Minerva

Prochlorperazine is better than ondansetron at preventing postoperative nausea and vomiting after total joint replacement (Archives of Internal Medicine1998;158:2124-8http://www.bmj.com/cgi/external_ref?access_num=9801179&link_type=MED). In a randomised controlled trial patients given ondansetron were over three times as likely to experience nausea and twice as likely to vomit than controls given prochlorperazine. Ondansetron is considerably more expensive than traditional antiemetics, and most trials so far have tested it only against placebo.

The literature on the use of aminophylline in acute asthma in children is plagued with methodological problems, including small sample sizes, so Minerva was pleased to see a randomised trial in 163 children (Archives of Diseases in Childhood1998;79:405-10[Abstract/Full Text]). All the children had acute asthma unresponsive to inhaled salbutamol. Aminophylline improved results of respiratory function tests at six hours, improved oxygen saturation at 30 hours, and reduced the need for rescue ventilation, but tended to make the children sick. The authors suggest using it as a last resort when salbutamol, ipratropium bromide, and steroids have all failed.

Technologists have invented a smart needle with an inbuilt Doppler sensor to help doctors hit difficult subclavian veins. Unfortunately, a trial finds that the new toy doesn't help (Archives of Surgery1998;133:1089-93http://www.bmj.com/cgi/external_ref?access_num=9790206&link_type=MED). Doctors using the smart needle …