Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyDural puncture epidural analgesia is not superior to continuous labor epidural analgesia.
Some anesthesiologists consider combined spinal epidural (CSE) analgesia as superior alternative to continuous labor epidural (CLE) analgesia. However, during CSE, even small doses of intrathecally administered local anesthetics with opioids induce almost instant analgesia that precludes the testing of epidural catheters as well as early appreciation of failed epidural catheters. To overcome the shortcomings of CSE analgesia, dural puncture epidural (DPE) analgesia had been devised. ⋯ DPE technique did not provide superior labor analgesia as compared to CLE technique. Technically, fewer immediate failures in labor analgesia but higher incidence of paresthesias were observed with DPE technique.
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyTheophylline versus acetaminophen in the treatment of post-dural puncture headache (PDPH).
Post-dural puncture headache (PDPH) is the most frequent complication of procedures associated with dural puncture for spinal anesthesia or following accidental dural puncture during epidural anesthesia. Since invasive treatments have known complications, pharmacologic management may be preferable. The aim of this study was to evaluate and compare the efficacy of theophylline and Acetaminophen in treatment of PDPH. ⋯ Theophylline is a safe and effective treatment for PDPH. It may be tried in PDPH patients before using any invasive technique. Further investigations studying other Methylxanthines are recommended as well.
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyLow concentration lidocaine (0.5%) bolus epidurally can initiate fast-onset, effective and safe analgesia for early stage labor.
There is no consensus on the optimal local anesthetic agent to initiate labor analgesia for patients in active labor. Currently used local anesthetic agents for initiating labor analgesia include 0.25% bupivacaine, 0.5% bupivacaine, 0.2% ropivacaine without or with various types and doses of opioids. ⋯ We included 32 cases (16 in Lidocaine group and 16 in Bupivacaine group). We found that 0.5% lidocaine is fast-onset, very effective and safe in initiating epidural analgesia for early stage labor.
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Middle East J Anaesthesiol · Oct 2013
Randomized Controlled Trial Comparative StudyComparison larygeal mask airway with the endotracheal tube for the external dacryocystorhionostomy surgery. A randomized clinical trial.
General anesthesia (GA) is considered the gold standard for external dacryocystorhinostomy (DCR) surgery. There are few reports about laryngeal mask airway (LMA) use in DCR surgery. The aim of this study was to compare the use of endotracheal intubation (ETT) vs LMA for airway management during DCR surgery. ⋯ LMA can be used in external DCR, to decrease the hemodynamic changes, to decrease coughing, straining at the end of anesthesia and the incidence of PONV.
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Middle East J Anaesthesiol · Oct 2013
Case ReportsRetrograde intubation in the patient with cystic tumor located at the base of tongue.
Retrograde intubation is one of the methods used to maintain an airway in the event of a difficult intubation. Retrograde intubation has been successfully carried out on patient for whom intubation was not possible with a direct laryngoscope and fiber optic bronchoscope. The central venous catheter needle and guide wire are the materials that are the most practical to prepare and access for the retrograde intubation. To conclude, In conclusion, retrograde intubation may be good alternative to invasive airway management such as surgical tracheostomy for difficult or impossible intubations because it can be performed easily, quickly, and successfully.