Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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The routine plain-film abdominal series, consisting of supine and upright abdominal radiographs and upright chest radiograph of 246 patients, who presented with abdominal pain from the emergency room of Bangkok Metropolitan Administration Medical College and Vajira Hospital from January 2000 to May 2001 were reviewed. Each radiograph was independently interpreted to detect any radiographic abnormality. ⋯ Most of the detectable abnormalities in the upright views were pneumoperitoneums that were clearly demonstrated on the upright chest radiographs. So elimination of the upright abdominal view from the routine plain-film abdominal series in the screening of surgical cases from medical cases could result in cost-saving and a decrease in radiation exposure without significant loss of diagnostic information.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Remifentanil vs morphine for patients in intensive care unit who need short-term mechanical ventilation.
This randomized, double-blind study compared the safety and efficacy of remifentanil (9 microg/ kg/h) with morphine (0.045 mg/kg/h plus a bolus dose of 0.025 mg/kg). One hundred and eighty nine Intensive Care Unit (ICU) patients with normal renal function or mild renal impairment requiring mechanical ventilation were included in this study. A pre-defined dosing algorithm permitted initial titration of the opioids to predetermine the optimal level of sedation and pain score. ⋯ The dosing algorithm facilitated rapid extubation in both groups. Remifentanil provided comparable hemodynamic stability to morphine, and was not associated with an increase in cardiovascular adverse event. Remifentanil is therefore considered to be effective and well tolerated in ICU patients.
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Randomized Controlled Trial Clinical Trial
Can lidocaine reduce succinylcholine induced postoperative myalgia?
This study was undertaken to determine the effect of lidocaine pretreatment on reduction of succinylcholine-induced myalgia in patients undergoing general anesthesia for gynecological surgery. One hundred and thirty-five patients were assigned to one of three groups in a prospective, double blind, randomized manner. Group PS, the control group, received normal saline and succinylcholine 1.5 mg x kg(-1); Group LS, lidocaine 1.5 mg x kg(-1) and succinylcholine 1.5 mg x kg(-1); Group PR, normal saline and rocuronium 0.6 mg x kg(-1). ⋯ A correlation was not found between the incidence of myalgia and the occurrence of muscle fasciculation. The changes in systolic and diastolic blood pressure and heart rate were not significant among the three groups. In conclusion, where succinylcholine is used, lidocaine is proven to be the useful pretreatment agent for the reduction of postoperative myalgia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A double-blind, randomized study comparing postoperative pain management using epidural ropivacaine with intravenous ketorolac or intravenous ketorolac alone following transabdominal hysterectomy.
The aim of this study is to compare the effect on postoperative pain of epidural ropivacaine in combination with intravenous ketorolac with intravenous ketorolac alone following transabdominal hysterectomy. ⋯ We demonstrated that epidural infusion of ropivacaine in addition with intravenous ketorolac gave superior pain relief at rest and on coughing in patients undergoing transabdominal hysterectomy when compared to the group receiving intravenous ketorolac alone.
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Randomized Controlled Trial Clinical Trial
Adding droperidol to morphine patient-controlled analgesia: effect on nausea and vomiting.
This prospective, double-blind, randomized, controlled trial was performed to evaluate the antiemetic effectiveness and side effects of adding droperidol to morphine delivered via a patient-controlled analgesia (PCA) device in 94 women undergoing transabdominal hysterectomy with a standardized anesthetic regimen. They were randomly allocated to receive postoperative PCA as either bolus doses of morphine I mg or a combination of morphine 1 mg and 0.0625 mg droperidol with a lockout interval of 5 minutes and no continuous infusion. The incidence of nausea 6-18 hours postoperatively and 18-24 hours postoperatively was significantly lower in the morphine and droperidol group than in the morphine only group and its severity 2-6 hours, 6-18 hours, and 18-24 hours postoperatively was significantly lower. ⋯ The drug and consumable item cost was not different between the groups. We conclude that droperidol added to morphine in PCA reduces nausea. The appropriate dose of droperidol should be further investigated to reduce the incidence of vomiting.