Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 1998
Aspirated air capnography with esophageal detector device to confirm tracheal intubation in rapid sequence induction.
Verification of the proper placement of a tracheal tube by capnography in rapid sequence induction can lead to aspiration if the patient is ventilated with the tube in the esophagus. In this study we have associated the capnography with the esophageal detector device as modified by Nunn. In 49 patients, two endotracheal tubes were introduced, one in the esophagus and the other in the trachea. ⋯ Two types of reinflation were seen with the tracheal tube: slow (6 cases), all were obese, and instant (43 cases) in the remaining patients. The air aspirated from the respiratory tract by the bulb was analyzed by the capnograph; CO2 was detected from all the tracheal tubes but not from the esophageal ones. We concluded that the esophageal detector device and capnography used as described in our study is a simple reliable test to confirm the proper placement of a tracheal tube before starting ventilation in rapid sequence induction.
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Middle East J Anaesthesiol · Feb 1998
Randomized Controlled Trial Clinical TrialPrevention of post-operative nausea and vomiting following laparoscopic surgery--ephedrine vs propofol.
Postoperative nausea and vomiting (PONV) are relatively common troublesome distressing symptoms. The incidence is reported to be as high as 20-51%. Ninety adult ASA I and II patients scheduled for laparoscopic gynecological or surgical interventions, were randomly and equally assigned to one of the three groups in the immediate postoperative period: Group 1 received 0.1 ml.kg(-1) normal saline intravenously, while Group 2 received 0.5 mg.kg(-1) ephedrine intramuscularly and Group 3 received 0.25 mg.kg(-1) propofol intravenously as preventive antiemetic therapy. ⋯ Both ephedrine and propofol proved to have antiemetic properties. Ephedrine treated group of patient had significant less emetic score than propofol. No significant hemodynamic changes were recorded in both groups.
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Middle East J Anaesthesiol · Feb 1998
Case ReportsUse of the laryngeal mask for management of the compromised airway--a case report.
A 54-year old woman was scheduled for thoracotomy for excision of a tumor of the left upper lobe. Reduced thyromental distance and thyroid enlargement were identified by the preoperative physical examination and inability to visualize the larynx was encountered during direct laryngoscopy. A 37-Fr left sided double lumen tube was inserted in trachea with great difficulty after three failed attempts. ⋯ The patient underwent an uneventful prolonged (105 min) weaning via the LMA which was left in place until the patient regained full consciousness. Peripheral oxygen saturation remained greater than 95% throughout the airway manipulation. LMA insertion is an easy non-invasive technique and should be considered whenever airway management proves difficult.
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Middle East J Anaesthesiol · Oct 1997
Randomized Controlled Trial Clinical TrialMorphine-midazolam combination doses for presurgical analgesia in children.
We have examined the use of presurgical morphine-midazolam combination in 80 children aged 2-10 y undergoing repair of hypospadias. They were allocated randomly, in a double-blind study, to receive one of four morphine-midazolam combination doses (n = 20 each); (group I: 75 microg/kg each) [corrected] (group II: 75 microg/kg [corrected] morphine, 50 microg/kg [corrected] midazolam); (group III: 50 microg/kg [corrected] morphine, 75 microg/kg [corrected] midazolam); (group IV: 50 microg/kg [corrected] each). ⋯ Observational scoring system, using crying, movement, agitation, posture and localization of pain as scoring criteria, was used to assess the children during their stay in the recovery room together with their sedative and/or analgesic requirement. Pre-surgical morphine-midazolam administration produced stable hemodynamic variables with satisfactory postoperative analgesia suggesting 75 microg/kg [corrected] dose of both morphine and midazolam as upper permissible dose, and 50 microg/kg [corrected] each as lower effective dose.