Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1994
Randomized Controlled Trial Clinical Trial[Effects of ondansetron and metoclopramide on postoperative nausea and vomiting after epidural anesthesia in children].
We studied the preventive effect on postoperative nausea and vomiting (PONV) of ondansetron, metoclopramide and placebo associated with epidural anaesthesia. Sixty children, ASA I or II, 4 to 12 yr old underwent surgery for inguinal hernia repair (n = 30) or orchidopexy (n = 30). Children were randomly assigned to a postinduction intravenous medication group, ondansetron (5 mg.m-2), metoclopramide (0,12 mg.kg-1) or a saline solution placebo. ⋯ The incidence of postoperative emesis in the metoclopramide group was 25%, whereas that of placebo group was 10%. The administration of ondansetron was associated with a lower (P = 0.017) incidence of postoperative vomiting if compared to the metoclopramide group. In conclusion ondansetron given preoperatively had proven to be an effective treatment for PONV after epidural block for lower abdominal surgery.
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Cahiers d'anesthésiologie · Jan 1994
Comparative Study[Comparative study of propofol versus thiopental-halothane in the occurrence of oculocardiac reflex and postoperative vomiting after surgery for strabismus in children].
Strabismus surgery in children is associated with side-effects, intraoperative oculocardiac reflexes in relation with muscular tractions and postoperative vomiting. Studies with propofol anaesthesia in this surgery have shown a lower incidence of these side-effects. So, a prospective study compared these incidences with propofol (P) versus thiopental/halothane (T+H) anaesthesia. Propofol appears to be efficient in reducing postoperative vomiting but might be associated with more frequent OCR.
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Giving a definition of analgesia in ICU needs to answer several questions: Why sedation? Which drugs can we use? How can we deal with sedation? (monitoring, continuous administration, weaning...)? Two different types of sedation must be considered: treatment-sedation (status epilepticus, tetanus, intracranial hypertension...) and comfort-sedation in anxious and/or restless and/or painful patients and in those necessitating mechanical ventilation. Analgesic consumptions vary widely with diseases and their outcome, background diseases and ICU environment. Several studies have shown that pain and analgesia are frequently neglected in ICU. ⋯ A particular place is reserved to regional techniques, often underused in ICU. Indications are then fully discussed, according to several specific pathological conditions. Monitoring and weaning of sedation are also discussed at the end of the review.
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Cahiers d'anesthésiologie · Jan 1994
[Laryngeal masks in pediatric anesthesia. Apropos of 251 cases].
A series of 251 anaesthesias with a laryngeal mask (LM) in a paediatric surgery unit is studied retrospectively. After some short training, using LM is most often easy and allows a good airway control without any frequent or severe complications. Therefore this technique should quickly supplant the facial mask and many endotracheal intubations.