Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2009
Randomized Controlled Trial Comparative StudyPrevention of propofol pain: a comparative study.
A common drawback of propofol is pain on injection and lignocaine is commonly mixed with propofol to reduce the incidence and severity of this pain. In this study we sought to draw a comparison between the effectiveness of propofol medium chain and long chain triglyceride (MCT/LCT) alone, propofol medium chain and long chain triglyceride (MCT/LCT) premixed with lignocaine, and propofol long chain triglyceride (LCT) premixed with lignocaine, in preventing propofol pain on injection. 300 patients were randomly divided into three equal groups. Group A received propofol-MCT/LCT premixed with normal saline, Group B received propofol-MCT/LCT premixed with 20 mg lignocaine and Group C received propofol-LCT premixed with 20 mg lignocaine. ⋯ There was no significant difference in incidence of pain between Groups B and C (X2 = 2.5, p = 0.11). To conclude, propofol MCT/LCT alone provides no advantage to reduce pain on injection in comparison to propofol MCT/LCT premixed with lignocaine and propofol LCT premixed with lignocaine. Also, there is no significant difference in pain on injection between propofol LCT and propofol MCT/LCT as soon as lignocaine is added.
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Middle East J Anaesthesiol · Feb 2009
Randomized Controlled Trial Comparative StudyThe analgesic effects of ropivacaine in ilioinguinal-iliohypogastric nerve block in children--concentration or volume?
The aim of the present study was to compare the analgesic effects of ripovacaine when used as high concentration/small volume, versus its use as high volume/low concentration, in ilioinguinal-iliohypogastric nerve block in children. ⋯ Ropivacaine when used with high concentration/small volume is more efficient than when used a high volume/low concentration, for ilioinguinal-iliohypogastric nerve block in children.
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Middle East J Anaesthesiol · Feb 2009
Randomized Controlled Trial Comparative StudyRemifentanil-propofol vs dexmedetomidine-propofol--anesthesia for supratentorial craniotomy.
The aim of the present study was to compare the perioperative hemodynamics, propofol consumption and recovery profiles of remifentanil and dexmedetomidine when used with air-oxygen and propofol, in order to evaluate a postoperative analgesia strategy and explore undesirable side-effects (nausea, vomiting, shivering). In a prospective randomized double-blind study 50 ASAI-III patients scheduled for supratentorial craniotomy, were allocated into two equal Groups. Group D patients (n = 25), received i.v. dexmedetomidine 1 microg kg(-1) as preinduction over a 15-min period and 0.2-1 microg kg(-1) hr(-1) by continuous i.v. infusion during the operation period. ⋯ Propofol-remifentanil and propofol-dexmedetomidine are both suitable for elective supratentorial craniotomy and provide similar intraoperative hemodynamic responses and postoperative adverse events. Propofol-remifentanil allows earlier cognitive recovery; however, it leads to earlier demand for postoperative analgesics. Undesirable side-effects were similar in two Groups.
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Middle East J Anaesthesiol · Feb 2009
Randomized Controlled Trial Comparative StudyComparative study of neuromuscular blocking and hemodynamic effects of rocuronium and cisatracurium under sevoflurane or total intravenous anesthesia.
Neuromuscular blockers (NMB) are important adjuvant to general anesthesia. Rocuronium bromide and cisatracurium besylate are considered relatively recently introduced non-depolarizing muscle relaxants. ⋯ We conclude that the effects of rocuronium and cisatracurium are significantly enhanced during sevoflurane compared with propofol anesthesia and the recovery is lower.
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Middle East J Anaesthesiol · Feb 2009
Jaw thrust as a predictor of insertion conditions for the proseal laryngeal mask airway.
We test the hypothesis that the response to jaw thrust is an effective predictor of insertion conditions for the ProSeal laryngeal mask airway (ProSeal LMA). One hundred and sixty patients (ASA grade 1-3, aged >18 yr) were studied. Five anesthetists blinded to the response to jaw thrust participated in the study, each performed >30 insertions. ⋯ The accuracy, sensitivity and specificity were 0.82, 0.95 and 0.44, respectively. We conclude thatjaw thrust is a reliable predictor of insertion conditions for the ProSeal LMA with the digital insertion technique after induction of anesthesia with propofol. We suggest that clinicians learn how to apply the correct amount of jaw thrust and perform this test routinely.