RESUMO
Forty patients scheduled to undergo thoracotomy were randomly allocated to receive either transcutaneous electrical nerve stimulation with intramuscular papaveretum (20 patients) or intramuscular papaveretum alone (20 patients) for postoperative pain relief. Total intramuscular analgesic requirements in the first 24 hours, time to satisfactory transfer to oral analgesia, antiemetic requirements and length of stay in hospital postoperatively were noted. Peak expiratory flow rate was compared pre- and postoperatively in the two groups. Use of nerve stimulation did not significantly alter the requirements for analgesia although there was a reduction in postoperative nausea and vomiting in the nerve stimulation group. There was no difference between the two groups with respect to changes in peak expiratory flow rate.
Assuntos
Terapia por Estimulação Elétrica , Fluxo Expiratório Forçado , Dor Pós-Operatória/terapia , Pico do Fluxo Expiratório , Toracotomia , Estimulação Elétrica Nervosa Transcutânea , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ópio/uso terapêutico , Dor Pós-Operatória/fisiopatologia , Estudos Prospectivos , Distribuição AleatóriaRESUMO
A case report is presented in which a patient receiving the monoamine oxidase inhibitor, phenelzine, developed a delayed excitatory reaction following administration of topical cocaine spray during anaesthesia for vocal cord surgery. The pharmacological basis of the drug interaction is discussed.
Assuntos
Anestesia Local/efeitos adversos , Cocaína/efeitos adversos , Coma/induzido quimicamente , Fenelzina/efeitos adversos , Prega Vocal/cirurgia , Idoso , Interações Medicamentosas , Humanos , Masculino , Serotonina/metabolismo , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/metabolismo , Fatores de TempoRESUMO
One hundred and thirty-two patients staying in hospital more than 24 h were visited pre- and postoperatively. Patients were asked a standard set of questions, and 39% could not remember accurately what they were asked. This has important medicolegal implications. In 15% of patients, information that significantly altered subsequent anaesthetic management was discovered, but in less than 3% would ignorance of the patient's condition have required postponement of the surgery. We conclude that the major reason for a pre-operative visit by an anaesthetist is that patients appreciate it, rather than it being medically necessary.