Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled TrialDexamethasone added to bupivacaine prolongs duration of epidural analgesia.
Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind, controlled clinical trial to evaluate the effect of dexamethasone added to bupivacaine-fentanyl on the duration of postoperative analgesia via epidural catheterization. ⋯ This study revealed that dexamethasone added to bupivacaine-fentanyl solution in epidural analgesia prolongs the duration of analgesia in abdominal or thoracic surgery.
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled TrialScalp nerve blockade reduces pain after headframe placement in radiosurgery: a double blind, randomized clinical trial.
Patients undergoing stereotactic headframe placement for radiosurgery report that discomfort associated with the headframe often lasts for the duration of the treatment day (approximately 6 hours). We hypothesize that blockade of scalp nerves prior to headframe placement reduces the incidence of moderate to severe head pain during the entire treatment day. We describe a randomized, double-blind, placebo-controlled study of awake patients having radiosurgery for intracranial pathology that examines whether scalp nerve blockade and local anesthetic infiltration results in superior patient comfort versus infiltration alone. ⋯ Scalp nerve block significantly decreased moderate to severe head pain in radiosurgery patients throughout the treatment day.
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled Trial Comparative StudyA comparison of rectal misoprostol and intravenous oxytocin on hemorrhage and homeostatic changes during cesarean section.
Post partum bleeding is a major cause of mortality and morbidity in pregnant women. In this study the effects of rectal misoprostol and oxytocin on post-cesarean bleeding are compared. ⋯ Misoprostol is an appropriate alternative for intravenous oxytocin in patients undergoing cesarean section, with lesser side effects and longer duration of action.
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled TrialThe effectiveness of patient-controlled epidural analgesia with ropivacaine 0.165% with fentanyl 2.0 miroc g/ml or levobupivacaine 0.125% with fentanyl 2.0 micro g/ml as a method of postoperative analgesia after major orthopaedic surgery.
This prospective randomized single-blinded study was conducted to determine whether there were differences in consumption, demand dosing and postoperative analgesia quality between PCEA using ropivacaine and levobupivacaine. Seventy patients with ASA classification I and II aged 18 to 80 years old scheduled for elective total knee replacement or total hip replacement were studied. All patients received CSE and then were randomly allocated to receive either ropivacaine 0.165% (Group A) or levobupivacaine 0.125% (Group B) both added with fentanyl 2.0 mcro g/ml via epidural route. ⋯ One patient in Group B had vomiting and there was no sedation, hypotension, pruritus or motor block recorded in both groups. In conclusion this study showed that both PCEA using ropivacaine 0.165% with fentanyl 2.0 micro g/ml and levobupivacaine 0.125% with fentanyl 2.0 micro g/ml provided effective postoperative analgesia within the first 48 hours of major lower limb orthopaedic surgery despite clinically significant dose difference. There was no hypotension, pruritus, sedation or motor block recorded in both groups.
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Middle East J Anaesthesiol · Feb 2013
Case ReportsRemifentanil infusion prolongs spinal anesthesia.
Spinal anesthesia was given to a patient undergoing transurethral resection ofprostate (TURP). A total of 3.2 ml of bupivacaine 0.5% mixed with fentanyl 20 mcg were used. The patient started experiencing sensation after 150 min. Remifentanil intravenous infusion prolonged the duration of anesthesia for an additional 105 minutes.