Anesthesia, essays and researches
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Laryngoscopy and intubation cause an intense reflex increase in heart rate, blood pressure, due to an increased sympathoadrenal pressor response. Lignoocaine has shown blunting of pressor response to intubation. Dexmedetomidine has sympatholytic effects. ⋯ We conclude that dexmedetomidine 1μg/kg adequately attenuates the hemodynamic response to laryngoscopy and endotracheal intubation when compared with dexmedetomidine 0.5μg/kg and lignocaine 1.5mg/kg.
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Although mephentermine (Termin) and ephedrine are commonly used drugs for the treatment of hypotension during anesthesia but their abuse have markedly increased, especially in the young population due to its stimulant properties. Here, we report a case of 23-year-old man with a history of chronic mephentermine abuse, posted for Achilles tendon repair under spinal anesthesia. During intraoperative period, spinal induced hypotension showed unusual resistance to ephedrine boluses and was managed by using directly acting vasoconstrictor, that is, phenylephrine.
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Postoperative pain is a common complaint and despite the availability of various drugs, is still not managed well. Analgesic effects of glucocorticoids are still to be substantially established. Hence, we designed randomized, double-blind, placebo-controlled trial to compare the effect of two different doses of dexamethasone on postoperative pain in patients undergoing infra-umbilical surgeries under spinal anesthesia. ⋯ Dexamethasone 16 mg reduces postoperative pain on motion at 24 and 36 h. It has no effect on postoperative pain at rest or on nausea and vomiting.
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Intrathecal neostigmine and magnesium sulfate (MgSO4) produce substantial antinociception, potentiate analgesia of bupivacaine without neurotoxicity. ⋯ Intrathecal Neostigmine and MgSo4 does not affect characteristics of SA. Postoperative analgesia of neostigmine was better than MgSO4. Neostigmine provides some protection against hypotension of SA whereas MgSO4 protects against bradycardia.
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Flupirtine is a centrally-acting, nonopioid analgesic that interacts with N-methyl-D-aspartate receptors. ⋯ Oral flupirtine and diclofenac sodium were equally effective for postoperative analgesia. There was faster onset of analgesia with diclofenac sodium, but flupirtine was better tolerated by the patients because of its minimal adverse effects.