Cok, Oya Y. | Eker, H. Evren | Pelit, Aysel | Canturk, Silay | Akin, Sule | Aribogan, Anis | Arslan, Gulnaz

Article | 2011 | EUROPEAN JOURNAL OF ANAESTHESIOLOGY28 ( 12 ) , pp.836 - 841

Context Strabismus surgery is one of the most common ophthalmic surgical procedures in children and is associated with significant postoperative nausea and vomiting (PONV). Objective We evaluated the effect of intravenous paracetamol on PONV in children after strabismus surgery. Design Prospective, placebo-controlled, randomised double-blind study. Setting University hospital. Patients Ninety children, between 2 and 14 years scheduled for strabismus surgery, were recruited. Eighty-six completed the study. Interventions After induction of anaesthesia, intravenous dexamethasone 0.1 mg kg(-1) was administered to all. The patients were . . .enrolled to receive either intravenous physiological saline (group S) or paracetamol 15 mg kg(-1) (group P). Main outcome measure Incidence of PONV in the first 24 h postoperatively. Results General and clinical characteristics of the children were similar in both groups. PONV during the first 24 h was significantly higher in group S in comparison with group P (group S vs. group P, 33 vs. 14.6%, respectively, P = 0.038 for nausea; 24.4 vs. 7.3%, respectively, P = 0.030 for vomiting). The number of analgesic administrations during the first 24 h was higher in group S compared with group P (1.31 +/- 0.85 and 0.73 +/- 0.6, respectively, P = 0.001). The repeat number of postoperative analgesic administrations was significantly different between groups during the first 24 h (P = 0.005), but during 24-48 h was not significant. Conclusion Intraoperative administration of intravenous paracetamol decreases the incidence of PONV during the first 24 h in children after strabismus surgery. Eur J Anaesthesiol 2011;28:836-84 Daha fazlası Daha az

Altunkaya, H | Ozer, Y | Demirel, CB | Ozkocak, I | Keser, S | Bayar, A

Article | 2005 | ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY125 ( 9 ) , pp.609 - 613

Introduction The aim of the study was to demonstrate the possible effects of preoperative intraarticular, intravenous, or intrathecal administration of morphine on postoperative pain management. Materials and methods Sixty patients undergoing arthroscopic menisectomy were included. Spinal anesthesia was performed in the lateral decubitus position with 3 ml of 0.5% hyperbaric bupivacaine, and the patients were randomized into 4 groups. The IVM (intravenous, iv, morphine) group received 3 mg of iv morphine after completion of spinal anesthesia, the ITM (intrathecal morphine) group received 0.3 mg of morphine together with bupivacaine . . .during spinal anesthesia, the IAM (intra-articular morphine) group received 3 mg intraarticular morphine diluted in 10 ml of saline after spinal anesthesia had been induced but 15 min before surgery, while the C (control) group did not receive any drugs in addition to spinal anesthesia. The sensory block level was determined 15 min after spinal anesthesia. Pain at rest (by visual analogue scale, VAS) and pain at 30 degrees of flexion (by verbal rating scale, VRS) were evaluated during each of the first 2 h of the postoperative period and once every 4 h thereafter until 24 h. In each group; the number of patients in need of analgesics, the timing of the first analgesic intake (duration of analgesia), and the cumulative dose of analgesics were recorded. Results The mean duration of analgesia in the IAM group was significantly longer and the mean analgesic intake was significantly lower when compared with the other groups) < 0.05). The mean VAS value of the ITM group at the 4th postoperative hour was significantly lower than that of the other groups. Mean VAS values at 8 and 12 h and mean VRS values at 4 and 8 It were significantly lower in the ITM and IAM groups (p < 0.05). The ITM group had the highest rates of nausea, vomiting, pruritus, and headache (p < 0.05). Conclusion It was concluded that the preoperative administration of morphine, either intrathecally or intra-articularly, provides postoperative pain relief. Of these two, the intra-articular route seems to be superior in terms of fewer side-effects (nausea, vomiting, and pruritus), longer duration of analgesia, and reduction of total need for analgesics Daha fazlası Daha az