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  • 1
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Descriptive data report a very low rate of postoperative nausea and vomiting (PONV) following spinal anaesthesia in children. In an attempt to corroborate this observation, we designed a prospective randomized study to compare spinal anaesthesia with intravenous propofol sedation (SA) (n=21) to inhalational sevoflurane anaesthesia (IA) (n=19) with regard to PONV and postoperative analgesia in children (aged 3–12 years) undergoing ambulatory inguinal surgery. Results: No difference was found concerning the number of patients experiencing PONV in each group (SA 1/21 versus IA 5/19; P=0.085). However, spinal anaesthesia was associated with a reduced number of PONV episodes (1/21) compared with inhalation anaesthesia (8/19) (P=0.014) and the need for supplemental postoperative analgesia with ketoralac was significantly lower in the SA group (3/21) compared to the IA group (14/19) (P 〈 0.001). Despite these benefits of spinal anaesthesia compared with inhalational anaesthesia, spinal anaesthesia did not decrease the time to discharge from the ambulatory surgery unit [SA 161 (SD 51) min, IA 164 (SD 41) min; P=NS] and the overall PONV experience was rated as ‘no problem’ by all patients, except one, regardless of anaesthetic protocol used. Conclusions: Despite the reduced number of emetic episodes and the better immediate postoperative analgesia associated with spinal anaesthesia, no difference could be identified between the two different anaesthetic protocols regarding time to discharge or overall patient satisfaction. Thus, despite minor advantages associated with spinal anaesthesia with propofol sedation, both anaesthetic regimen appear equally suitable for use in the paediatric outpatient setting.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied 200 female patients (ASA group 1) scheduled for termination of pregnancy under general anaesthesia. The patients were randomly allocated to receive one of four anaesthetic combinations; (1) propofol in combination with ketamine 20 mg, (2) propofol in combination with fentanyl 0.1 mg, (3) thiopentone in combination with fentanyl 0.1 mg, (4) methohexitone in combination with fentanyl 0.1 mg. All patients were breathing oxygen in nitrous oxide 1:2. Patients' self assessments of per- and postoperative course and time to discharge were compared. No patient's response suggested light anaesthesia, but dreams were frequently experienced during anaesthesia especially among the propofol-ketamine combination (29 out of 50). Time to discharge was shortest for the groups of patients given propofol; the mean time was 93 and 96 minfor the ketamine and fentanyl groups respectively. During the recovery period significantly more patients experienced pain in the ketamine-propofol group. Complaints of nausea were seen in only 15 patients, and seven patients noted psychomimetic side effects during recovery, without any differences between the groups. All four combinations tested offered good conditions for short outpatient procedures. However, the propofol-fentanyl combination was found to offer the best quality of anaesthesia as assessed by the patients themselves.
    Type of Medium: Electronic Resource
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