Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialHemodynamic response to tracheal intubation via direct laryngoscopy and intubating laryngeal mask airway (ILMA) in patients undergoing coronary artery bypass graft (CABG).
A marked stress response including hypertension, tachycardia, arrhythmias and an increase in intracranial pressure often follows direct laryngoscopy. This response can be harmful specially in patients with underlying cardiac disease. The intubating laryngeal mask airway (ILMA)--a new modified laryngeal mask airway--has been introduced that facilitates tracheal intubation without using laryngoscopy. Oropharyngeal stimulation-proposed as the probable cause of stress response--have been shown to be attenuated in ILMA. We conducted this study to evaluate the stress response following two techniques in patients undergoing coronary artery surgery which are most likely to benefit from decreased hemodynamic changes during intubation. ⋯ Finally we could hardly ascertain if intubation with ILMA is a prefered method in patients with high cardiac risk or not. But it seems that ILMA does not have much greater benefit over conventional DL in patients undergoing coronary artery by-pass grafting.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialEffects of clonidine as premedication on plasma renin activity, serum and urine electrolytes and body fluids in general anesthesia. A randomized double blind placebo controlled clinical trial.
Clonidine is a relative alpha2 agonist that's used as a premedicative drug in anesthesia in recent years. The aim was to asses the effect of oral clonidine as premedicative drug on 24 hours urine output, urine specific gravity, serum and urine electrolyte level and renin plasma activity ⋯ This study suggested that clonidine is a safe premedication drug in anesthesia and does not change the serum electrolytes level.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled Trial Comparative StudyRelief of chronic shoulder pain: a comparative study of three approaches.
Shoulder pain is one of the most common complaints in pain clinics and rheumatology departments, usually originates from trauma, degeneration, inflammation, vascular disease and also be referred from the hand and neck pain or headache. ⋯ Combination of physical treatment with Suprascapular nerve block is a safe and efficacious treatment for the treatment of shoulder pain in frozen and arthritis. It improves pain, disability, and range of movement of the shoulders compared with intra-articular corticosteroid injection of the shoulder and/or physiotherapy alone. SSNB is a useful adjunct treatment for management of chronic shoulder pain. Direct ultrasound visualization significantly improve outcome.
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Middle East J Anaesthesiol · Feb 2011
Randomized Controlled TrialDexmedetomidine premedication of outpatients under IVRA.
Dexmedetomidine is approximately 8 times more selective toward the alpha-2-adrenoceptors than clonidine. It induces analgesia in patients and decreases anesthetic requirements by up to 90%. The current study aimed to evaluate the effects of dexmedetomidine premedication on tourniquet pain, intraoperative - postoperative analgesic requirements, sedation levels, quality of anesthesia, and the hemodynamic parameters when used as a single dose before intravenous regional anesthesia (IVRA). ⋯ The premedication of 0.5 microg/kg low dose dexmedetomidine before IVRA improves the quality of anesthesia and decreases the postoperative analgesic requirement of outpatients undergoing hand surgery without any serious side effects.