Abstract:
STUDY OBJECTIVE:To identify the maximally effective dolasetron dose (i.e., maximum efficacy with minimum adverse events) for prevention of postoperative nausea and vomiting (PONV) using the statistical power generated in a pooled patient sample from three large, nearly identical clinical trials. DESIGN:Three randomized, multicenter, placebo-controlled, double-blinded trials. SETTING:Trials 1, 2, and 3 enrolled patients at 10, 25, and 17 hospitals and/or surgical centers, respectively. PATIENTS:A total of 1,946 ASA physical status, I, II, and III patients. Trials 1 and 2 enrolled only female patients (n = 916) undergoing gynecologic surgery. Trial three enrolled 722 females (approximately 70% gynecologic surgeries) and 308 males (approximately 46% orthopedic surgeries) undergoing a variety of surgical procedures. INTERVENTIONS:All surgical procedures used balanced general anesthesia. Patients received 12.5, 25, 50, or 100 mg of the antiemetic, dolasetron, near the end of anesthesia. MEASUREMENTS AND MAIN RESULTS:Efficacy endpoints were identical and measured for 24 hours: complete response (no vomiting or rescue medication) and maximum nausea, reported using a 100-mm visual analog scale (VAS). Safety was assessed using adverse event reports, laboratory and electrocardiographic data, and vital signs. All four dolasetron doses produced significant increases in complete response and decreases in maximum VAS nausea compared with placebo (p < 0.01). No increased efficacy was observed with dolasetron doses higher than 12.5 mg. Safety was similar between each dolasetron dose and placebo. CONCLUSION:Dolasetron 12.5 mg, given near the end of anesthesia, is the maximally effective dose studied for preventing postoperative nausea and vomiting.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Philip BK,McLeskey CH,Chelly JE,McKenzie R,Kovac AL,Diemunsch P,DuBois DMdoi
10.1016/s0952-8180(99)00123-3subject
Has Abstractpub_date
2000-02-01 00:00:00pages
1-8issue
1eissn
0952-8180issn
1873-4529pii
S0952818099001233journal_volume
12pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::The acceptance of new and increasingly expensive technologies is a major component of the rising costs of health care. While the practice of anesthesia has been relatively immune from the effects of cost containment, it is inevitable that practitioners will have to justify costly practices. Available pharmacoeconomic ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(05)80008-x
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVES:To determine the psychometric outcomes of patients participating in an extensive patient-centered verification process before receiving sedation for regional anesthesia. DESIGN:Survey. SETTING:Perioperative areas of university-affiliated hospital. PATIENTS:Two hundred eligible patients scheduled for elect...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.10.009
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the optimal concentration of lidocaine that reduces pain on injection of a propofol-lidocaine mixture. DESIGN:Prospective, randomized, double-blinded, clinical investigation. SETTING:Medical center, university teaching hospital. PATIENTS:240 ASA physical status I and II female outpatient...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(99)00040-9
更新日期:1999-06-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil. DESIGN:Prospective randomized study. SETTING:Operating room of a university hospital. PATIENTS:78 ASA physical status 1 and 2 women, aged 20 to 65 years, who were scheduled to undergo a th...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2014.02.002
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hybrid operating room suites with intraoperative magnetic resonance imaging enable image guided surgery in a fully functional operating room environment. While this environment creates challenges to anesthetic care, the effects on anesthetic adverse events and outcomes are largely unknown. This...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2018.10.022
更新日期:2019-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effects of fresh gas flow on inspired gas composition during low-flow anesthesia. DESIGN:Randomized trial with 2-hour observation periods in patients assigned to one of three groups. SETTING:Inpatient surgery clinic at a medical center. PATIENTS:Thirty-six patients undergoing abdomin...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(92)90214-l
更新日期:1992-11-01 00:00:00
abstract:STUDY OBJECTIVE:Neuraxial blockade may increase external cephalic version (ECV) success rates. This survey aimed to assess the frequency and characteristics of neuraxial blockade used to facilitate ECV. SETTING AND DESIGN:We surveyed Society for Obstetric Anesthesia and Perinatology members regarding ECV practice usin...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.05.040
