Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2009
Case ReportsPerioperative care of a child with Ullrich congenital muscular dystrophy.
Ullrich congential muscular dystrophy (UCMD) is a severe form of congenital muscular dystrophy manifesting axial muscle contractures and distal joint hyperlaxity. Severe hypotonia and associated respiratory failure may occur early in the disease process. ⋯ Anesthetic care implications included the need for a rapid airway control to limit the risks of aspiration due to the intra-abdominal process, choice of neuromuscular blocking agent for rapid sequence intubation, associated airway issues related to micrognathia and limited mouth opening, and the potential for involvement of the cardiovascular and respiratory systems. The perioperative management of patients with UCMD is discussed including the use of propofol and remifentanil for rapid sequence intubation to avoid the need for neuromuscular blocking agents.
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Middle East J Anaesthesiol · Jun 2009
Randomized Controlled TrialThe prophylactic effect of rectal acetaminophen on postoperative pain and opioid requirements after adenotonsillectomy in children.
Postoperative pain in children is common after adenotonsillectomy. Rectal acetaminophen has been used effectively for postoperative pain management in small children. The aim of this randomized double blind study was to evaluate the prophylactic effect of rectal acetaminophen on postoperative pain management and opioid requirements in children undergoing adenotonsillectomy. ⋯ We conclude that prophylactic rectal acetaminophen is effective in reducing pain after adenotonsillectomy and postoperative analgesic requirement.
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Middle East J Anaesthesiol · Jun 2009
Randomized Controlled Trial Comparative StudyRobotic laparoscopic radical cystectomy inhalational versus total intravenous anesthesia: a pilot study.
Robotic assistance may refine laparoscopic radical cystectomy. Steep Trendelenburg tilt (TT) and pneumoperitoneum (PP) are challenging anesthesia maneuvers. In view of those maneuvers, would inhalational anesthesia or total intravenous anesthesia (TIVA) be the more appropriate anesthetic management for this kind of surgery? This issue is under consideration in this clinical trial. ⋯ Though the number of patients is small in this study (n = 15), it nevertheless brings to light the advantages of TIVA during the robotic laparoscopic radical cystectomy (RLRC), by shortening the duration of PP without an increase in prothrombin and fibrinogen concentrations. A lager number of clinical trial are needed to further clarify this issue.
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Middle East J Anaesthesiol · Jun 2009
Randomized Controlled Trial Comparative StudyAttenuation of hemodynamic responses following laryngoscopy and tracheal intubation -- comparative assessment of clonidine and gabapentin premedication.
The present study was conducted to compare the effect of clonidine and gabapentin premedication in modifying the hyperdynamic response following laryngoscopy and tracheal intubation. ⋯ The data propose that both clonidine and gabapentin have effective role in blunting hyperdynamic responses after laryngoscopy, more so with gabapentin.