Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 1999
Comparative Study Clinical TrialArteriovenous fistula in chronic renal failure patients: comparison between three different anesthetic techniques.
The creation of arteriovenous fistula is an established form of therapy for patients with chronic renal failure. Anesthetic management in such patients is governed by the presence of risk factors such as hypertension, ischemic heart disease, diabetes, chronic pulmonary disease, anemia, coagulopathy, metabolic acidosis and/or hyperkalemia. In an attempt to improve the quality of anesthetic care and outcome we designed the present study to compare the different anesthetic techniques which are used for creation of arteriovenous fistula. ⋯ We conclude that brachial plexus blockade or local anesthetic infiltration are good alternatives to general anesthesia in these patients undergoing creation of arteriovenous fistula. Age, ASA class and cardiac status were the three determining factors for the choice of the anesthetic technique. Further multivariate prospective study are needed to confirm these results.
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Middle East J Anaesthesiol · Oct 1999
ReviewHaemostasis-altering drugs and central neuraxial block.
The purpose of this article is to review the literature concerning the use of epidural and spinal anaesthesia in patient receiving haemostasis-altering drugs, and to provide clear guidelines concerning the safe use of those anaesthetic in this category of patients. ⋯ Central neuraxial block should be avoided in fully anticoagulated patients. In partially anticoagulated patient, strict delays should be respected according to the pharmacology of the anticoagulants used, before institution of the central neuraxial block. Manipulation of epidural catheters should not be done unless the level of anticoagulation is low.
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Middle East J Anaesthesiol · Jun 1999
Randomized Controlled Trial Clinical TrialAlfentanil decreases myoclonus caused by etomidate.