This prospective, randomized, placebo-controlled, double-blinded study was designed to evaluate the efficacy of tropisetron in preventing postoperative nausea and vomiting after elective supratentorial craniotomy in adult patients. We studied 65 ASA physical status I-III patients aged 18 to 76 years who were undergoing elective craniotomy for resection of various supratentorial tumors. Patients were divided into two groups and received either 2 mg of tropisetron (group T) or saline placebo (group P) intravenously at the time of dural closure. A standard general anesthetic technique was used. Episodes of nausea and vomiting and the need for rescue antiemetic medication were recorded during 24 hours postoperatively. Demographic data, duration of surgery and anesthesia, and sedation scores were comparable in both groups. Nausea occurred in 30% of group T patients and in 46.7% of group P patients (P >.05). The incidence of emetic episodes was 26.7% and 56.7% in the two groups (P <.05). Rescue antiemetic medication was needed in 26.7% and 60% of the patients (P <.05). Administration of a single dose of tropisetron (2 mg intravenously) given at the time of dural closure was effective in reducing postoperative nausea and vomiting after elective craniotomy for supratentorial tumor resection in adult patients.

Desflurane and sevoflurane at 0.5, 1 and 2 MAC inhibit the frequency and amplitude of myometrial contractions induced with oxytocin in a dose-dependent manner. However, desflurane inhibits the amplitude less than sevoflurane at 1 MAC. We suggest that 0.5 MAC of both agents and 1 MAC of desflurane may be safely used in the presence of oxytocin following delivery of the infant and placenta during Cesarean section without fear of uterine atony and hemorrhage.

Background and objectives: The aim of this study was to compare the effect of adding magnesium to levobupivacaine on sensory and motor block onset and duration for axillary brachial plexus block in chronic renal failure (CRF) patients scheduled for arteriovenous fi stule surgery (AVFS). Methods: 80 patients, ASA III, aged 30 to 70 years, randomized and divided into 4 groups: Group I (n = 20) received total 41 ml of levobupivacaine 0.5 % + 1 ml NaCl 0.9 % mixture; Group II (n = 20) received 41 ml of levobupivacaine 0.5 % + 1 ml magnesium sulfate (150 mg) mixture; Group III (n = 20) received total 41 ml of levobupivacaine 0.25 % + 1 ml NaCl 0.9 % mixture; and Group IV (n = 20) received total 41 ml of levobupivacaine 0.25 % + 1 ml magnesium sulfate (150 mg) mixture by perineural axillary brachial plexus block. All patients were evaluated with regard to motor and sensory blocks. Motor and sensory block ending times were recorded. Results: Motor and sensory block onset times were statistically decreased in Group II when compared with Goup I, and also the motor and sensory block durations were increased in Group II when compared with Goup I (p < 0.05). Sensory block onset times were statistically decreased in Group IV when compared with Goup III (p < 0.05). Conclusions: We conclude that by its decreasing effect on local anesthetic dose, magnesium may reduce the side effects due to high local anesthetic doses in patients with CRF (Tab. 1, Ref. 11).

Low-dose epinephrine offers more stable hemodynamics and similar blockade, and thus may be beneficial for patients undergoing forearm and hand surgery who are at risk for tachycardia and/or hypertension.

In patients who underwent craniotomy for supratentorial lesions, patients who received 1 MAC desflurane-based anesthesia had earlier postoperative cognitive recovery and postoperative neurologic examination compared with patients who received 1 MAC isoflurane-based anesthesia. The observed benefits of early recovery from anesthesia, however, should be considered with risks such as higher MAP in patients administered 1 MAC desflurane.