British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following major gynaecological surgery.
Domperidone 20 mg, droperidol 2.5 mg, metoclopramide 10 mg and placebo (saline) were given i.v. 10 min before the end of anaesthesia, to 200 women undergoing major gynaecological surgery, and the incidence of postoperative nausea and vomiting following a standard anaesthetic technique was assessed. Droperidol was significantly more effective than domperidone, metoclopramide or placebo in reducing emetic sequelae. ⋯ Patients given droperidol required less postoperative analgesia than those given domperidone or metoclopramide. It was concluded that, of the drugs studied, droperidol alone was effective in protecting against nausea and vomiting after major gynaecological surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following gynaecological surgery in day cases.
The efficacy of domperidone 20 mg, droperidol 2.5 mg, metoclopramide 10 mg or placebo (saline) administered i.v. before induction of anaesthesia, was studied in 199 women undergoing gynaecological surgery as day cases. Following a standardized general anaesthetic technique, droperidol or metoclopramide significantly reduced the incidence of nausea and vomiting; domperidone decreased the incidence of postoperative nausea alone. ⋯ Patients treated with antiemetics were no more sedated than those given placebo. Those receiving droperidol complained of significantly less postoperative pain than those who had received domperidone or metoclopramide.
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The effects of overnight fasting on gastric contents and on the symptoms associated with fasting were studied prospectively in female outpatients. Group A (n = 66) were patients scheduled for first trimester therapeutic abortion; group B (n = 66) were scheduled for minor gynaecological surgery. It was demonstrated that overnight fasting (15 +/- 3 h) did not guarantee an empty stomach (volume 22 +/- 13 ml) and that gastric acidity was high (pH 1.6 +/- 0.5). ⋯ Before anaesthesia, 50% of all patients had symptoms of moderate to severe hunger, while 44% of patients had symptoms of moderate to severe thirst. Neither the severity of symptoms of fasting nor the duration of fast correlated with gastric volume or pH. Patients in group A had significantly greater symptoms of hunger; however, they also had fasted for significantly longer (P less than 0.002).
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Randomized Controlled Trial Clinical Trial
The cricoid yoke--a device for providing consistent and reproducible cricoid pressure.
An instrument is described which, when used during the accelerated induction technique, ensures that consistent and adequate cricoid pressure can be applied. Mothers undergoing general anaesthesia for elective Caesarean section were studied in order to illustrate the clinical application of the instrument. The consequences to intubating conditions of applying adequate cricoid pressure, and an assessment of the instrument's control over the incidence of regurgitation during operation were investigated.