Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2014
ReviewFentanyl-induced cough--pathophysiology and prevention.
Many reports have demonstrated that intravenous administration of a bolus of fentanyl at induction of anesthesia can cause coughing with varying degrees. This cough can be benign, but sometimes it causes undesirable side effects including an increase in intraabdominal, intracranial or intraocular pressure. ⋯ This cough was described by several mechanisms including an inhibition of central sympathetic system leading to vagal predominance, reflex bronchonstriction after the stimulation of tracheobronchial tree receptors, or histamine release. The efficacy of several measures to avoid fentanyl-induced cough have been demonstrated, and several anesthetics adjuncts can be given prior to fentanyl administration aiming at decreasing this unwanted side effect.
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Middle East J Anaesthesiol · Jun 2014
Randomized Controlled Trial Comparative StudyThe use of Airtraq laryngoscope versus Macintosh laryngoscope and fiberoptic bronchoscope by experienced anesthesiologists.
The aim was to compare the hemodynamic parameters, intubation times, upper airway trauma and postoperative sore throat scores of the patients with normal airway anatomy, intubated with the Airtraq, Macintosh laryngoscope and fiberoptic bronchoscope, by experienced anesthesiologists. ⋯ The Airtraq laryngoscope seems to be a more traumatic airway device in the routine endotracheal intubation compared to Macintosh laryngoscope and fiberoptic bronchoscope, when used by experienced anesthesiologists. It also does not offer advantage over the first-attempt success rates, the intubation times and hemodynamic parameters.
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Middle East J Anaesthesiol · Jun 2014
Randomized Controlled Trial Comparative StudyComparison between intravenous patient controlled analgesia and patient controlled epidural analgesia in cirrhotic patients after hepatic resection.
Postoperative pain is one of the most important problems that confront surgical patients. The aim of this work is to compare pain control using intravenous patient controlled analgesia (PCA) and patient controlled epidural analgesia (PCEA) in cirrhotic patients undergoing elective hepatic resection. ⋯ The two modalities of pain control seems to be nearly equivalent, but considering the risk of epidural catheter insertion and removal in cirrhotic patients who are further exposed to hepatectomy with subsequent additional coagulopathy, it may be wise to consider IVPCA technique as a policy for pain management in cirrhotic patient undergoing hepatectomy.