BMC anesthesiology
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Randomized Controlled Trial Comparative Study
Efficacy of ultrasound guided erector spinae plane block compared to wound infiltration for postoperative analgesia following laparoscopic living donor nephrectomy: a double-blinded randomized controlled trial.
Postoperative pain remains a significant problem in patients undergoing donor nephrectomy despite reduced tissue trauma following laparoscopic living donor nephrectomy (LLDN). Inadequately treated pain leads to physiological and psychological consequences, including chronic neuropathic pain. ⋯ Ultrasound-guided ESPB provided effective pain relief compared to wound infiltration with local anaesthetic in patients who underwent LLDN.
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Randomized Controlled Trial Comparative Study
Comparative study between high and low dose methylene blue infusion in septic cancer patients: a randomized, blinded, controlled study.
Septic shock is a common threat, and is the primary cause of death in almost all critical care units. Mortality of septic shock remains exceedingly high. The early use of methylene blue (MB) in different doses as adjunctive to vasopressors has promising results. ⋯ In cancer patients with septic shock, early adjunctive MB delivery reduces the time to a vasopressor stoppage and increases the vasopressor-free days. No significant difference between high and low MB bolus doses, and no significant adverse effects were noted. Compared to placebo, the 4 mg/kg bolus dose shows a survival advantage.
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Randomized Controlled Trial
The effect of preoperative topical magnesium sulfate spraying in the oropharyngeal region on postoperative sore throat following gynecological laparoscopic surgery: a randomized clinical trial.
Postoperative sore throat is a common complication following general anesthesia. This study aimed to investigate the impact of preoperative topical magnesium sulfate spraying in the oropharyngeal region on postoperative sore throat following gynecological laparoscopic surgery. ⋯ This study confirmed that preoperatively spraying magnesium sulfate locally in the Oropharyngeal Region can reduce the frequency and severity of postoperative sore throat.
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Randomized Controlled Trial
Prevention of sufentanil-induced cough during induction of general anesthesia by low-dose esketamine.
Sufentanil is commonly used to induce general anaesthesia due to its rapid onset of action, strong analgesic effect, long-lasting effect, and stable haemodynamics; however, it often induces cough, increasing the risk of anaesthesia. This study aimed to investigate the preventive effect of low-dose esketamine on sufentanil-induced cough. ⋯ Low-dose esketamine (0.2 mg/kg) can significantly reduce the incidence of sufentanil-induced cough during the induction of general anaesthesia in patients, with a small impact on haemodynamics, no adverse reactions, and good safety.
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In resource-limited settings, advanced airway management tools like fiberoptic bronchoscopes are often unavailable, creating challenges for managing difficult airways. We present the case of a 25-year-old male with post-burn contractures of the face, neck, and thorax in Nigeria, who had been repeatedly denied surgery due to the high risk of airway management complications. This case highlights how an awake intubation was safely performed using an Airtraq® laryngoscope, the only device available, as fiberoptic intubation was not an option. The patient had a mouth opening of 3.5 cm, a Mallampati score of 4, and no neck extension, making intubation challenging. Pre-procedural counseling was provided, and after explaining the risks, the patient gave informed consent. ⋯ This case emphasizes that safe awake intubation with an Airtraq® laryngoscope is feasible in low-resource environments when key principles-oxygenation, topical anesthesia, and careful procedural steps-are followed. The reuse of a single-use device like the Airtraq® laryngoscope extends its utility in resource-constrained settings, enabling complex airway management when alternatives are unavailable. The patient tolerated the procedure well and reported minimal discomfort. This experience underscores the critical importance of innovation, resourcefulness, and patient cooperation in managing difficult airways when standard tools are unavailable, offering valuable lessons for similar resource-constrained environments.