Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 2009
Randomized Controlled TrialIntraoperative minimal acute normovolemic hemodilution in patients undergoing coronary artery bypass surgery.
Efficacy of minimal acute normovolemic hemodilution (ANH) in avoiding homologous blood transfusion during cardiovascular surgery remains controversial. Postoperative bleeding and transfusion remain a source of morbidity and cost after open heart operations. Our objective was to evaluate the impact of minimal ANH on blood transfusion requirements during open cardiovascular surgery using cardiopulmonary bypass (CPB). ⋯ Minimal ANH is safe and cost effective and its routine use in eligible patients is therefore justified. Intraoperative autologous blood donation in CABG surgery decreased perioperative allogeneic blood requirement. However, the removal and reinfusion of about one unit autologous blood had no effect on postoperative bleeding or platelet count.
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Middle East J Anaesthesiol · Oct 2009
The 'best fit' endotracheal tube in children --comparison of four formulae.
Uncuffed endotracheal tubes are still being recommended by most pediatric of anesthetists at our Institutes. Different algorithms and formulae have been proposed to choose the best-fitting size of the tracheal tube. The most widely accepted is related to the age of the child [inner diameter [ID] in mm = (age in yr/4) + 4; the second is a body, length-related formula (ID in mm = 2 + height in cm/30); the third, a multivariate formula (ID in mm = 2.44 + age in yr x 0.1 + height in cm x 0.02 + weight in kg x 0.016]5; the fourth, the width of the 5th fingernail is used for ID prediction of the ETT (ID in mm = maximum width of the 5th fingernail). The primary endpoint of this prospective study was to compare the size of the 'best fit' tracheal tube with the size predicted using each of the above mentioned formulae. ⋯ The age-based and 5th fingernail width-based predictions of ETT size are more accurate than length-based and multivariate-based formulae in terms of mean value and case matching.
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Middle East J Anaesthesiol · Oct 2009
Randomized Controlled TrialPrevention of propofol injection pain with small-dose ketamine.
Propofol is a popular i.v. anesthetic induction drug that causes pain when given i.v., the incidence of which is between 28%-90%. We plan to determine the optimal dose of ketamine in the prevention of propofol injection pain and compare it with lidocaine, the commonly proposed pre-treatment. ⋯ Administration of ketamine 100 microg x kg(-1) immediately before propofol injection is a safe and effective method in preventing propofol injection pain.
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Middle East J Anaesthesiol · Oct 2009
Randomized Controlled Trial Comparative StudyProSeal laryngeal mask airway in infants and toddlers with upper respiratory tract infections: a randomized control trial of spontaneous vs pressure control ventilation.
ProSeal LMA (PLMA), one of the advanced supraglottic devices has been successfully used to provide both spontaneous and controlled ventilation in children with upper respiratory tract infection (URTI). URTI does not imply restriction of disease to upper respiratory tract; it has been shown to produce pulmonary dysfunction. PEEP has been shown to improve oxygenation in such cases. This randomized prospective study was designed to compare postoperative adverse events associated with spontaneous respiration (SR) and pressure control ventilation (PCV) with PEEP in infants and toddlers with URTI when using PLMA as an airway device. ⋯ Pressure control ventilation with PEEP using PLMA is associated with lower incidence of adverse events in comparison to spontaneous respiration in infants and toddlers with upper respiratory tract infection undergoing infra umbilical surgeries under general anesthesia.