Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2011
Randomized Controlled Trial Comparative StudyEffect of propofol titration v/s bolus during induction of anesthesia on hemodynamics and bispectral index.
Propofol when given as 2 mg/kg IV bolus for induction of anesthesia is known to cause hypotension requiring vasopressors. The objective of our study was to compare Propofol 2 mg/kg single IV bolus (Precalculated group, PG) with the titration of Propofol (Titration group, TG) to clinical parameters as 10 mg IV increments every 3 seconds on hemodynamic Parameters and Bispectral Index (BIS), during induction. The effect of titration on dose requirement for induction was also evaluated. ⋯ Titration of Propofol reduces hemodynamic changes, dose requirement and is able to achieve same level of BIS as in bolus.
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Middle East J Anaesthesiol · Jun 2011
ReviewPreoperative anxiety in children risk factors and non-pharmacological management.
It is important for anesthesiologists to appreciate the impact of preoperative anxiety in children. Not only does it cause suffering in many children prior to their surgical experience, it has a negative impact on their postoperative recovery and possibly long afterwards. Because of these concerns, continued research is warranted to seek ways of minimizing their fears in the perioperative setting. ⋯ This review will also explore issues surrounding parental presence during a child's anesthesia induction and how understanding child development can enhance their cooperativeness during the preoperative period, especially during anesthesia induction. Non-pharmacological interventions as a means of decreasing pediatric anxiety will be explored. Finally recent trends and new directions will be touched upon.
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Middle East J Anaesthesiol · Jun 2011
Clevidipine for controlled hypotension during spinal surgery in adolescents.
Clevidipine is an ultra-shorting acting, intravenous calcium channel antagonist of the dihydropyridine class. Metabolism by blood and tissue esterases results in a half-life of 1-2 minutes thereby allowing easy titration by i.v. administration. We present preliminary experience with this novel agent to provide controlled hypotension (CH) in a cohort of adolescents undergoing posterior spinal fusion. ⋯ Clevidipine effectively controlled MAP and provided CH. Mild tachycardia was noted in some patients with the occasional need for a beta-adrenergic antagonist. No episodes of excessive hypotension were noted. Given its short half-life, clevidipine can be rapidly titrated to provide CH when changing levels of sympathetic stimulation may occur. Should inadvertent hypotension occur, its short duration of action offers an additional advantage over several other i.v. antihypertensive agents.