Der Anaesthesist
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Randomized Controlled Trial Clinical Trial
Mivacurium or vecuronium for paediatric ENT surgery. Clinical experience and cost analysis.
The present study compared the quality of neuromuscular block and costs after equipotent doses of mivacurium and vecuronium in the context of paediatric ENT surgery. ⋯ In conclusion, mivacurium-induced NMB is of very short duration in paediatric patients, and therefore repetitive doses are required to maintain a deep neuromuscular block. Nevertheless, residual paralysis is less frequent after mivacurium. The neuromuscular block after mivacurium was more expensive and residual paralysis less frequent compared to vecuronium.
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Randomized Controlled Trial Clinical Trial
[Tropisetron for prevention of nausea and vomiting in children undergoing tonsillectomy and/or adenoidectomy].
Postoperative nausea and vomiting (PONV) after tonsillectomy is a common problem in children. Tropisetron is a new 5HT3 receptor antagonist and is successfully used in paediatric patients receiving cancer therapy. The aim of the study was to assess efficacy and safety of a single intravenous dose of tropisetron for prevention of PONV in paediatric patients at risk for postoperative vomiting. ⋯ A single intravenous prophylactic dose of tropisetron effectively reduces the incidence of PONV during the first 24 postoperative hours after tonsillectomy and/or adenoidectomy. Because of the low incidence of adverse effects, the prophylactic use of tropisetron seems to be safe and justified in paediatric surgical patients at high risk for postoperative vomiting.
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Randomized Controlled Trial Clinical Trial
[Cognitive impairment in the early postoperative period after remifentanil-propofol and sevoflurane-fentanyl anesthesia].
In ambulatory anaesthesia the time required to recover from cognitive impairment should be as short as possible. The aim of this study was to compare the early cognitive recovery after remifentanil/propofol (R/P) and sevoflurane/fentanyl (S/F) anaesthesia. ⋯ The duration of cognitive impairment in the early postoperative period differed by the test procedures and the anaesthetic procedures used in this investigation. Recovery appeared to be faster after sevoflurane/fentanyl than after remifentanil/propofol at least in aspects of cognitive function.
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Randomized Controlled Trial Clinical Trial
[The effect of aprotinin and tranexamic acid on fibrinolysis and thrombin generation during cardiopulmonary bypass].
Antifibrinolytic drug therapy has proved to be effective in reducing blood loss associated with cardiac surgery and cardiopulmonary bypass (CPB). Concerns remain regarding the risk of enhancing thrombosis. In the present study we investigated the effect of aprotinin (AP) and tranexamic acid (TA) on fibrinolysis and thrombin generation during CPB. ⋯ After the administration of AP for cardiac surgery we observed reductions in both intraoperative fibrinolysis and thrombin generation. In case of TA suppression of fibrinolytic activity in the absence of concomitant reduction in thrombin generation occurred. These results suggest that TA could potentiate a hypercoagulable state with the risk of thrombosis in the perioperative setting.
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Randomized Controlled Trial Clinical Trial
[The effect of different priming doses on the pharmacodynamics of cisatracurium].
The aim of the study was to evaluate the effect of two different priming regimen on the onset time of 100 micrograms/kg cisatracurium, when compared to bolus administration. ⋯ Our data indicate that the "priming principle" is an appropriate technique to shorten the onset time of cisatracurium. To achieve a maximum effect the priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium is recommended.