Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 2016
Randomized Controlled Trial Comparative StudyNasotracheal Intubation with Parker Flex-Tip Versus Preformed Nasal Endotracheal Tubes for Children Undergoing Adenotonsillectomy.
The design of the endotracheal tube might be an important factor in the incidence of injurious complications during nasotracheal intubation. ⋯ It seems that the flexible tapered tip of the PFT tube has led to easier insertion through the nasal passages as well as less trauma to the nasal mucosa in children having nasopharyngeal pathology in the form of adenoids. At the same time, the duration of intubation was less in the PFT group relative to the control group in spite of the more familiarity of the investigator with the standard portex tube.
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Middle East J Anaesthesiol · Oct 2016
Ultrasound Guided In-Plane Penile Nerve Block for Circumcision: A New, Modified Technique Suggests Lower Anesthetic Volume and Narcotic Use.
Circumcision is one of the most common surgical procedures in pediatric males. Anesthesia is often the classic dorsal penile nerve block (DPNB), which is based on landmark identification and tactile feel of tissue resistance during needle advancement. However, this technique is associated with technical failures and vascular complications. ⋯ The ultrasound-guided DPNB technique appears to offer advantages over classic DPNB and warrants a prospective controlled trial to confirm these findings.
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Middle East J Anaesthesiol · Jun 2016
Randomized Controlled Trial Comparative StudyCOMPARISON OF THE EFFECTS OF PREEMPTIVE INTRAVENOUS AND RECTAL ACETAMINOPHEN ON PAIN MANAGEMENT AFTER INGUINAL HERNIORRHAPHY IN CHILDREN: A PLACEBO-CONTROLLED STUDY.
Postoperative pain management is a critical concern in pediatric surgery. Acetaminophen is the safest and most widely used analgesic in children. The present study compared the analgesic efficacy of intravenous (IV) and rectal acetaminophen versus placebo in children undergoing inguinal herniorrhaphy. ⋯ Both IV and rectal acetaminophen were more effective than placebo in pain relief after inguinal hernia repair in children. They were also associated with lower frequencies of postoperative vomiting. The greatest analgesic efficacy of both forms was observed during the first two hours after surgery.
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Middle East J Anaesthesiol · Jun 2016
SHORT-TERM POSTOPERATIVE COGNITIVE FUNCTION OF ELDERLY PATIENTS UNDERGOING FIRST VERSUS REPEATED EXPOSURE TO GENERAL ANESTHESIA.
General anesthesia (GA) may affect cognitive functions and result in postoperative cognitive dysfunction. The aim of our prospective pilot study was to compare the short-term postoperative cognitive function of unimpaired elderly patients undergoing first versus repeated exposure to GA. ⋯ Our pilot study suggests that prior exposure of elderly patients to GA might lead to prolonged cognitive impairment and repeated GA exposure seems to be a potential risk factor for greater short-term postoperative cognitive impairment.
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Middle East J Anaesthesiol · Jun 2016
Case ReportsLOEYS-DIETZ SYNDROME: PERIOPERATIVE ANESTHESIA CONSIDERATIONS.
Loeys-Dietz syndrome (LDS) is a rare autosomal dominant disease related to genetic mutations in receptors for the cytokine transforming growth factor-receptor type 1 (TGFB-R1) or 2 gene (TGFB-R2) on the cell surface. LDS results in abnormal protein synthesis and dysfunctional connective tissue, which can result in unique cardiovascular anesthesia challenges related to perioperative management. Patients with LDS may manifest hypertelorism, bifid uvula or cleft palate, and arterial tortuosity. ⋯ LDS patients who require surgical intervention require meticulous vigilance from the anesthesiologist. We describe a 26 year old patient with documented LDS type 1 who presented for repair of an ascending/root aneurysm in this case report. Recognition of LDS and intra-operative management of the cardiovascular manifestations of this disease is paramount in ensuring successful surgical outcome and to limit morbidity and mortality.