Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2013
Use of the bilateral BIS monitor as an indicator of cerebral vasospasm in ICU patients.
Earlier diagnosis of cerebral vasospasm and delayed cerebral ischemia (DCI) and treatment has the potential to decrease post-bleed morbidity after subarachnoid hemorrhage (SAH). Previous studies have shown that electroencephalogram (EEG) can detect blood flow changes associated with DCI sooner than other modalities potentially leading to earlier diagnosis. However, continual monitoring with raw EEG requires significant expertise and effort, and may be difficult due to the intermittent need for MRI studies in these patients. Here we describe a series of patients with subarachnoid hemorrhage in the Neurosurgical ICU who underwent monitoring with the Bilateral Bispectral Index (BIS) monitor.
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Middle East J Anaesthesiol · Jun 2013
Randomized Controlled TrialKetamine improves postoperative pain and emergence agitation following adenotonsillectomy in children. A randomized clinical trial.
Management of postoperative pain and emergence agitation following adenotonsillectomy in pediatrics has been a major challenge for anesthesiologists. Although analgesic sparing effect of ketamine has been studied during tonsillectomy in pediatrics, there is a lot of controversy about its efficacy. Present study was designed to evaluate the effect of intravenous low dose ketamine (0.25 mg/kg) during induction of anesthesia on postoperative pain and emergence agitation following adenotonsillectomy in children. ⋯ Low-dose ketamine during induction of anesthesia improves emergence agitation and postoperative pain following adenotonsillectomy in children.
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Middle East J Anaesthesiol · Jun 2013
Randomized Controlled TrialPost-operative cognitive functions after general anesthesia with sevoflurane and desflurane in South Asian elderly.
The duration of the recovery of cognition after anesthesia and surgery is multifactorial and is dependent on the type of anesthesia used, the type of surgery, and the patient. The present study compared the speed of recovery in elderly patients undergoing general anesthesia with sevoflurane or desflurane and the incidence and duration of cognitive impairment in them. ⋯ Desflurane was associated with a faster early recovery than sevoflurane in elderly patients. However, postoperative recovery of cognitive function was similar with both volatile anaesthetics.
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Middle East J Anaesthesiol · Jun 2013
Case ReportsUse of airway exchange catheter for bronchoscopy of a patient with Down's syndrome.
Tracheobronchial injuries (TBI) are highly fatal, and early diagnosis and repair are crucial for survival. The anesthesiologist and the surgeon must secure the integrity and patency of the airway for these cases. These injuries remain infrequent, and are becoming less fatal due to the availability of the resources necessary to achieve a secure airway, and thus some of them can be managed conservatively. We report an unusual case of upper airway compromise and extensive subcutaneous emphysema due to traumatic bronchial rupture and its conservative repair in a patient with Down's syndrome.
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Middle East J Anaesthesiol · Jun 2013
Randomized Controlled TrialSuccess of ultrasound guided popliteal sciatic nerve catheters is not influenced by nerve stimulation.
There is debate as to whether nerve stimulation (NS) is required to place peripheral nerve catheters when using ultrasound (US) guidance. There is conflicting evidence for whether stimulating catheters improve postoperative analgesia compared to non-stimulating catheters. The use of US in combination with NS has been shown to be superior to NS alone in terms of popliteal nerve blockade. Given the previously published reports, we hypothesized that there is improvement in sensory and motor blockade for stimulating popliteal perineural catheters placed under US guidance when NS is used. ⋯ We have found that the addition of NS provides no benefit over US alone. US alone was associated with a significantly shorter block performance time. US+NS showed no significant difference in pain control, patient satisfaction, or block success.