Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2004
Randomized Controlled Trial Clinical TrialComparison of serum cortisol level in open heart surgery--morphine versus sufentanil.
In open-heart surgery, cardiopulmonary bypass (CPB) can cause a rise in the level of stress hormones such as cortisol. Reducing this hormonal response is beneficial in the recovery period. Anesthetic agents and methods used in such operations have different effects on this response. In the present study two agents (morphine and sufentanil) routinely used for the cardiac surgery in Nemazi Hospital were compared regarding their effect on the serum cortisol levels. ⋯ Neither morphine nor sufentanil in the mentioned doses could reduce the endocrine response in the postoperative period, and thus have no preference, in cardiac surgery.
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Middle East J Anaesthesiol · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialPost operative analgesia with continuous epidural infusion.
Forty eight ASA I or II patients of either sex between 20-70 years undergoing major upper abdominal surgery were grouped into sixteen each, on complaint of pain. They received an epidural bolus dose, followed by infusion of the assigned drug at 4ml per hour through BARD PCA I pump. Pain assessment, for the first four hours, was hourly, and subsequently at l0th, 16th, 22nd, 28th, 36th and 40th hour by VAS and VRS. ⋯ In all groups sedation ranged from 0-1. There was hypotension in Group I (2/16).urinary retention in Group II (8/9 not catheterised); unilateral sensory impairment and motor weakness in Group I (3/16) and Group III (1/16). This study showed that continuous infusion of low dose morphine with bupivacaine provides better quality post operative analgesia with fewer side effects than bupivacaine or morphine alone.
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Middle East J Anaesthesiol · Jun 2004
Review Comparative StudyDesflurane vs. sevoflurane--a review.
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Middle East J Anaesthesiol · Jun 2004
Comparative StudyInduced preconditioning of cardiac performance in coronary bypass surgery--sevoflurane vs propofol.
Twenty ASA III and IV adult patients scheduled for elective coronary artery surgery were included in the study. Anesthesia was induced and maintained with either sevoflurane (sevoflurane group; n = 10) or propofol (propofol group; n = 10). All preoperative cardiac medications were continued until the morning of surgery. There were significant decreases in mean arterial blood pressure, cardiac index and ejection fraction after CPB in propofol group compared with sevoflurane. Further, the plasma creatine kinase myocardial isoenzyme concentrations were significantly higher in propofol group but did not approach the critical values needed for diagnosis of myocardial infarction. ⋯ It is concluded that, sevoflurane appears to be associated with better hemodynamic stability before and after CPB than propofol. This could be attributed to cardioprotective effect of sevoflurane during ischemia and reperfusion.