Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2014
Curriculum development for an advanced regional anesthesia education program: one institution's experience from apprenticeship to comprehensive teaching.
Results of recent attitude survey studies suggest that most practicing physicians are inadequately treating postoperative pain. Residents in anesthesia are confident in performing lumbar epidural and spinal anesthesia, but many are not confident in performing the blocks with which they have the least exposure. Changes need to be made in the training processes to a comprehensive model that prepares residents to perform a wider array of blocks in postgraduate practice. ⋯ We have now redesigned and implemented an advanced regional anesthesia program within our institution to provide residents with experience in regional anesthesia at a competent level. Resident's knowledge in regional anesthesia did improve after the first year of implementation as reflected in improvements between the pre- and post-tests. As the advanced regional anesthesia education program continues to improve, we hope to demonstrate levels of validity, reliability, and usability by other programs.
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyEffect of intravenous magnesium sulphate on postoperative pain following spinal anesthesia. A randomized double blind controlled study.
Magnesium sulphate (MgSO4), NMDA receptor antagonist, is known to reduce perioperative requirement of anesthetics and analgesics. However, no studies assessed the effect of MgSO4 on onset and recovery from spinal anesthesia. A prospective, randomised, double blind study was designed to assess the effect of intravenous (IV) MgSO4 on onset and recovery from spinal anesthesia and post operative analgesic requirement following below umbilical surgery. ⋯ Intravenous MgSO4 improves postoperative analgesia without affecting the onset and recovery from spinal anesthesia.
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Middle East J Anaesthesiol · Oct 2013
Case ReportsMethemoglobinemia with the use of benzocaine spray for awake fiberoptic intubation.
We report a case in which the use of benzocaine spray to facilitate awake fiber optic intubation (FOI) in a patient with a difficult airway caused methemoglobinemia intraoperatively. Local benzocaine was sprayed to numb the patient's airway for a total time of one second, fifteen minutes later SpO2 decreased to 85% on the pulse oximeter. ⋯ The patient was successfully treated with methylene blue intravenously and recovered uneventfully. Small amounts of local benzocaine sprayed to numb the airway can cause significant methemoglobinemia that requires immediate recognition and appropriate management.
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Middle East J Anaesthesiol · Oct 2013
Comparative StudyDo the choices of airway affect the post-anesthetic occurrence of nausea after knee arthroplasty? A comparison between endotracheal tubes and laryngeal mask airways.
The primary goal of this study was to assess the impact of airway devices on the incidence of nausea after knee arthroplasty and their interaction with the use of nitrous oxide. ⋯ The frequency of PONV was almost twice with ETT as with LMA. Longer duration of anesthesia, neuromuscular blockade and non-standardized antiemetic regimen may have contributed to the increase PONV in ETT group. Prospective randomized studies are necessary to further explore whether and to which extend airway devices influence the incidence of PONV.