Middle East journal of anaesthesiology
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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 TrialProspective, randomized controlled study to assess the role of dexmedetomidine in patients with supratentorial tumors undergoing craniotomy under general anesthesia.
Preliminary data on the perioperative use of dexmedetomidine in patients undergoing craniotomy for brain tumor under general anesthesia indicate that the intraoperative administration of dexmedetomidine is opioid-sparing, results in less need for antihypertensive medication, and may offer greater hemodynamic stability at incision and emergence. Dexmedetomidine, alpha 2 adrenoceptor agonist, is used as adjuvant to anesthetic agents. Relatively recent studies have shown that dexmedetomidine is able to decrease circulating plasma norepinephrine and epinephrine concentration in approximately 50%, decreases brain blood flow by directly acting on post-synaptic alpha 2 receptors, decreases CSF pressure without ischemic suffering and effectively decreases brain metabolism and intracranial pressure and also, able to decrease injury caused by focal ischemia. ⋯ Continuous intraoperative infusion of dexmedetomidine during craniotomy for supratentorial tumors under general anesthesia maintained the hemodynamic stability, reduced sevoflurane and fentanyl requirements, decreased intracranial pressure, and improved significantly the outcomes.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialThe importance of training for ultrasound guidance in central vein catheterization.
To review the complication and success rates associated with CVC placement in patients undergoing cardiovascular surgery depending on the technique utilized and the degree of ultrasound experience of the anesthesia provider. ⋯ With adequate US training, the complications from CVC including carotid artery puncture and pneumothorax can be significantly reduced.
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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 TrialEffects of clonidine as premedication on plasma renin activity, serum and urine electrolytes and body fluids in general anesthesia. A randomized double blind placebo controlled clinical trial.
Clonidine is a relative alpha2 agonist that's used as a premedicative drug in anesthesia in recent years. The aim was to asses the effect of oral clonidine as premedicative drug on 24 hours urine output, urine specific gravity, serum and urine electrolyte level and renin plasma activity ⋯ This study suggested that clonidine is a safe premedication drug in anesthesia and does not change the serum electrolytes level.