British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of patient-controlled analgesia in children by i.v. and s.c. routes of administration.
Sixty children undergoing appendicectomy were allocated randomly to receive one of two PCA regimens with morphine. Group IV received standard i.v. PCA with a bolus dose of morphine 20 micrograms kg-1 and a background infusion of 4 micrograms kg-1 h-1 while group SC received PCA by the s.c. route with a bolus dose of morphine 20 micrograms kg-1 and a background infusion of 5 micrograms kg-1 h-1. ⋯ PCA. By giving patients feedback on the occurrence of valid demands for analgesia, s.c. PCA may produce more appropriate and effective use of PCA.
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Randomized Controlled Trial Comparative Study Clinical Trial
Haemodynamic and catecholamine changes after induction of anaesthesia with either thiopentone or propofol with suxamethonium.
We have compared the haemodynamic and catecholamine responses to laryngoscopy and tracheal intubation in 43 patients after induction of anaesthesia with either thiopentone 5.1 (SD 0.9) mg kg-1 or propofol 2.2 (0.1) mg kg-1, each with suxamethonium and without opioid pretreatment. Heart rate increased significantly above baseline after induction and intubation in both groups, but there were no differences between groups. Arterial pressure increased significantly at 1 min after intubation in both groups and at 2 min in the thiopentone group only. ⋯ Plasma concentrations of adrenaline were significantly greater in the thiopentone group than in the propofol group at both 1 and 2 min after intubation. Plasma concentrations of noradrenaline showed no significant time-based within-group changes, but were significantly greater in the thiopentone group at 1 and 2 min after intubation. We conclude that doses of either thiopentone or propofol sufficient to obtund the eyelash reflex with suxamethonium 1 mg kg-1 alone do not adequately block the catecholamine and hypertensive responses to laryngoscopy and intubation in normal patients and although propofol suppressed increases in catecholamines to a greater extent than thiopentone, there were no clinical advantages.
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Comment Letter Comparative Study
Comparison of the Belscope with the Macintosh laryngoscope.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind comparison of ondansetron, droperidol and saline in the prevention of postoperative nausea and vomiting.
We have compared the efficacy of ondansetron with droperidol and saline in the prevention of postoperative nausea and vomiting (PONV) in 120 ASA I and II patients undergoing hip and knee replacements and femoral resections. They received a standardized combined extradural and general anaesthetic and at the end of surgery were allocated randomly to receive droperidol 1.25 mg, ondansetron 4 mg or 0.9% saline in a 25-ml bag. An extradural mixture containing 0.5% plain bupivacaine 10 ml, fentanyl 500 micrograms and saline 30 ml was infused and PONV assessed for 24 h. ⋯ The incidence of vomiting was 17% for ondansetron, 18% for droperidol and 45% for saline. There was no significant difference in the incidence of nausea between the groups. Metoclopramide, the rescue antiemetric, was demanded by 38%, 34% and 17% of patients receiving saline, droperidol and ondansetron, respectively (ondansetron vs droperidol P < 0.05).
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Randomized Controlled Trial Clinical Trial
Reduction in postoperative vomiting after surgical correction of prominent ears.
There is a high incidence of postoperative nausea and vomiting after surgical correction of prominent ears. A prospective, randomized study was performed to determine if the method of dressing the ears influenced the incidence of postoperative vomiting. Avoidance of packing the external auditory meatus and concha produced a significant reduction in postoperative nausea (83% vs 30%; P < 0.005) and vomiting (63% vs 22%; P < 0.01).