British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Prevention of postoperative nausea and vomiting after spinal morphine for Caesarean section: comparison of cyclizine, dexamethasone and placebo.
Low-dose intrathecal (spinal) morphine (0.1-0.2 mg) for Caesarean section delivers excellent postoperative analgesia but is associated with significant nausea and vomiting. We compared the antiemetic efficacy of cyclizine, dexamethasone, and placebo in this clinical setting. ⋯ We conclude that following spinal morphine 0.2 mg and fentanyl 10 micro g analgesia for Caesarean section, cyclizine 50 mg i.v. reduces the incidence of nausea compared with dexamethasone 8 mg i.v. or placebo. It also lessens the severity of nausea and vomiting, and increases maternal satisfaction in the early postoperative period.
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Randomized Controlled Trial Clinical Trial
Dextromethorphan and intrathecal morphine for analgesia after Caesarean section under spinal anaesthesia.
Dextromethorphan is an N-methyl-D-aspartic acid antagonist which can attenuate acute pain with few side-effects. In this prospective, randomized, double-blind study of dextromethorphan and intrathecal morphine, we investigated postoperative pain, pruritus, nausea and vomiting in women undergoing Caesarean section under spinal anaesthesia. ⋯ Postoperative pain after Caesarean section under spinal anaesthesia was not reduced by the addition of oral dextromethorphan to a multimodal approach including intrathecal morphine.
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Randomized Controlled Trial Clinical Trial
Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement.
Total knee arthroplasty (TKA) is often carried out using a tourniquet and shed blood is collected in drains. Tranexamic acid decreases the external blood loss. Some blood loss may be concealed, and the overall effect of tranexamic acid on the haemoglobin (Hb) balance is not known. ⋯ Tranexamic acid decreased total blood loss by nearly 30%, drainage volume by approximately 50% and drastically reduced transfusion. However, concealed loss was only marginally influenced by tranexamic acid and was at least as large as the drainage volume.
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Randomized Controlled Trial Clinical Trial
Warming by resistive heating maintains perioperative normothermia as well as forced air heating.
Even mild perioperative hypothermia is associated with several severe adverse effects. Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently. To assess this new warming system, we measured core temperature in patients during surgery who were warmed with circulating water mattresses, forced air covers or resistive heating covers. ⋯ Resistive heating maintains core body temperature as well as forced air heating and both are better than circulating water. Resistive heating offers the advantage of adjustable heating pods.
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Randomized Controlled Trial Clinical Trial
Relationship between awareness and middle latency auditory evoked responses during surgical anaesthesia.
Some studies support the view that meaningful auditory input can be processed by the brain during apparent surgical anaesthesia. Consequently, patients may be able to remember some information implicitly after anaesthesia as well through a 'dream-like process' (subconscious awareness). The aim of this study was to investigate the presence of subconscious awareness during anaesthesia and to examine its relationship to the mid-latency auditory evoked responses (MLAERs). ⋯ MLAERs may help to predict subconscious cerebral processing of auditory inputs during anaesthesia.