Anesthesia, essays and researches
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Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering. ⋯ Dexmedetomidine 0.5 μg/kg is more efficient than clonidine 1 μg/kg in controlling postspinal blockade shivering. Dexmedetomidine has early onset of effect, high response rate, and less recurrence rate with added advantage of good sedation and stable cardiorespiratory parameters.
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Airway management in large and retrosternal goiters with tracheal compression is often fraught with challenges and is a source of apprehension among anesthesiologists globally. ⋯ Airway management in patients with tracheal compression due to benign goiter is quite straightforward and can be managed in the conventional manner with little or no complications.
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Transversus abdominis plane (TAP) block has been used to provide intra- and post-operative analgesia with single incision laparoscopic (SIL) bariatric and gynecological surgery with mixed results. Its efficacy in providing analgesia for SIL cholecystectomy (SILC) via the same approach remains unexplored. ⋯ USG bilateral TAP blocks were not effective in decreasing 24 h morphine requirement as compared to local anesthetic infiltration in patients undergoing SILC although it provided some analgesic benefit intraoperatively and in the initial 4 h postoperatively. Hence, the benefits of TAP blocks are not worth the effort and time spent for administering them for this surgery.
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Various adjuvants have been introduced to decrease the dose of volatile agents and their side effects. Dexmedetomidine a potent alpha-2 adrenoreceptor agonist is one such agent. Our objective is to assess the effect of preanesthetic dexmedetomidine on isoflurane consumption and its effect on intraoperative hemodynamic stability and recovery profile. ⋯ Preanesthetic bolus dose of dexmedetomidine is a useful adjuvant to reduce isoflurane consumption.
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Catheter-related bladder discomfort (CRBD) is the most distressing symptom in patients due to intraoperative urinary catheterization. Amikacin significantly inhibits detrusor contraction evoked by prejunctional stimulation. ⋯ Amikacin can significantly reduce the incidence and severity of CRBD in the first few hours after surgery.