Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyEffect of intravenous magnesium sulphate on postoperative pain following spinal anesthesia. A randomized double blind controlled study.
Magnesium sulphate (MgSO4), NMDA receptor antagonist, is known to reduce perioperative requirement of anesthetics and analgesics. However, no studies assessed the effect of MgSO4 on onset and recovery from spinal anesthesia. A prospective, randomised, double blind study was designed to assess the effect of intravenous (IV) MgSO4 on onset and recovery from spinal anesthesia and post operative analgesic requirement following below umbilical surgery. ⋯ Intravenous MgSO4 improves postoperative analgesia without affecting the onset and recovery from spinal anesthesia.
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Middle East J Anaesthesiol · Oct 2013
Case ReportsMethemoglobinemia with the use of benzocaine spray for awake fiberoptic intubation.
We report a case in which the use of benzocaine spray to facilitate awake fiber optic intubation (FOI) in a patient with a difficult airway caused methemoglobinemia intraoperatively. Local benzocaine was sprayed to numb the patient's airway for a total time of one second, fifteen minutes later SpO2 decreased to 85% on the pulse oximeter. ⋯ The patient was successfully treated with methylene blue intravenously and recovered uneventfully. Small amounts of local benzocaine sprayed to numb the airway can cause significant methemoglobinemia that requires immediate recognition and appropriate management.
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Middle East J Anaesthesiol · Oct 2013
Comparative StudyDo the choices of airway affect the post-anesthetic occurrence of nausea after knee arthroplasty? A comparison between endotracheal tubes and laryngeal mask airways.
The primary goal of this study was to assess the impact of airway devices on the incidence of nausea after knee arthroplasty and their interaction with the use of nitrous oxide. ⋯ The frequency of PONV was almost twice with ETT as with LMA. Longer duration of anesthesia, neuromuscular blockade and non-standardized antiemetic regimen may have contributed to the increase PONV in ETT group. Prospective randomized studies are necessary to further explore whether and to which extend airway devices influence the incidence of PONV.
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyDural puncture epidural analgesia is not superior to continuous labor epidural analgesia.
Some anesthesiologists consider combined spinal epidural (CSE) analgesia as superior alternative to continuous labor epidural (CLE) analgesia. However, during CSE, even small doses of intrathecally administered local anesthetics with opioids induce almost instant analgesia that precludes the testing of epidural catheters as well as early appreciation of failed epidural catheters. To overcome the shortcomings of CSE analgesia, dural puncture epidural (DPE) analgesia had been devised. ⋯ DPE technique did not provide superior labor analgesia as compared to CLE technique. Technically, fewer immediate failures in labor analgesia but higher incidence of paresthesias were observed with DPE technique.