更新日期:2016-11-01 00:00:00
abstract::Bispectral index is an accepted depth of anaesthesia monitor for guiding intraoperative hypnotic agent administration. Frontalis EMG displayed on BIS monitor may increase due to twitching of frontalis muscle. EMG increases are also known to cause artefactual increases in BIS values. We report a case of artefactual inc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.11.005
更新日期:2017-02-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate patient acceptability of continued versus divided anesthetic care. DESIGN:Patient satisfaction ratings with continuous and divided anesthetic care were assessed by patient questionnaire. In addition, the effect of training anesthesia personnel in communication regarding divided anesthesia c...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.04.004
更新日期:2007-02-01 00:00:00
abstract:STUDY OBJECTIVE:Erector spinae plane (ESP) block is a novel regional anesthesia technique and gaining importance for postoperative pain management. Since it was first described, the clinicians wonder if this new simple technique can replace paravertebral block (PVB). We aimed to compare the postoperative analgesic effe...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2019.06.036
更新日期:2020-02-01 00:00:00
abstract::We present a case in which an anemic patient with religious objections to blood transfusion experienced three episodes of severe myocardial ischemia during the perioperative period. The first episode of ischemia was successfully treated by discontinuing isoflurane and resolving the hypotension. The second and third ep...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(96)00086-4
更新日期:1996-08-01 00:00:00
abstract::A case of new-onset atrial fibrillation subsequent to activation of neuraxial anesthesia is presented. The development of atrial fibrillation was temporally related to placement and dosing of an epidural catheter, and may have been triggered by a vagal response to dosing of the anesthetic or the resulting treatment wi...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2011.10.013
更新日期:2012-06-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate five different preoperative anxiolytic regimens in cataract surgery performed under regional anesthesia; to quantify the pain associated with combined peri- and retrobulbar injection (PRBI) of local anesthetic drugs; and to describe a technique of painless eye block. DESIGN:Randomized, dou...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(98)00008-7
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To evaluate changes in cardiac troponin-I levels after major vascular surgery and their association with early and late postoperative cardiac complications. DESIGN:Prospective, observational investigation. SETTING:University teaching hospital. PATIENTS:75 consecutive patients undergoing major vascular surg...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2005.11.005
更新日期:2006-06-01 00:00:00
abstract:STUDY OBJECTIVE:Some outpatient procedures are performed under sedation with dexmedetomidine, although the effect of dexmedetomidine on cognitive function remains unclear. This study investigated the effect of dexmedetomidine on cognitive function in healthy volunteers. DESIGN:Observation study in volunteers. SETTING...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.03.017
更新日期:2016-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the opioid-sparing and analgesic effect of diclofenac sodium in ambulatory nonimmersion extracorporeal shock wave lithotripsy (ESWL). DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:Large referral hospital. PATIENTS:Twenty-seven ASA physical status I and II patients wit...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(93)90142-2
更新日期:1993-03-01 00:00:00
abstract:STUDY OBJECTIVE:To measure the parameter of job satisfaction among anesthesiologists. DESIGN:Survey instrument. SETTING:Academic anesthesiology departments in the United States. SUBJECTS:320 anesthesiologists who attended the annual meeting of the ASA in 2009 (95% response rate). MEASUREMENTS AND MAIN RESULTS:The a...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.01.007
更新日期:2013-06-01 00:00:00
abstract:STUDY OBJECTIVE:To establish the analgesic effective doses as defined as a visual analog pain scale (VAS) of at least 10 for 95% of parturients (ED95) receiving either epidural fentanyl or sufentanil with bupivacaine 0.125% for labor analgesia. DESIGN:Double-blind, randomized controlled study. SETTING:Two tertiary-ca...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(98)00113-5
更新日期:1998-12-01 00:00:00
