Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialSpinal anesthesia for transurethral resection operations: levobupivacaine with or without fentanyl.
The objective ofthe present study was double fold; to compare the characteristics of spinal blocks produced by 0.5% levobupivacaine with and without fentanyl in transurethral resection and to test the hypothesis that, fentanyl added to levobupivacaine, may be used as an alternative to pure levobupivacaine solution, in spinal anesthesia. ⋯ Both regimes are effective, and the addition of fentanyl to levobupivacaine may offers the advantage of shorter duration of motor block and may be used as an alternative to pure levobupivacaine solution in spinal anesthesia, for transurethral resections.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialPreoperative oral dextromethorphan does not reduce pain or morphine consumption after open cholecystectomy.
Dextromethorphan (DM), the D-isomer of the codeine analogue levorphanol, is a weak, noncompetitive N-Methyl-D-Aspartate (NMDA) receptor antagonist. It has been suggested that NMDA receptor antagonists induce preemptive analgesia when administrated before tissue injury occurs, thus decreasing the subsequent sensation of pain. ⋯ Dextromethorphan, 45 and 90 mg orally administrated 2 h before surgery had no effect on postoperative morphine requirement and pain intensity.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialPretreatment with remifentanil is associated with less succinylcholine-induced fasciculation.
Succinylcholine is a popular muscle relaxant and one of its most common side effects is muscle fasciculation. The purpose of this study was to evaluate the efficacy of remifentanil in preventing succinylcholine-induced fasciculation in patients undergoing general anesthesia. ⋯ Our findings indicate that remifentanil can reduce the duration and the intensity of succinylcholine induced fasciculation. However, it induces greater bradycardia.
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Middle East J Anaesthesiol · Feb 2010
ReviewUpdate on anesthesia considerations for electroconvulsive therapy.
Depression is diagnosed in 14 million Americans every year, and pharmacotherapy is the standard treatment. However, in approximately 50% of patients, pharmacology intervention does not resolve depression. Electroconvulsive therapy (ECT) has been a mainstay as a treatment option for treatment-resistant major depression since its inception in the 1930s. ⋯ The clinical anesthesiologist must be aware of these changes as well as have an understanding of perioperative pharmacological interventions. ECT is a proven therapy for select psychiatric patients, and appropriate anesthesia is a critical part of successful ECT. Careful review of the patient's medical history may reveal pertinent anesthetic considerations.
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Major obstetric hemorrhage is an extremely challenging obstetric emergency associated with significant morbidity and mortality. Pharmacological treatment of uterine atony has not altered much in recent years apart from the increasing use ofmisoprostol, although controversy surrounds its advantages over other uterotonics. ⋯ Interventional radiology may reduce blood loss in these cases. Uterine compression sutures, intrauterine tamponade balloons and cell salvage have been introduced in the last decade.