British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Haemolysis after etomidate: comparison of propylene glycol and lipid formulations.
We sought to determine if the solvent in the formulation of etomidate is responsible for haemolysis in patients. In a randomized, prospective, double-blind study of 49 patients undergoing otolaryngological surgery, patients received etomidate dissolved in propylene glycol or in lipid emulsion. ⋯ Correspondingly, reductions in haptoglobin concentrations were significantly greater in the propylene glycol group (P < or = 0.002). We conclude that with respect to haemolysis, lipid emulsion is superior to propylene glycol as a solvent for etomidate.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Acute affect of mitral calve replacement on extravascular lung water in patients receiving colloid or crystalloid priming of cardiopulmonary bypass.
Despite numerous studies on extravascular lung water (EVLW) in patients undergoing coronary artery bypass surgery, few data are available on the perioperative time course of EVLW in patients undergoing mitral valve replacement for mitral valve insufficiency (MVI). We have investigated 26 patients undergoing elective mitral valve replacement in order to determine the influence of the preoperative degree of mitral valve insufficiency (degree III or IV) and the effect of different priming solutions for cardiopulmonary bypass. Crystalloid priming with Ringer's lactate was compared with human albumin priming solution. ⋯ During the postoperative time course a significant decrease in EVLW was observed in patients with MVI-degree IV whereas in patients with MVI-degree III the amount of EVLW did not change. However, compared with patients undergoing coronary artery bypass surgery, EVLW remained above normal in both groups. There was no interaction between the type of priming solution and the postoperative time course of EVLW, and no differences in respiratory variables or duration of mechanical ventilation were observed between groups.
-
Randomized Controlled Trial Clinical Trial
Transient neurological symptoms after spinal anaesthesia with 4% mepivacaine and 0.5% bupivacaine.
Several studies have reported transient neurological symptoms after spinal anaesthesia with 5% lignocaine. In order to evaluate the role of concentrated solutions of local anaesthetic in the development of transient neurological symptoms, 200 ASA I or II patients undergoing minor orthopaedic or rectal surgery under spinal anaesthesia were allocated randomly to receive 4% mepivacaine 80 mg or hyperbaric 0.5% bupivacaine 10 mg. ⋯ The incidence of transient neurological symptoms consisting of pain in the buttocks or pain radiating symmetrically to the lower extremities differed (P < 0.001) between patients receiving mepivacaine (30%) and those receiving bupivacaine (3%). Hyperbaric 0.5% bupivacaine can be recommended for minor operations on the lower abdomen or lower extremities.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Ondansetron compared with metoclopramide in the treatment of established postoperative nausea and vomiting. The French Ondansetron Study Group.
We have studied 746 males and females undergoing general anaesthesia for any type of surgical procedure in a double-blind, controlled, randomized study. After experiencing at least one nausea and/or one emetic episode in the 6 h after recovery from anaesthesia, patients received either ondansetron 4 mg i.v. or metoclopramide 10 mg i.v. Patients were observed for postoperative nausea and vomiting (PONV) for 24 h after drug administration. ⋯ Furthermore, ondansetron was associated with greater patient satisfaction than metoclopramide (P < 0.001) with 49% and 32% of patients, respectively, very satisfied. The overall incidence of adverse events was similar in the ondansetron (7%) and metoclopramide (8%) groups. Ondansetron was as well tolerated and more effective than metoclopramide for all assessment criteria in the treatment of established PONV.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison between halothane and sevoflurane for adult vital capacity induction.
We have examined the differences in ventilatory characteristics between halothane and sevoflurane when used for adult vital capacity induction of anaesthesia. The study was conducted in a randomized, double-blind manner. ⋯ Although the sample size was small, minute volumes appeared to be maintained in the sevoflurane group. Ventilatory frequencies were similar in the two groups after insertion of the laryngeal mask airway, but tidal volumes were significantly greater in the sevoflurane group (P = 0.0013).