Anaesthesia
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Randomized Controlled Trial Clinical Trial
Oral midazolam premedication for day case breast surgery, a randomised prospective double-blind placebo-controlled study.
We conducted a randomised prospective double-blind placebo-controlled study to assess the efficacy of oral midazolam premedication in 50 ASA I and II female patients scheduled to undergo day case breast surgery. Anxiety was assessed using 100-mm visual analogue scales (VAS) and The State-Trait Anxiety Inventory (STAI) psychometric questionnaire. ⋯ Arterial desaturation during induction of anaesthesia and insertion of a laryngeal mask airway occurred more often in patients who received placebo (p = 0.022). There was a good correlation between VAS and STAI used to assess the anxiolytic effects of premedication. (Spearman coefficient 0.58, p < 0.0001).
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Randomized Controlled Trial Clinical Trial
Fenoldopam: renal and splanchnic effects in patients undergoing coronary artery bypass grafting.
Impairment of renal and splanchnic perfusion during and after cardiopulmonary bypass may be responsible for acute renal failure and endotoxin-mediated systemic inflammation, respectively. We hypothesised that fenoldopam, a selective dopamine receptor agonist, would preserve renal function after cardiopulmonary bypass through its selective renal vasodilatory and natriuretic effects, and increase gastrointestinal mucosal perfusion by selective splanchnic vasodilation. We examined the effects of fenoldopam on haemodynamic parameters, creatinine clearance, fractional excretion of sodium, urine output, free water clearance and gastric mucosal pH in 31 patients undergoing elective coronary revascularisation. ⋯ In the placebo group, but not the fenoldopam group, mean (SD) creatinine clearance decreased after separation from cardiopulmonary bypass, from 107 (36) to 71 (22) ml x min(-1) (p < 0.01) and from 107 (36) to 79 (26) ml x min(-1) (p < 0.01) for the 0-4 h and 4-8 h intervals after cardiopulmonary bypass, respectively. Changes in intramucosal pH were similar in both groups. The findings are consistent with the hypothesis that fenoldopam possesses a renoprotective effect in patients undergoing cardiopulmonary bypass.
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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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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.