Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2008
Clinical TrialTracheostomy under jet-ventilation--an alternative approach to ventilating patients undergoing surgically created or percutaneous dilational tracheostomy.
In a prospective observational study we compared the results of 297 elective tracheostomies under jet-ventilation with regard to its complication rate and practicability. Of those, 156 patients underwent surgically created tracheostomy (SCT) and 141 patients percutaneous dilational tracheostomy (PDT). Initially, in 159 patients jet-ventilation was performed using a jet-cannula inserted intratracheally through the cricothyroid membrane. ⋯ The bronchoscope-guided gas stream, when compared to jet-cannula inserted intratracheally, offered more space for tracheostomy and safety for the patient. The permanent danger of mishappenings and dislocation involved with the jet-cannula could be avoided, since the bronchoscope was operating on under direct visualization. Under these circumstances, PDT is an acceptable approach to inserting a tracheostomy tube under jet-ventilation via bronchoscope, particularly for the management of difficult airway in critically ill patients.
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Middle East J Anaesthesiol · Feb 2008
Randomized Controlled TrialOpioid saving strategy: bilateral single-site thoracic paravertebral block in right lobe donor hepatectomy.
Postoperative analgesia after hepatectomy remains a challenge, mainly because of limited therapeutic index of the conventional opioids. The aim of this study is to evaluate the efficacy of bilateral single-site thoracic paravertebral block for the management of postoperative pain following right lobe donor hepatectomy (RLDH) using a prospective, randomized and controlled study design. ⋯ Bilateral single-site thoracic paravertebral block is easy, safe and efficient technique for postoperative pain management in patients undergoing right lobe donor hepatectomy.
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Middle East J Anaesthesiol · Feb 2008
Case ReportsTransient severe left ventricular diastolic dysfunction during intraoperative transesophageal echocardiography--a case report.
A 55-year-old man with significant lesion of left anterior descending artery and left ventricular systolic dysfunction, became candidate for coronary artery bypass grafts surgery. Intraoperative transesophageal echocardiography (TEE) was done for evaluation of severity of mitral regurgitation. ⋯ After restoring blood pressure to 110/60 mmHg, LV diastolic pattern returned to baseline pattern. The decreased coronary perfusion pressure and its effect on diastolic function may be responsible for this pattern of diastolic dysfunction.