Journal of anesthesia
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Journal of anesthesia · Feb 2014
Randomized Controlled TrialEffect of clonidine added to lidocaine for sub-Tenon's (episcleral) anesthesia in cataract surgery.
We aimed to evaluate the duration of anesthesia, analgesia and ocular akinesia of clonidine added to lidocaine in sub-Tenon's anesthesia in patients undergoing cataract surgery. ⋯ The addition of clonidine 1 μg/kg to 2 % lidocaine in sub-Tenon's anesthesia for cataract surgery increased the duration of sensory anesthesia, ocular akinesia, and the duration of analgesia.
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Journal of anesthesia · Feb 2014
Review Case ReportsDexmedetomidine-induced atrioventricular block followed by cardiac arrest during atrial pacing: a case report and review of the literature.
Sinus bradycardia is a well-known consequence of stimulation of presynaptic α2 adrenergic receptors due the adminstration of dexmedetomidine. One of the most serious adverse effects of dexmedetomidine is cardiac arrest. Some cases demonstrating such an arrest due to the indiscriminate use of this drug were recently reported. ⋯ The PQ interval in electrocardiography gradually prolonged during the infusion; finally, complete atrioventricular block and subsequent cardiac arrest occurred. Immediate cardiopulmonary resuscitation was carried out, including re-intubation, and recovery of spontaneous circulation was attained 15 min after the event. The patient was discharged from hospital on the 25th postoperative day without any neurological complications.
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Although pain after craniotomy is a clinically significant problem that has a continuously expanding literature, it is still a source of concern and controversy. Postcraniotomy headache (PCH) has been neglected for years. It is assessed regularly by only a few neurosurgical centers, and its frequency and severity tend to be underestimated by medical staff; hence, PCH is often undertreated and poorly managed. ⋯ NSAIDs seem to have inadequate analgesic effects, whereas opioids have a wide range of drawbacks; nevertheless, both types of medicaments are regarded as cornerstones of a balanced and adequate multimodal therapy. The purpose of this review is to collect the currently available knowledge about the incidence, assessment, pathophysiological mechanism, and predictors of acute and chronic PCH. Therefore, a broad search of the literature has been carried out to collect evidence of potential prevention and treatment strategies.
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Journal of anesthesia · Feb 2014
Randomized Controlled Trial Comparative StudyComparison between intranasal dexmedetomidine and intranasal ketamine as premedication for procedural sedation in children undergoing MRI: a double-blind, randomized, placebo-controlled trial.
Providing anesthesia to children undergoing MRI is challenging. Adequate premedication, administered noninvasively, would make the process smoother. In this study, we compare the efficacy of intranasal dexmedetomidine (DXM) with the intranasal administration of ketamine for procedural sedation in children undergoing MRI. ⋯ DXM and ketamine were equally effective, by the intranasal route, as premedication in children undergoing MRI.