Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 1993
ReviewValvular heart disease: Anesthetic considerations in non-cardiac surgery.
In all cases of valvular heart disease one should avoid heavy premedications. This will ensure that the balance between preload and afterload is maintained and will avoid respiratory depression which may aggravate pulmonary hypertension. ⋯ Controlled ventilation is safer than spontaneous ventilation. Appropriate monitoring is essential in every case.
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This paper reviews cardiac dysrhythmias occurring in the perioperative period. Electrocardiography was the first application of electronic monitoring to anesthesia care. The detection of dysrhythmias remains the most important use of this technology today. ⋯ The later two demand emergency management with DC cardioversion when perfusion is impaired. The major abnormality of conduction is complete heart block which usually requires emergency treatment in the perioperative period. Prompt evaluation and management of perioperative dysrhythmias reduce anesthetic morbidity and mortality.
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Middle East J Anaesthesiol · Jun 1993
Randomized Controlled Trial Clinical TrialKetamine anesthesia for short transurethral urologic procedures.
Ketamine (K) is a good analgesic and anesthetic agent in short procedures, but the associated cardiovascular responses and emergence reactions limit its use. Benzodiazepines have been used to improve recovery with favourable reports for midazolam (M). Methylphenidate (MPH), the mild CNS stimulant, improves behaviour and mental concentration and can be used to improve recovery from K anesthesia. ⋯ Ketamine produced satisfactory anesthesia for short transurethral urologic procedures. Addition of M did not change the cardiovascular responses of K but resulted in smooth recovery with no changes in the recovery scores. MPH did not improve the recovery scores but increased the incidence of vomiting, excessive talking, and limb movements.