Acta anaesthesiologica Belgica
-
Acta Anaesthesiol Belg · Jan 2011
Randomized Controlled TrialOptimum dose of ketamine for prevention of postanesthetic shivering; a randomized double-blind placebo-controlled clinical trial.
Our objective was to investigate the efficacy and the optimum dosage of ketamine for post anesthetic shivering prevention. One-hundred and twenty patients (ASA I-II) scheduled for elective orthopedic surgery were randomly allocated to receive ketamine in 3 groups ; groups A (0.125 mg/Kg), groups B (0.25 mg/Kg) and C (0.5 mg/Kg) along with those receiving 0.9% normal saline as the placebo group. Tympanic temperature was measured immediately after induction of anesthesia, 30 min after induction, before administration of the study drug and by the end of the surgery. ⋯ The frequency of shivering was significantly less in groups B (0.25 mg/Kg) and C (0.5 mg/Kg) than in groups A (0.125 mg/Kg) and D (placebo). In addition recovery, extubation time and hallucination was observed to be less in group B compared to group A. Prophylactic 0.25 and 0.5 mg/kg ketamine was found to be effective in preventing postanesthetic shivering with a better response observed with 0.25 mg/kg dosage.
-
Acta Anaesthesiol Belg · Jan 2011
ReviewMedication in the perioperative period: stop or continue? A review.
Preoperative evaluation of medication is important as part of the anesthetic plan. The aim of this manuscript is to evaluate and compare through literature review the existing evidence to support optimal perioperative medication management.
-
Acta Anaesthesiol Belg · Jan 2011
Comparative StudyMaintenance of anesthesia in morbidly obese patients using propofol with continuous BIS-monitoring: a comparison of propofol-remifentanil and propofol-epidural anesthesia.
Aim of this study was to evaluate maintenance of anesthesia using propofol with continuous Bispectral Index (BIS)-monitoring in morbidly obese patients receiving propofol-remifentanil and propofol-epidural anesthesia. ⋯ Using both BIS and hemodynamic parameters as an endpoint, a maintenance dose of propofol of 4-6 mg/kg/hr is proposed for maintenance of anesthesia in morbidly obese patients undergoing bariatric surgery either in combination with remifentanil or epidural analgesia. There was no difference in propofol concentration-BIS relation in morbidly obese patients receiving propofol-remifentanil or propofol-epidural anesthesia.
-
Acta Anaesthesiol Belg · Jan 2011
Case ReportsUnexpected entropy response to saline spraying at the end of posterior fossa surgery: a few cases report.
The Spectral Entropy proposed to monitor the depth of anesthesia includes the State Entropy (SE) computed from the EEG (0.8-32 Hz frequency band), and the Response Entropy (RE) computed from EEG and facial muscles activity (0.5-47 Hz frequency band). We report an unexpected Entropy response to saline spraying at the end of posterior fossa surgery. Six patients undergoing scheduled functional surgery of the posterior fossa were included in this report. ⋯ We conclude that Entropy can increase during posterior fossa surgery in non-paralyzed patients. This response probably reflects an increase in facial muscle activity rather than a change in depth of anesthesia, as far as it can be attenuated by a small dose of rocuronium. While this hypothesis requires further investigation, these observations suggest that saline spraying may confound interpretation of Entropy during posterior fossa surgery.