Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2012
Predictive model for the inadequate labor epidural analgesia: an outcome of the prospective observational study at university women's hospital.
Continuous epidural analgesic infusions provide superior analgesia as compared to other forms of labor analgesia. However, inadequate analgesia after labor epidurals is not uncommon and has been found to be as high as 24% in some studies. The mechanism of these failures include inappropriate epidural catheter location, tissue compartmentalization within epidural space, delayed migration, kinking, occlusion or disconnection of correctly placed epidural catheter. ⋯ In parturients identified as being at high risk for failed epidural, ultrasound guidance, saline-based loss of resistance technique, and appropriate intra-epidural-space length of catheter are the methods that should be utilized to lower the incidence of failure.
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Middle East J Anaesthesiol · Jun 2012
Randomized Controlled Trial Comparative StudyA prospective, randomized comparison of the effects of thiopental and propofol on bispectral index during caesarean section till delivery of newborn.
Since in caesarean operations skin incision to delivery time is very short, induction agent could be still effective on BIS level till the time of delivery. Therefore this study was designed to analyze the effect on maintaining adequate bispectral index levels till delivery of neonate of propofol and thiopental as an induction agent for caesarean section. ⋯ Anesthesia induction with propofol in a dose of 2.5 mg/kg maintains lower levels of heart rate, blood pressure and BIS till delivery when compared with thiopental in a dose of 5 mg/kg. There is no financial support taken from any kind of company or person. There are no financial relationships between authors and commercial interests with a vested interest in the outcome of study.
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Middle East J Anaesthesiol · Jun 2012
Randomized Controlled Trial Comparative StudyCombined axillary block with "selective" injection of nerves and the axillary catheter: comparison of bupivacaine 0.25% or levobupivacaine 0.25%.
The aim of this study is to apply combination of axillary plexus block with "selective" injection of nerves and continuous catheter technique, and to compare the anesthetic and postoperative analgesic effects of bupivacaine and levobupivacaine. ⋯ In this tecnique, for median and radial nevre, bupivacained 0.25% produced slightly beter sensory and motor block intensity than levobupivacaine 0.25% in onset of the block. General success in relation to surgery and in the duration of the analgesia was identical in the two groups.
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Middle East J Anaesthesiol · Jun 2012
ReviewHyperparathyroidism, hypercalcemia and difficult laryngoscopy: a retrospective review.
The incidence of difficulty with intubation in the general population depends upon the definition used but results as high as 37% have been published. Endocrine disorders such as diabetes and hyperthyroidism have been linked to an increased incidence of difficult intubation via laryngoscopy. Hypercalcemia with resulting calcification has been demonstrated to result in neck pain, decreased cervical range of motion, and loss of skin and tendon compliance. We speculated that patients with hyperparathyroidism and resulting hypercalcemia would have an increased incidence of intubation difficulty via laryngoscopy. ⋯ To our knowledge, this is the first manuscript evaluating the impact of parathryoidectomy surgery and hypercalcemia on ease of intubation via laryngoscopy. Despite the fact that patients presenting for parathyroidecomy have many potential etiologies of increased difficulty with laryngoscopy, they do not appear to be at increased risk of laryngoscopy problems. The same is true of those patients presenting with hypercalcemia. Source(s) of support: There was no source of funding for this study. Presentation at a meeting: Society for Airway Management Annual Meeting 2009 Las Vegas NV and American Society of Anesthesiologists Annual Meeting 2010 San Diego, CA. Conflicting Interest (If present, give more details): With regard to conflict of interest, Dr. Arndt is a paid consultant for Cook Medical and receives royalties based on the sale of products that he invented.
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Middle East J Anaesthesiol · Jun 2012
Comparative StudyDoes management of cardiac arrest scenarios differ between residents of different disciplines? A comparison with simulation.
Training multidisciplinary teams using simulation allows for communication, development and maintenance of teamwork. In this study we compared the behavior of residents from emergency and anesthesiology departments on treatment of cardiac arrest. ⋯ This study demonstrates the use of simulation to identify the deficiencies in basic knowledge and the skills of emergency and anesthesiology residents. It highlights the need to emphasize criteria that should be used in resuscitation.