Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialOndansetron and meperidine prevent postoperative shivering after general anesthesia.
Postoperative shivering is one of the common problems following general anesthesia and may lead to multiple complications. The aim of this study was to examine the preventive effects of Ondansetron and Meperidine on postoperative shivering. ⋯ Ondansetron can effectively reduce post operative shivering.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialHemodynamic response to tracheal intubation via direct laryngoscopy and intubating laryngeal mask airway (ILMA) in patients undergoing coronary artery bypass graft (CABG).
A marked stress response including hypertension, tachycardia, arrhythmias and an increase in intracranial pressure often follows direct laryngoscopy. This response can be harmful specially in patients with underlying cardiac disease. The intubating laryngeal mask airway (ILMA)--a new modified laryngeal mask airway--has been introduced that facilitates tracheal intubation without using laryngoscopy. Oropharyngeal stimulation-proposed as the probable cause of stress response--have been shown to be attenuated in ILMA. We conducted this study to evaluate the stress response following two techniques in patients undergoing coronary artery surgery which are most likely to benefit from decreased hemodynamic changes during intubation. ⋯ Finally we could hardly ascertain if intubation with ILMA is a prefered method in patients with high cardiac risk or not. But it seems that ILMA does not have much greater benefit over conventional DL in patients undergoing coronary artery by-pass grafting.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled Trial Comparative StudyComparison of local anesthetic effects of tramadol and lidocaine used subcutaneously in minor surgeries with local anesthesia.
In this study, the local anesthetic and post-operative analgesic effects of tramadol were compared to those of lidocaine in minor surgeries under local anesthesia. ⋯ Tramadol 2 mg/kg has local anesthetic and post-operative analgesic effect equal to lidocaine 1 mg/kg in minor surgeries performed subcutaneously. Therefore, we concluded that tramadol can be used as an alternative drug to lidocaine in local anesthesia and has the ability to decrease the demand for post operative analgesics.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialPreemptive peritonsillar ketamine infiltration: postoperative analgesic efficacy versus meperidine.
The current study was planned to assess post-tonsillectomy analgesic efficacy of pre-emptive peritonsillar ketamine infiltration with or without bupivacaine in comparison to meperidine alone or in combination with bupivacaine. ⋯ Peritonsillar injection of a combination of bupivacaine and ketamine provided efficient postoperative analgesia after adenotonsillectomy and achieved higher parents' satisfaction for the outcome of surgery. The used drugs' combination and volume could be recommended as a routine preemptive analgesic policy for children assigned for adenotonsillectomy.
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Middle East J Anaesthesiol · Feb 2011
Case ReportsDifficult passage of the endotracheal tube and massive nasal bleeding during awake nasal fiberoptic intubation in a patient with airway obstruction caused by neck hematoma--a case report.
A 60 yr-old male underwent anterior cervical fusion under general anesthesia. Neck swelling was observed at the next morning. Subsequently, emergent CT scanning was performed, which revealed a retropharyngeal hematoma narrowing the upper airway and right anterior neck hematoma significantly deviating the trachea and larynx. ⋯ The patient was submitted to emergent evacuation of the hematoma. Reevaluation of the preoperative CT images showed the nasal cavity narrowing because of widespread nasal mucosal swelling. It is necessary to anticipate that nasal mucosal swelling and bleeding tendency due to impairment of venous drainage can exist in such a case.