Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2007
Randomized Controlled Trial Comparative StudyPost-thoracotomy analgesia--comparison epidural fentanyl to intravenous pethidine.
To evaluate the efficacy of postthoracotomy analgesia with intermittent epidural fentanyl. 50 patients were allocated randomly into 2 groups. The first group received intermittent epidural fentanyl and the second group received intermittent intravenous analgesia using pethidine. The variables studied were: pain score; total amount of additional intravenous opioid analgesia, and ventilatory function parameters [forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and FEV1/FVC ratio]: ⋯ The analgesic effect of intermittent epidural fentanyl is not adequate and postoperative pain relief has not any significant advantage over the more easily-applied intravenous analgesia. However, better preservation of ventilatory function makes epidural fentanyl a useful adjunct analgesia in reduction of post-thoracotomy pulmonary complications.
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Middle East J Anaesthesiol · Feb 2007
ReviewManagement of the patient at high risk for postoperative nausea and vomiting.
Postoperative nausea and vomiting continue to be problematic areas in anesthesia as evidenced by frequent reports of therapies in the literature. No single therapy has been proven curative for all cases, in part because of the several emetic centers, all of which may be blocked by different classes of drugs and the diverse risk factors which act alone or in combination to cause vomiting. Identification of the patient most at risk allows for cost effective prophylactic management. An appropriate anesthetic technique can be planned that, relying on evidence based medicine, will decrease if not prevent the incidence of this most troubling complication.
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Middle East J Anaesthesiol · Feb 2007
Randomized Controlled Trial Comparative StudyRecovery profile for magnetic resonance imaging in pediatric daycase--sevoflurane vs. isoflurane.
Magnetic resonance imaging (MRI) is gaining ground over other investigations particular in study of brain and soft tissues. The MRI procedure is painless but requires an immobile patient for a successful study. Children are required to be sedated or anesthetized for this procedure. We compared two inhalational anesthetics, namely sevoflurane and isoflurane, for the recovery profile of each with aim to determine the ideal drug for early discharge of children. ⋯ Sevoflurane can be an ideal inhalational anesthetic for Volatile Induction and Maintenance Anesthesia (VIMA) in children under going daycase MRI examinations.
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Middle East J Anaesthesiol · Feb 2007
Randomized Controlled TrialWomen emerge from general anesthesia faster than men.
Interest in the speed with which patients recover post operatively, the type of deficits that anesthesia may induce in them and the overall profile of their physiologic and psychological states, has grown rapidly over the last two decades. Recovery from general anesthesia is dependent on factors governing drug sensitivity and drug disposition. In our study of 60 males and 60 females we have tried to find out if there is any significant difference in males and females, in their emergence from the effects of general anesthesia. ⋯ Considering the multitude of factors that may influence recovery, the gender effect appears to be a strong one. The difference could probably be explained by differences in physiology, enzyme activity etc. Investigators have noted that normal differences account for changes in function of the GABA receptor known to be important in the action of many anesthetics.
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Middle East J Anaesthesiol · Feb 2007
Post-operative symptoms at home in children following day case surgery.
This prospective questionnaire-based study examined the post-operative symptoms encountered by children who had day case surgery at a dedicated day case surgery unit. The study evaluated the postoperative symptoms at home. The parents also evaluated the instructions given in the hospital for care at home. ⋯ Post operative symptoms following elective day case surgery are amenable to treatment and prevention with a wider use of available drugs for peri-operative analgesia.