abstract::Approximately 2 million closed head injuries (CHIs) occur yearly in the United States. Twenty-five percent of these injuries require hospitalization, and 70,000 to 90,000 of those hospitalized suffer long-term disability. This case conference details one such case of CHI in which the patient ultimately died. Close att...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(05)80020-0
更新日期:1994-09-01 00:00:00
abstract:STUDY OBJECTIVES:To examine the possible pharmacodynamic interaction of propofol and sufentanil with respect to the induction of loss of consciousness. DESIGN:Prospective, randomized, double-blinded study. SETTING:University hospital. PATIENTS:30 female, ASA physical status I and II patients undergoing elective gyne...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(99)00076-8
更新日期:1999-08-01 00:00:00
abstract:STUDY OBJECTIVE:To compare 4 different anesthesia induction protocols, in a simulated model of rapid-sequence induction, in controlled hypertensive patients. DESIGN:Prospective, randomized, double-blind, clinical investigation. SETTING:Large metropolitan university hospital. PATIENTS:120 ASA II-III adult hypertensiv...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2005.06.006
更新日期:2006-02-01 00:00:00
abstract::This report highlights transient Horner's syndrome and trigeminal nerve palsy following labor epidural analgesia. A 29-year-old primigravida had a lumbar epidural catheter placed for analgesia in labor. The analgesia was maintained by infusion of a dilute local anesthetic/opioid mixture and turned off after achieving ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(02)00406-3
更新日期:2002-11-01 00:00:00
abstract::Horner's syndrome is a rare side effect of epidural analgesia. In association with ipsilateral brachial plexus block, it has only been reported once before, in French. Unilateral blockade has also been reported, although its etiology is unclear and may be multifactorial. The patient described here experienced an asymm...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(02)00399-9
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Childhood and adolescent obesity increased in recent decades, and caregivers face an increasing number of obese pediatric surgical patients. Some clinical and pharmacogenetic data suggest that obese patients have altered pain sensitivity and analgesic requirements. OBJECTIVE:To test the primary hypothesis t...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109729
更新日期:2020-06-01 00:00:00
abstract::Turner syndrome is a complex and common genetic disorder that affects women and is associated with a wide variety of anatomic and physiological disorders. These abnormalities, especially those relating to the airway and cardiovascular system, pose a challenge to the anesthesiologist. We report a case of Turner syndrom...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.06.010
更新日期:2005-03-01 00:00:00
abstract::Recent pharmacologic evidence supports the importance of the integrity of the endothelium in modulating vascular reactivity. The endothelial cells produce one or more endothelium derived relaxing factor(s) or EDRF that cause relaxation of vascular smooth muscle cells through production of cyclic guanosine monophosphat...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/0952-8180(88)90033-5
更新日期:1988-01-01 00:00:00
abstract::During surgical removal of tumors of the skull base or cerebellopontine angle with brainstem compression, the vagus nerve is at a high risk for injury that can result in permanent or transient swallowing and speech dysfunction. Intramuscular recording of cricothyroid muscle can be used for vagal nerve mapping during i...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.01.002
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:Obesity has detrimental effects on general health and respiratory function. This study aimed to evaluate respiratory muscle strength in the morbidly obese population, before and after bariatric surgery, and to compare these estimates with the predictive values using different mathematical equations avai...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.03.005
更新日期:2016-08-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate perioperative dual antiplatelet therapy management in patients with previously placed coronary stents. DESIGN:Retrospective medical record review. SETTING:Academic medical center. PATIENTS:A total of 1891 surgical cases performed at Vanderbilt University Medical Center in 2012 were evalua...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.01.030
更新日期:2016-09-01 00:00:00
abstract::Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, th...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2011.05.002
更新日期:2011-09-01 00:00:00