Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1993
Randomized Controlled Trial Comparative Study Clinical TrialOpen placebo controlled comparison of the antiemetic effect of droperidol, metoclopramide or a combination of both in pediatric strabismus surgery.
In children, strabismus surgery is frequently followed by vomiting. The present study compares the antiemetic effects of droperidol (10 micrograms/kg) and/or metoclopramide (0.1 mg/kg) in 104 children undergoing strabismus surgery. The patients were randomly divided into four groups. ⋯ There was no statistically significant difference in the incidence of vomiting among these four groups. Moreover, the incidence of vomiting in the placebo group was much lower (17.9% in the recovery room, 3.6% at return in the ward, 25% during the first hour, 7.1% from 6 to 12 hours and 3.6% the next day) than that reported in previous studies. We think that this could result from the additive effects of some aspects of the technique of anesthesia described and discussed in this paper.
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Acta Anaesthesiol Belg · Jan 1993
Randomized Controlled Trial Clinical TrialBedside evaluation of intraocular pressure in critically ill patients, ventilated at different levels of positive end-expiratory pressure.
Animal experiments suggest that the application of positive end-expiratory pressure (PEEP) levels > or = 10 cm H2O increase intraocular pressure (IOP), probably through ophthalmic and episcleral venous outflow obstruction secondary to PEEP-induced increase in central venous pressure (CVP). To evaluate whether a similar response occurs in humans, we studied the effects of varying levels of PEEP on IOP in 11 critically ill sedated and mechanically ventilated patients, aged 35 to 88 yrs (mean: 68 yrs), without evidence of ocular disease. Measured variables included PaCO2, PaO2, mean arterial pressure (MAP), CVP and IOP, and were recorded at zero end-expiratory pressure and at 5, 10 and 15 cm H2O PEEP, applied in random order. ⋯ IOP increased significantly (p < 0.01) from 12 +/- 4 to 14 +/- 4 mmHg at 10 cm H2O PEEP and from 13 +/- 4 to 16 +/- 5 mmHg at 15 cm H2O PEEP. CVP also increased significantly (p < 0.01) and in parallel with IOP at 10 and 15 cm H2O PEEP. Since IOP tends to rise significantly when PEEP levels exceed 10 cm H2O, PEEP-ventilated patients in whom such increase is undesirable might benefit from regular bedside IOP monitoring.
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Acta Anaesthesiol Belg · Jan 1993
Randomized Controlled Trial Clinical TrialAnalgesic efficiency of propacetamol hydrochlorid after lumbar disc surgery.
The influence of intravenous propacetamol hydrochlorid administration on postoperative analgesia and intramuscular opioid consumption was assessed in a randomized placebo-controlled study. Fourty patients scheduled for lumbar disc surgery were randomly allocated to two groups. ⋯ The cumulative narcotic consumption (piritramide on request) was higher in the placebo group from 6 hours till 9 hours after surgery but not significantly different after 24 hours. Piritramide administration decreased VAS score significantly in both groups while propacetamol reduced it in a significant way only when given from 12 hours after surgery.
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Acta Anaesthesiol Belg · Jan 1993
Comparative StudyDoes ketorolac tromethamine, a new analgesic, decrease postoperative recovery time, narcotic requirements, nausea and/or vomiting, and unscheduled hospital admissions: a retrospective analysis.
This study retrospectively evaluated patients receiving intramuscular ketorolac for postoperative analgesia as compared to intravenous narcotics. Ninety-eight patients' charts were reviewed. Forty-nine subjects who received ketorolac postoperatively (intramuscularly) when entering the post anesthesia recovery unit, were matched with forty-nine subjects who had had similar diagnoses (operated on during the same eight months) who did not receive ketorolac (groups 1 and 2). ⋯ Procedures ranged from dilatation and curettage to major spinal surgeries. Post anesthesia recovery unit times, narcotic dosages and nausea and/or vomiting were not different between group 1 and 2. The timing of administration for the ketorolac may be a reason for these results; it may be beneficial if administered intraoperatively, or intravenously (when FDA approved in the United States) during the postoperative period.
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Acta Anaesthesiol Belg · Jan 1993
Comparative StudyEffects of low doses of aprotinin on clotting times activated with celite and kaolin.
The effects of aprotinin (2 x 10(6) and 4 x 10(6) PIU Iniprol) on the activated clotting time (ACT) with both celite- and kaolin-activated tubes were investigated in 52 patients, scheduled for elective coronary artery bypass grafting. Two whole blood samples (2 ml sample volume) were tested simultaneously with Hemochron automated timing systems at different intervals before, during and after cardiopulmonary bypass. At none of the times of measurement there was a difference in ACT measured with celite or with kaolin as coagulation activator. It is concluded that when aprotinin is used in this low dose regimen, celite- and kaolin-activated tubes are equally reliable for monitoring ACT.