Anesthesia, essays and researches
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Epidural volume extension (EVE) is claimed to increase the block height and decrease the dose requirement for intrathecal drug. However, almost all studies have been done in obstetric population and none actually compares the effect of additional drugs added to epidural volume. ⋯ EVE can increase the block height significantly, but it seems to be limited only to the physical property of additional volume in epidural space and fentanyl or tramadol do not seem to differ in their ability to alter block properties.
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General anesthesia and neuraxial blockade have their own advantages and disadvantages over each other when used for hip surgery. Single shot lumbar plexus block can be the choice of the anesthetic technique for postrenal transplant, immunocompromised, postspinal surgery patient to undergo dynamic hip screw surgery.
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To evaluate the efficacy of lidocaine patch applied around wound in laparoscopic colorectal surgery in reduction of postoperative pain and illus compared to intravenous lidocaine infusion and placebo. ⋯ The lidocaine patch was equal to i.v. lidocaine infusion in decreasing pain scores and morphine consumption but not in acceleration of bowel function return.
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Daily interruption of sedation could minimize the problem of sedatives accumulation. Nevertheless, whatever is the sedation strategy; sedation, particularly deep levels, has been associated with high frequency of patient-ventilator asynchrony. Extending these findings, one would expect that no sedation protocol could reduce the frequency of patient-ventilator asynchrony. ⋯ No sedation protocol reduces the asynchrony index and preserves the patient's effort during triggering.
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The incidence of anaphylaxis during anesthesia has been reported to range from 1 in 4000 to 1 in 25,000. Anaphylaxis during anesthesia can present as cardiovascular collapse, airway obstruction, and/or skin manifestation. It can be difficult to differentiate between immune and nonimmune mast cell-mediated reactions and pharmacologic effects from the variety of medications administered during general anesthesia. ⋯ Protamine can cause severe systemic reactions through IgE-mediated or nonimmunologic mechanisms. Blood transfusions can elicit a variety of systemic reactions, some of which might be IgE-mediated or mediated through other immunologic mechanisms. The management of anaphylactic reactions that occur during general anesthesia is similar to the management of anaphylaxis in other situations.