British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Granisetron-droperidol combination for the prevention of postoperative nausea and vomiting in female patients undergoing breast surgery.
We have compared the efficacy and safety of the combination granisetron-droperidol with each antiemetic alone in preventing postoperative nausea and vomiting (PONV) after breast surgery. In a randomized, double-blind study, 150 female patients received granisetron 3 mg, droperidol 1.25 mg or granisetron 3 mg with droperidol 1.25 mg (n = 50 each) i.v., immediately before induction of anaesthesia. ⋯ The incidence of PONV during the first 24 h after anaesthesia was 18% with granisetron, 38% with droperidol and 4% with the granisetron-droperidol combination (P < 0.05; overall Fisher's exact probability test). We conclude that the granisetron-droperidol combination was more effective than each antiemetic alone in the prevention of PONV in female patients undergoing breast surgery.
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We report changes in arterial blood-gas tensions for up to 5 min of apnoeic oxygenation in 26 anaesthetized paediatric patients (21 children, five infants). Changes in oxygen and carbon dioxide tension were greatest in the first minute of apnoeic oxygenation. In subsequent minutes, rates of change in gas tension were approximately constant. ⋯ The small number of infants studied showed rapid decreases in oxygen tension which if sustained would be expected to limit the safe duration of apnoeic oxygenation, unlike adults where apnoeic oxygenation is limited by hypercapnia. Extrapolation of our results suggests that when preoxygenation has been successful, apnoeic oxygenation could continue safely in children for at least 10 min. Infants may become hypoxic after only 2 min.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ketorolac, diclofenac and ketoprofen are equally efficacious for pain relief after total hip replacement surgery.
We have compared the efficacy of ketorolac 30 mg i.v. followed by infusion at a rate of 90 mg/15.5 h, with that of diclofenac 75 mg followed by infusion of 75 mg/15.5 h or ketoprofen 100 mg followed by infusion of 100 mg/15.5 h, on postoperative pain in 85 patients after hip replacement surgery under spinal anaesthesia in a prospective, double-blind, randomized study. Supplementary analgesia was administered during the 16-h postoperative period with bolus doses of fentanyl delivered by a patient-controlled analgesia system. ⋯ Median VAS scores were low over the entire study in each group and there was no significant difference between groups. No serious adverse events were recorded.