Anesthesia, essays and researches
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Postoperative pain has a significant impact on patient's recovery and optimal nonopioid analgesia would reduce postoperative pain and pain-related complications. This study was aimed to evaluate the analgesic efficacy and safety of intravenous paracetamol versus parecoxib for postoperative analgesia after surgery. ⋯ Postoperative nonopioid intravenous analgesia with paracetamol and parecoxib is comparable in the early postoperative period with no adverse effects.
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Though rocuronium has a rapid onset of neuromuscular blockade like succinylcholine without the latter's adverse effects, its use is limited due to its prolonged action. ⋯ Rocuronium in dose of 0.3 mg/kg does not give clinically acceptable intubating conditions at 60 or 90 s but has shorter duration of action. Rocuronium in dose of 0.6 mg/kg gives clinically acceptable intubating conditions at 60 or 90 s, comparable to succinylcholine 1 mg/kg.
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Ultrasound-guided sciatic nerve block, in combination with femoral nerve and lateral femoral cutaneous nerve blocks, is frequently used to induce anesthesia for lower limb surgery. The anterior approach to the sciatic nerve is performed in the supine position and repositioning of the patient between injections is avoidable. We compared the relative utility and efficiency of anterior versus transgluteal sciatic nerve blocks in conjunction with femoral nerve and lateral femoral cutaneous nerve blockade. ⋯ Ultrasound-guided anterior blockade of the sciatic nerve has advantages over the transgluteal approach - it provides efficient anesthesia and results in excellent patient satisfaction.
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The most common cause of difficult intubation in pediatrics is due to congenital anomalies of airway. We report a case of neonate with congenital epulis (CE) who presented with a difficult airway. A 7-day old neonate weighted 3.2 kg with a large mass occupying the oral cavity that was diagnosed as congenital epulis was scheduled for excision biopsy. ⋯ In conclusion, epulis presents a real challenge to anesthesiologists. It can be excised either under local or general anesthesia, depending on the size of its pedicle. If done under general anesthesia, assessment of the airway is mandatory for better airway management and safe endotracheal intubation.
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The purpose of this study was to evaluate the effect of two different volume of crystalloid given intraoperatively on postoperative nausea and vomiting (PONV). ⋯ From the current study it was concluded that patients who received larger volume of crystalloid intraoperatively have lesser incidence of PONV.