Anesthesia, essays and researches
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Abdominal hysterectomy is associated with sever postoperative pain. Quadratus lumborum (QL) block is a regional analgesic technique which has an evolving role in postoperative analgesia. ⋯ Bilateral QL block provided better intraoperative and postoperative analgesia with less opioids consumption compared with bilateral TAP block, in patients undergoing total abdominal hysterectomy.
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Supraclavicular brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Adjuvants are added to local anesthetists to improve various block characteristics. There are limited studies comparing the efficacy of dexmedetomidine and fentanyl as an adjuvant to levobupivacaine. ⋯ This study concludes that addition of dexmedetomidine to levobupivacaine for supraclavicular brachial plexus block shortens the onset time and prolongs the duration of sensory and motor blockade as compared to the addition of fentanyl.
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Apneic mass movement of oxygen by applying continuous positive airway pressure (CPAP) is possible only when the airway is kept patent which helps to reduce the rate of desaturation. ⋯ Preoxygenation with CPAP of 5 cmH2O followed by apneic oxygenation with CPAP keeping the airway patent with an oropharyngeal airway results in significantly higher PaO2 after preoxygenation and slower reduction in PaO2 during apnea.
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Stress-induced neuroendocrine and metabolic changes lead to intraoperative hyperglycemia which is related to surgery and the type of intravenous fluids used. ⋯ Nondiabetic patients undergoing major abdominal surgeries who received acetate-based fluids had relatively higher intraoperative blood sugar levels as compared to those receiving lactated solutions, but the incidence of hyperglycemia was comparable. When the duration of surgery exceeded 6 h, acetate-based solutions resulted in significantly higher lactate levels with progressive metabolic acidosis.
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Shivering is a common problem in patients undergoing surgery under spinal anesthesia. ⋯ Clonidine provides early relief from shivering than tramadol with fewer side effects in patients undergoing surgery under spinal anesthesia.