PubMed Health⌕ Search

Biomedical subjects

R Ramboatiana

Publications and source records attributed to R Ramboatiana.

10 recordsLinked to original sources
PubMed1998

Meta-analysis of the efficacy of extradural clonidine to relieve postoperative pain: an impossible task.

Clonidine, an alpha2 adrenoceptor agonist, has anti-hypertensive and anti-nociceptive effects. It is commonly used in association with local anaesthetics and opioids to enhance the quality and duration of extradural analgesia in the postoperative period, and to decrease the incidence of side effects. As a sole analgesic, it has seldom been used to relieve postoperative pain. The dose of extradural clonidine to achieve good pain relief without deleterious side effects remains undetermined. In order to address this problem, we performed a computer search via two well-known databases, Medline and Excerpta Medica, covering the period from 1985 to September 1997. One hundred and fifty-nine articles were retrieved of which 38 dealt with extradural clonidine and postoperative pain. All but 16 studies suffered from serious design flaws, such as lack of controls and/or randomization, or inadequate statistical analysis. The data from these studies were difficult to interpret because of the tremendous variation in variables, especially dose of clonidine, level of extradural injection, time of administration, type of anaesthesia, type of surgery, and reference and rescue drugs. The simultaneous extradural use of local anaesthetics and opioids further hindered data interpretation, and precluded any meta-analysis. Proposals for a standard study design are made to help comparison between studies involving extradural clonidine and postoperative pain.

Adrenergic alpha-Agonists↗
PubMed1990

[Postoperative analgesia for circumcision in children].

Circumcision in children is followed by severe pain. This study analysed retrospectively anesthetic techniques of 110 children from 17 months to 14 years old who had undergone ambulatory of 24 h stay circumcision. There were two groups of patients: one being operated on under locoregional techniques combined with general anesthesia (53.6%), the other one under general anesthesia alone (46.4%). Post operative analgesia was provided by the regional anesthesia (with or without additional analgesics via rectal route) for the former group whereas analgesic drugs were administered only rectally for the latter one. In this second group, pain relief assessment was insufficiently recorded and was considered poor. In the first group, dorsal nerves block of the penis (DNBP) was performed on 47 children (79.8% of the locoregional techniques), caudal block on 10 patients and ring block on 2 patients. Regional techniques offered a satisfactory, safe and reliably effective post circumcision analgesia. DNBP should be used systematically in order to shorten duration of day circumcision stay.

Administration, Rectal↗
PubMed1990

[Intramuscular methohexital. A simple and reliable means of sedation for cerebral computed tomography in children].

Intramuscular methohexital sedation was retained as an easy and reliable method to sedate children for a C.T. scan. In this retrospective study of 50 cases of children aged from 2 months to 7 years all the children were administrated an oral premedication (diazepam: 1 drop/kg and atropine: 0.02 mg.kg-1) one hour before the scanner examination. Once in the operating room, they were administrated 10 mg.kg-1 methohexital saline 2.5% solution, intramuscularly deep in the buttock. E.C.G. was the main monitoring. Spontaneous breathing was evidenced by means of a simple device. At the end of the scan, the child was taken care for in the recovery room. The methohexital dose provided adequate sedation in most cases. Once the injection was given, a motionless state was reached in 4.20 minutes. The insertion of an intravenous catheter induced movements in 96% cases, which did not interfere with the successful intravenous puncture. In 33% cases, 1 to 2 mg.kg-1 ketamine was necessary because of a failed attempt at obtaining the required state, or of an awakening due to iodized injection. Among those cases, half the children were overweight for their ages. In this situation an adjusting dose should be considered. On average, a child under the influence of the drug slept for 35 minutes and the required time for a C.T. scan is 23.3 minutes. Time in the recovery room is on average 20 minutes. There was no episode of cardiovascular or respiration failure, or local reaction at the injection site. There was also no episode of seizure.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1986

[Oral premedication with diazepam].

A double blind study has been carried out on patients scheduled for appendicectomy. They were divided into two groups who were given diazepam as premedication either orally or intramuscularly. The clinical effects were measured with regard to anxiolysis, gastric contents volume and acidity. Orally premedicated patients were not significantly less anxious. No significant differences between both groups concerning gastric contents (volume and pH) were found. Therefore, oral premedication did not increase the risk of inhalation. Taking into account the previous findings in the literature, the pharmacological advantages of the oral route and the lack of complications, a wider use of oral premedication for elective operations in adults is recommended.

Administration, Oral↗