Middle East journal of anaesthesiology
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ICU patients, mainly those who need prolonged ventilatory support, may require tracheostomy, which once was done in the operating room, nowadays is performed in the ICU, as percutaneous dilatational tracheostomy (PDT). Forty two patients 18-72 yrs of age (mean 44 yrs), with varying indications for tracheostomy, had undergone PDT in the ICU under the standard protocol for this procedure. ⋯ The difficulties encountered were mainly the anatomical landmarks (10%), difficulties in dilatation (5%) and peristomal oozing (1%). It is concluded that percutaneous dilatational tracheostomy is an easy, cost effective, practical when done at bedside in the ICU, and spares transferring the patient to the operating theater.
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Middle East J Anaesthesiol · Jun 2006
Editorial Historical ArticleMiddle East Journal of Anesthesiology--hand, head and heart.
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Middle East J Anaesthesiol · Jun 2006
ReviewMedico-legal aspects in anesthesia: how to lead a happy life.
This article discusses medico-legal aspects in anesthesia. It underlines the standards of care by which anesthesiologists should abide by, as well as define malpractice, its causes, and ways to avoid it. The role of the expert witness is explained and the ethical guidelines to follow are outlined.
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Middle East J Anaesthesiol · Jun 2006
Clinical TrialRemifentanil preventing hemodynamic changes during laparoscopic adrenalectomy for pheochromocytoma.
In this prospective case-series study, a balanced anesthetic scheme of sevoflurane in nitrous oxide supplemented with remifentanil and sustained neuromuscular block was applied in nine patients scheduled for laparoscopic adrenalectomy for pheochromocytoma. Laparoscopic adrenalectomy to treat pheochromocytoma results in marked catecholamine release during pneumoperitoneum and tumor manipulation. ⋯ Increased infusion rate of remifentanil was used (up to 3 microg/kg/min) to prevent and treat marked hemodynamic changes from catecholamine release during tumor manipulation. Hpotension after tumor removal was treated with additional colloids fluids and decreasing the remifentanil infusion rate by 25-50%.