Middle East journal of anaesthesiology
-
Middle East J Anaesthesiol · Jun 2008
Comparative StudyHemodynamic effects of anesthetic induction in patients treated with beta and calcium channel blockers.
The response to anesthetic induction and airway manipulation in the presence of cardiovascular disease and antihypertensive therapy has not been adequately investigated. ⋯ Hypotension requiring treatment in patients receiving a combination of BB + CCB is more frequent after induction of anesthesia.
-
Middle East J Anaesthesiol · Jun 2008
Case ReportsCesarean hysterectomy for placenta percreta invading the anterior abdominal wall: anesthetic considerations--a case report.
Placenta accreta is defined as an abnormal adherence of the placenta to the uterine wall owing to a faulty or an absent decidua basalis. Placenta accreta is further subdivided into placenta accreta vera, increta and percreta, depending on the level of invasion of the uterine wall and surrounding structures. Placenta percreta represents invasion to the serosa and/or other pelvic structures. We herein present the case of a pregnant patient with placenta percreta invading anterior abdominal wall and review the perioperative (Cesarean hysterectomy) anesthetic management of this complication.
-
Middle East J Anaesthesiol · Jun 2008
The feasibility of spinal anesthesia with sedation for laparoscopic general abdominal procedures in moderate risk patients.
One of the major advantages of laparoscopic surgery is minimizing postoperative morbidity. The previous limitations to the use of spinal anesthesia in laparoscopic surgery were the limited work space, high failure rate, more intra-operative morbidity and significant arterial blood gas alterations. However, the addition of a small-dose Ketamine infusion to propofol might provide a suitable sedative combination to be used with high spinal anesthesia, producing titerable sedation, increased hemodynamic stability, and minimal respiratory depression. ⋯ The addition of a sedative combination of ketamine and propofol to spinal anesthesia was found to be safe and efficient from both the anesthetic and surgical point of view, especially for sick patients with intermediate clinical predictors.
-
Middle East J Anaesthesiol · Jun 2008
Anesthesia with etomidate and remifentanil for cesarean section in a patient with severe peripartum cardiomyopathy--a case report.
Patients with peripartum cardiomyopathy may require analgesia/anesthesia for delivery or cesarean section. Many different methods of anesthesia has been used for this purpose. ⋯ She was scheduled for emergency cesarean section becaue of threatening mother's life and fetal distress. General anesthesia was induced with etomidate and maintained with remifentanil infusion safely, without any adverse outcome on mother or newborn.
-
Middle East J Anaesthesiol · Jun 2008
Randomized Controlled TrialAnalgesic requirements for patients undergoing lower extremity orthopedic surgery--the effect of combined spinal and epidural magnesium.
Polypharmacological approach is the most common practice to treat perioperative pain, as no single agent has yet been identified to specifically inhibit nociception without associated side effects. Opioids such as Fentanyl is commonly added to local anesthetics to produce spinal and epidural anesthesia. However, significant adverse effects, such as pruritus, respiratory depression, hemodynamic instability and occasionally severe nausea and vomiting, may limit their use. Our present study was designed to assess the effectiveness of using combined intrathecal and epidural magnesium (Mg) in reducing intra-and postoperative analgesic requirements and improving the quality of analgesia. ⋯ For lower extremity orthopedic procedure, supplementation of spinal anesthesia with combined intrathecally injected and epidurally infused Mg, considerably reduced the perioperative analgesic requirements without any side effects.