Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 1996
Randomized Controlled Trial Clinical Trial[Antiemetic prophylaxis after laparoscopic cholecystectomy: comparative study of dehydrobenzperidol, metoclopramide, ondansetron and placebo].
To compare the efficacy of ondansetron to that of metoclopramide, dehydrobenzperidol and placebo for the prevention of postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy in a double-blind random study. ⋯ Ondansetron provides safe, effective prophylaxis for PONV after laparoscopic cholecystectomy, but it is not superior to the antiemetic drugs usually used. Its use may be justified in patients in whom dehydrobenzperidol or metoclopramide are contraindicated.
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Sevoflurane is a fluoridated derivative of methyl isopropyl ether. Its administration does not require the use of sophisticated vaporizers and its blood/gas partition coefficient is 0.69. Sevoflurane is the only ethereal anesthesia that does not trigger a reflex response or cause airway irritation during inhaled induction. ⋯ Renal toxicity has not been reported even though fluoride is a metabolic product. Sevoflurane breaks down in the presence of soda lime, producing compound A and giving rise to controversy and investigation although the toxicity of compound A is more theoretical than real. Sevoflurane is not harmful to the ozone layer.
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Desflurane is a new fluoride-only halogenated inhalational anesthetic. It differs from other halogenated anesthetics, in having a lower solubility in all tissues and greater molecular stability in all media. These traits mean, on the one band, that desflurane affords rapid achievement of depth of anesthesia, recovery and management during surgery, and on the other, that its potential toxicity is low and that it is safe for use in low flow circuits. ⋯ Induction of anesthesia with desflurane causes irritation of the airways, particularly in children, and its use in pediatric surgery is therefore inadvisable. Desflurane potentiates the action of neuromuscular relaxants, much like isoflurane. Desflurane represents a step forward in the search for the ideal anesthetic.
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Rev Esp Anestesiol Reanim · Aug 1996
Randomized Controlled Trial Clinical Trial[Comparison of the double burst stimulus with the train-of-four stimuli in monitoring muscle relaxation during anesthesia].
To compare double burst stimulus (DBS) and the train-of-four stimuli (TOF) for monitoring neuromuscular blockade during anesthesia in terms of muscle relaxation requirements, dose of anticholinesterase agents and the possibility of postanesthetic residual relaxation. ⋯ The use of DBS increased the vecuronium dose required during anesthesia and risk in those patients who arrived at the PARU with residual muscle block (T4/T1r < 70%).