Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2013
Case ReportsRole of laryngeal mask airway in interventional bronchoscopy procedures for upper tracheal stenosis: case series.
Bronchoscopic interventional procedures are novel means of treating airway lesions which are less invasive and well tolerated for patients with endo-luminal lesions, but managing the airway and oxygenating the patient in a field that is shared by both anesthesiologist and bronchoscopist is a major concern. Also in cases with subglottic and upper tracheal stenotic lesions an airway device placed inside the lumen interferes with the procedure and occasionally bears the hazard of ignition. Therefore, an airway device placing above the glottis with effective oxygenation is required. Laryngeal mask airway is a supra-glottic device which facilitates assisted or spontaneous positive pressure ventilation. ⋯ Laryngeal mask airway could be regarded as a reliable alternative for airway management during interventional bronchoscopic procedures, especially when they are located near the glottis or in the upper third of the trachea.
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled Trial Comparative StudyEsmolol versus dexmedetomidine in scoliosis surgery: study on intraoperative blood loss and hemodynamic changes.
Surgical correction ofscoliosis carries significant blood loss and needs for blood transfusion with its inherent risks and cost. The aim of this double-blind, randomized, controlled study was to compare the effects of esmolol or dexmedetomidine on intraoperative blood loss, anesthetics consumption, intra operative hemodynamic and effects on spinal cord monitoring in patients undergoing scoliosis surgery. ⋯ Both esmolol and dexmedetomidine, added to anesthetic regimen, provided an effective and well-tolerated method to reduce the amount of blood loss in patients undergoing scoliosis surgery. dexmedetomidine, was associated with plonoged extubation and recovery times.
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled Trial Comparative StudyA comparison of two different doses of bupivacaine in caudal anesthesia for neonatal circumcision. A randomized clinical trial.
We aimed to compare the analgesia quality of caudal block of low volume, high concentration bupivacaine to the conventionally used volumes and concentrations of the drug in neonates undergoing circumcision with sole caudal anesthesia. ⋯ Low volume high concentration caudal bupivacaine provided a similar perioperative analgesia quality, time and safety profile compared to conventional bupivacaine doses in awake neonates undergoing circumcision. Low volume, high concentration bupivacaine may be used to reduce the risk of local anesthetic toxicity in outpatient neonates.
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Middle East J Anaesthesiol · Feb 2013
Randomized Controlled TrialThe effectiveness of patient-controlled epidural analgesia with ropivacaine 0.165% with fentanyl 2.0 miroc g/ml or levobupivacaine 0.125% with fentanyl 2.0 micro g/ml as a method of postoperative analgesia after major orthopaedic surgery.
This prospective randomized single-blinded study was conducted to determine whether there were differences in consumption, demand dosing and postoperative analgesia quality between PCEA using ropivacaine and levobupivacaine. Seventy patients with ASA classification I and II aged 18 to 80 years old scheduled for elective total knee replacement or total hip replacement were studied. All patients received CSE and then were randomly allocated to receive either ropivacaine 0.165% (Group A) or levobupivacaine 0.125% (Group B) both added with fentanyl 2.0 mcro g/ml via epidural route. ⋯ One patient in Group B had vomiting and there was no sedation, hypotension, pruritus or motor block recorded in both groups. In conclusion this study showed that both PCEA using ropivacaine 0.165% with fentanyl 2.0 micro g/ml and levobupivacaine 0.125% with fentanyl 2.0 micro g/ml provided effective postoperative analgesia within the first 48 hours of major lower limb orthopaedic surgery despite clinically significant dose difference. There was no hypotension, pruritus, sedation or motor block recorded in both groups.
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Middle East J Anaesthesiol · Feb 2013
Case ReportsSub-dural hematoma following spinal anesthesia treated with epidural blood patch and burr-hole evacuation: a case report.
The appearance of a subdural hematoma (SDH) following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. Patients with post-dural puncture headache (PDPH) non-responsive to conservative measures and/or those patients with a change of the character of the headache should be considered seriously. In symptomatic patients, evacuation of SDH is essential but epidural blood patch should be strongly considered as it can prevent reappearance of SDH by sealing the dural defect.