Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2006
Randomized Controlled TrialThe bispectral index system in pediatrics--is it related to the end-tidal concentration of inhalation anesthetics?
BACKGROUND AND GOAL OF STUDY: Bispectral Index (BIS) has been used in adults to measure depth of anesthesia using various protocols. Though less investigated in children, there is growing evidence that bispectral index seems adequately calibrated for monitoring the depth of isoflurane and sevoflurane anesthesia in pediatric patients. A range of BIS scores (40-60) has been seen to be an indicator for an acceptable level of hypnosis and anesthesia. Davidson and Czarnecki have reported that, at an end-tidal concentration of 1 MAC, the BIS for halothane was significantly greater than isoflurane (56.5 +/- 8.1 vs. 35.9 +/- 8.5). The explanation given is the fact that the volume concentration of the MAC value is inversely related to the BIS value. Accordingly, it is expected that the BIS value at 1 MAC of desflurane must be less than halothane and isoflurane. ⋯ The use of a relatively equipotent end-tidal concentration of different inhalational agents may result in different BIS values.
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Middle East J Anaesthesiol · Feb 2006
Randomized Controlled Trial Comparative StudyLiving donor hepatectomy (LDH)--comparative study between two different anesthetic techniques.
Living donor hepatectomy (LDH) is now widely used to meet the need for liver grafts due to the shortage of cadaveric livers. Donor safety and perioperative anesthetic management are our major concern. The aim of our study was to compare two anesthetic techniques for management of living donor hepatectomy. ⋯ In conclusion, our study demonstrated that both anesthetic techniques were well tolerated for living donor hepatectomy, with no blood transfusion required, with short and safe discharge from PACU and short hospital stay, but with significant laboratory changes reflecting transient impairment in metabolic liver function. These procedures have proven useful as an important alternative to the cadaveric liver transplantation. Both techniques can be used as fast tract technique for living donor hepatectomy.
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Middle East J Anaesthesiol · Feb 2006
Saudi patients' knowledge and attitude toward anesthesia and anesthesiologists--A prospective cross-sectional interview questionnaire.
Patients' awareness of the duties of anesthesiologists in the operating theatres may sometimes be limited. Many studies around the world proved lack of patient perception of the anesthesiologist's role in surgical practice. ⋯ Reasonable percentage of the patients knew that the anesthesiologist is a doctor who administers anesthesia. Services of anesthesiologists were highly appreciated, but their function during the operation and nature of anesthetics administered were poorly known. These results call for the necessity to educate the surgical patient by the anesthesiologists preoperative interview allow more time to establish rapport, by distributing educational material related to anesthesia and use of the media to educate illiterate section of the public on subjects pertaining to anesthesia.
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Middle East J Anaesthesiol · Feb 2006
Case ReportsAnesthesia for encephalo-trigeminal angiomatosis (Sturge-Weber syndrome).
A case report of rare congenital disease of encephalo-trigeminal angiomatosis (Sturge-Weber Syndrome) (SWS), is presented to alert the anesthesiologist of its potential risk. The case was anesthetized for emergency orthopedic surgery. ⋯ This patient tolerated balanced anesthesia well. Anesthesia should be planned to avoid trauma to the hemangiomata, increases in intraocular and intracranial pressure, and be cognizent of current anticonvulsant therapy.
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Middle East J Anaesthesiol · Feb 2006
Medico-legal liabilities of anesthesia practice in Saudi Arabia.
The aim of this paper is to reveal the anesthesia malpractice claims that were referred to the National Medico-Legal Committee (MLC) in Riyadh KSA, in order to evaluate the magnitude and underlying factors of its medico-legal litigations. ⋯ Of the anesthesia litigation claims, 9.1% resulted in positive legal action. More than one anesthesiologist may be involved for a given claim, and anesthesiologist may share partial responsibility with the surgeon in claims primarily targeting surgery or an incident of resuscitation. It is concluded that adherence to the standards of medical practice, is by far, the best policy to avoid or reduce the incidence of litigation.