British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Emetic effects of morphine and piritramide.
Successful management of postoperative pain requires that adequate analgesia is achieved without excessive adverse effects. Opioid-induced nausea and vomiting is known to impair patients' satisfaction, but there are no studies providing sufficient power to test the hypothesis that the incidence of opioid-induced nausea and vomiting differs between micro -opioid receptor agonists. Thus, we tested the hypothesis that the incidence of vomiting and nausea differs between morphine and piritramide. ⋯ Opioid-induced emesis was observed in about one-third of the patients using morphine and piritramide for PCA and the incidence of vomiting was one-half of that. Potential differences in the incidence of vomiting during PCA therapy between these micro-opioid receptor agonists can be excluded.
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Randomized Controlled Trial Clinical Trial
Supplemental oxygen for prevention of nausea and vomiting after breast surgery.
Administration of supplemental oxygen 80% has been shown to halve the incidence of postoperative nausea and vomiting (PONV). We tested the efficacy of supplemental oxygen 50% in decreasing the incidence of PONV after breast surgery. ⋯ The incidence of vomiting decreased during the short postoperative administration of supplemental oxygen 50%. However, perioperative oxygen 50% administration did not prevent PONV over the 24-h follow-up period in patients undergoing breast surgery performed under general anaesthesia.
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Randomized Controlled Trial Clinical Trial
Effect of nitrous oxide on cerebrovascular reactivity to carbon dioxide in children during sevoflurane anaesthesia.
Sevoflurane and nitrous oxide have intrinsic cerebral vasodilatory activity. To determine the effects of nitrous oxide on cerebrovascular reactivity to carbon dioxide (CCO(2)R) during sevoflurane anaesthesia in children, middle cerebral artery blood flow velocity (V(mca)) was measured over a range of end-tidal carbon dioxide concentrations (E'(CO(2))), using transcranial Doppler (TCD) ultrasonography. ⋯ Cerebrovascular carbon dioxide reactivity is reduced at and above an E'(CO(2)) of 45 mm Hg during 1.0 and 1.5 MAC sevoflurane anaesthesia. The addition of nitrous oxide to 1.5 MAC sevoflurane diminishes CCO(2)R in the hypocapnic range. This should be taken into consideration when hyperventilation techniques for reduction of brain bulk are being contemplated in children with raised intracranial pressure.
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Clinical Trial Controlled Clinical Trial
Dose-related effect of sevoflurane sedation on higher control of eye movements and decision making.
Saccadic latency may provide an objective method to assess sedative doses of anaesthetic on cortical oculomotor mechanisms and decision making. ⋯ Measurements of this kind could potentially provide estimates of cortical effects of sevoflurane sedation, and give a clinically useful measure of cognitive fitness.
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The aim of this study was to determine the prevalence of postoperative nausea and vomiting (PONV) after fast-track cardiac anaesthesia, risk factors for PONV and its influence on the length of stay in the intensive care unit (ICU). ⋯ The incidence of PONV is relatively low after FTCA and does not prolong ICU stay. Prophylactic administration of anti-emetic drugs before FTCA is not necessary.