Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2016
Randomized Controlled Trial Comparative StudyCOMPARISON OF THE EFFECTS OF PREEMPTIVE INTRAVENOUS AND RECTAL ACETAMINOPHEN ON PAIN MANAGEMENT AFTER INGUINAL HERNIORRHAPHY IN CHILDREN: A PLACEBO-CONTROLLED STUDY.
Postoperative pain management is a critical concern in pediatric surgery. Acetaminophen is the safest and most widely used analgesic in children. The present study compared the analgesic efficacy of intravenous (IV) and rectal acetaminophen versus placebo in children undergoing inguinal herniorrhaphy. ⋯ Both IV and rectal acetaminophen were more effective than placebo in pain relief after inguinal hernia repair in children. They were also associated with lower frequencies of postoperative vomiting. The greatest analgesic efficacy of both forms was observed during the first two hours after surgery.
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Middle East J Anaesthesiol · Jun 2016
Case ReportsLOEYS-DIETZ SYNDROME: PERIOPERATIVE ANESTHESIA CONSIDERATIONS.
Loeys-Dietz syndrome (LDS) is a rare autosomal dominant disease related to genetic mutations in receptors for the cytokine transforming growth factor-receptor type 1 (TGFB-R1) or 2 gene (TGFB-R2) on the cell surface. LDS results in abnormal protein synthesis and dysfunctional connective tissue, which can result in unique cardiovascular anesthesia challenges related to perioperative management. Patients with LDS may manifest hypertelorism, bifid uvula or cleft palate, and arterial tortuosity. ⋯ LDS patients who require surgical intervention require meticulous vigilance from the anesthesiologist. We describe a 26 year old patient with documented LDS type 1 who presented for repair of an ascending/root aneurysm in this case report. Recognition of LDS and intra-operative management of the cardiovascular manifestations of this disease is paramount in ensuring successful surgical outcome and to limit morbidity and mortality.
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Middle East J Anaesthesiol · Feb 2016
Randomized Controlled TrialEFFECT OF DEXMEDETOMIDINE ON HEMODYNAMIC PARAMETERS DURING EXTUBATION. A PROSPECTIVE RANDOMIZED DOUBLE BLIND STUDY.
Extubation is known to produce significant hemodynamic disturbances. There is a need to avoid increase in heart rate and blood pressure in hypertensive and cardiac patients and in vascular, neuro and intraocular surgeries. ⋯ Dexmedetomidine 0.5 µg/kg given before extubation attenuates hemodynamic reflexes during emergence from anesthesia without causing undue sedation, but prolongs time to extubation.
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Middle East J Anaesthesiol · Feb 2016
Randomized Controlled Trial Comparative StudyCOMPARISON OF INDIRECT VIDEO LARYNGOSCOPES IN CHILDREN YOUNGER THAN TWO YEARS OF AGE: A RANDOMIZED TRAINEE EVALUATION STUDY.
Gaining proficiency with various airway management tools is an important goal for anesthesiology training. Indirect video laryngoscopes facilitate tracheal intubation in adults, but it is not clear whether these findings translate to children. This study evaluates the total time to successful intubation when performed by anesthesiology trainees using GlideScope Cobalt® video laryngoscopy (GlideScope), Storz DCI® video laryngoscopy (Storz), or direct laryngoscopy (Direct) in children <2 years old with normal airway anatomy. ⋯ Anesthesiology trainees completed manikin tracheal intubation rapidly with all laryngoscopes studied, but required a clinically significant longer time to tracheally intubate children <2 years. Our findings suggest in vivo training should be included to facilitate proficiency with device-specific intubation techniques.
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Middle East J Anaesthesiol · Feb 2016
CONTINUOUS NON-INVASIVE ARTERIAL PRESSURE DEVICE AS AN ADJUNCT TO RECOGNIZE FLUCTUATING BLOOD PRESSURES DURING ELECTIVE CESAREAN SECTION UNDER SUBARACHNOID BLOCKADE (SAB).
Measuring non-invasive blood pressure (NIBP) in less than one minute intervals (STAT NIBP measurements) is not always feasible. Therefore, large number of undetectable hypotension episodes can only be recognized with continuous beat to beat monitoring of blood pressure, for example, by continuous non-invasive arterial pressure monitor (CNAP). ⋯ Continuous non-invasive arterial pressure (CNAP) device may ONLY act as an adjunct to recognize fluctuating blood pressures during elective cesarean section under subarachnoid blockade (SAB).