoing dental surgery.
This study compares the anti-emetic effect of acupuncture with that of ondansetron and a placebo. Ninety children undergoing dental treatment under general anaesthesia were randomly allocated to one of the three equal groups, to receive acupuncture needle insertion, intravenous ondansetron 0.15 mg x kg(-1) or a placebo. ⋯ A significant difference was also found between the treatment groups and the placebo group with respect to parental satisfaction score (p < 0.03). We conclude that traditional Chinese acupuncture is a valid non-pharmacological alternative anti-emetic treatment that can be recommended as a prophylactic technique in children undergoing dental surgery under general anaesthesia.
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Randomized Controlled Trial Clinical Trial
Effect of nitrous oxide on the bispectral index and the 95% spectral edge frequency of the electroencephalogram during surgery.
We studied the effect of nitrous oxide on the bispectral index and 95% spectral edge frequency of the electroencephalogram in 20 patients undergoing lumbar surgery under general anaesthesia combined with epidural administration of 5 mg morphine. Anaesthesia was induced with propofol and sufentanil, and maintained with sevoflurane in air/oxygen adjusted to keep the bispectral index between 40 and 60. ⋯ A negative correlation was found between nitrous oxide concentration and bispectral index (r = -0.48; p < 0.01) and spectral edge frequency (r = -0.39; p < 0.05). We conclude that this dose-dependent decrease in bispectral index and spectral edge frequency induced by nitrous oxide may reflect the level of analgesia associated with the anaesthetic regimen.
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Review Case Reports
Compartment syndrome associated with the Lloyd Davies position. Three case reports and review of the literature.
The Lloyd Davies position was developed to facilitate access to the pelvis for gynaecological, urological and colorectal procedures. Previous case reports have demonstrated that prolonged adoption (> 4 h) of this position has been associated with the development of bilateral compartment syndrome of the calves. All three patients reported here suffered severe bilateral calf pain despite the use of thoracic epidurals. ⋯ These case reports stress the dangers of use of the Lloyd Davies position for prolonged procedures and demonstrate that some patients are at risk after relatively short periods (< 3 h). Previous case reports and clinical studies have focused on the effect of limb elevation in stirrups on the arterial pressure in the lower limb. We review the pathophysiology of compartment syndrome and consider factors other than a decrease in arterial pressure that may predispose to compartment syndrome during adoption of the Lloyd Davies position.
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Randomized Controlled Trial Clinical Trial
Bloodletting acupuncture for the prevention of stridor in children after tracheal extubation: a randomised, controlled study.
Bloodletting acupuncture has been used for the treatment of a variety of upper respiratory tract problems, especially those of laryngeal origin. This study assesses its efficacy in reducing the incidence of stridor after tracheal extubation in children undergoing general anaesthesia with halothane. Sixty children were randomly allocated to an acupuncture group and a control group. ⋯ The incidence of stridor in the acupuncture group was significantly higher than in the control group. In addition, the severity of stridor was significantly greater in the acupuncture group. It is concluded that in children undergoing halothane anaesthesia, the incidence of postextubation stridor cannot be reduced by bloodletting acupuncture.