Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 2008
Randomized Controlled TrialEpidural ketamine for postoperative analgesia in the elderly.
We assessed the epidural use of ketamine in elderly patients undergoing major abdominal surgery. ⋯ Epidural ketamine, when compared to epidural morphine, appears to be associated with less sedation and a smaller risk of PONV, but necessitates more frequent or continuous administration to achieve comparable analgesia.
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Middle East J Anaesthesiol · Oct 2008
ReviewChronic obstructive lung disease: perioperative management.
Inflammatory mediators play a major role in pulmonary and extra pulmonary manifestations of COPD. In the preoperative risk evaluation, composite scoring systems like ASA physical status are more efficacious than any single risk factor. ⋯ Preoperative optimization of respiratory status and use of postoperative lung expansion maneuvers are effective measures for prevention of PPCs. Lastly, anesthesiologists need to evolve strategies based on the pathophysiology of the disease to ensure that their patients receive optimal perioperative care.
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Middle East J Anaesthesiol · Oct 2008
Randomized Controlled Trial Comparative StudyFetal responses to epidural analgesia as evidenced by Doppler indices.
This study was designed to evaluate the maternal effects ofepidural analgesia by different local anesthetics and their impact on placental and fetal blood flow. ⋯ All local anesthetics produced excellent analgesia during labor. The Doppler indices were improved in the three groups with the best results in levobupivacaine group.
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Middle East J Anaesthesiol · Oct 2008
Randomized Controlled TrialTwo lung ventilation through single lumen tracheal tube in thoracoscopic thymectomy: a randomized clinical trial of efficacy and safety.
Video assisted thoracoscopic surgery (VATS) has been successfully used for thymectomy in myasthenia gravis (MG). Thoracoscopic thymectomy (TT) is usually done under general anesthesia with double lumen tubes (DLT). The aim of this study is evaluation of two lung ventilation through single lumen tubes (SLT) during TT. ⋯ SLT is safe in TT. It provides good surgical exposure and decreases the cost, time and undesirable complications of DLT.
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Middle East J Anaesthesiol · Oct 2008
Randomized Controlled TrialHypertonic saline 5% vs. lactated ringer for resuscitating patients in hemorrhagic shock.
Though hypertonic and isotonic crystalloids are used nowadays in resuscitating patients in hemorrhagic shock, yet there is no sufficient data in support of either. The aim of this study was to compare the hemodynamic effects of hypertonic saline 5% and lactated ringer solutions when used for the resuscitation of patients in hemorrhagic shock. ⋯ Both hyper and isotonic crystalloid solutions can improve hemodynamic status and the blood gas measurements, similarly; however, lactated ringer is a more potent solution in improving tissue oxygenation.