Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 2010
Randomized Controlled TrialFentanyl pretreatment for alleviation of perineal symptoms following preoperative administration of intravenous dexamethasone sodium phosphate--a prospective, randomized, double blind, placebo controlled study.
Corticosteroids have anti-inflammatory, analgesic and antiemetic effects but causes severe perineal symptoms when given intravenously. Simultaneous administration of dexamethasone and fentanyl have been known to decrease the duration of perineal pain but its role in alleviating perineal pain has not been studied. Therefore, we hypothesized that fentanyl pretreatment could prevent the perineal symptoms associated with the dexamethasone. ⋯ Our study showed that the intravenous administration of dexamethasone sodium phosphate leads to significant perineal symptoms. These symptoms are alleviated by pretreatment with fentanyl (1 microg/kg) (incidence, severity and duration). The pharmacological mechanism explaining perineal pain with intravenous administration of dexamethasone remains poorly understood, but could be related to the phosphate ester. We conclude, that intravenous administration of dexamethasone sodium phosphate is associated with perineal pain and can be alleviated effectively by pretreatment with 1 microg/kg of fentanyl.
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Middle East J Anaesthesiol · Oct 2010
Randomized Controlled TrialThe effects of duration of Propofol injection on hemodynamics.
The aim of study was to see whether increasing the time of injection of standard dose of Propofol during induction can prevent fall in blood pressure in female patients; as is commonly observed with this anesthetic agent. ⋯ Varying the speed of injection of Propofol during induction of anesthesia in adult female patients does not cause any major difference in the drop of their heart rate, systolic blood pressure, diastolic pressure and mean arterial pressure.
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Middle East J Anaesthesiol · Oct 2010
Case ReportsConscious sedation for awake craniotomy in intra-operative magnetic resonance imaging operating theatre (IMRI OT) environment.
This technical report disrobes the first case in Intra-operative Magnatic Resonance Imaging operating theatre (iMRI OT) (BrainSuite), of Awake Craniotomy. The procedure was for frontal lobe glioma excision in 24 y. old man. He was scheduled to undergo eloquent cortex language mapping intra-operatively. ⋯ Patient tolerated the situation satisfactory and was cooperative till the finish without any event. We elicit in this report the special environment of iMRI OT for lengthy operation in pinned fixed patient having craniotomy. The text shows the special environment, its demands and its possible difficulties.
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Middle East J Anaesthesiol · Oct 2010
Case ReportsCesarean section under spinal anesthesia in a patient with ankylosing spondylitis--a case report.
It is generally accepted that neuraxial anesthesia is difficult to establish in patients with ankylosing spondylitis. General anesthesia also has some disadvantages, especially with respect to airway control in patients with ankylosing spondylitis. We present herein a gravida with ankylosing spondylitis who had a cesarean delivery performed under spinal anesthesia. ⋯ We suggest that spinal anesthesia can be safely and effectively used as an alternative to general anesthesia in patients with ankylosing spondylitis. Neuraxial techniques should not be regarded as unachievable in such patients; however, all necessary precautions should be taken to avoid complications of spinal anesthesia, and facilities to secure the airway should be available.
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Middle East J Anaesthesiol · Oct 2010
Transient neurological symptoms following spinal anesthesia for cesarean section.
Transient neurological symptoms (TNS) are defined as symmetrical bilateral pain in the back or buttocks or pain radiating to the lower extremities after recovery from spinal anesthesia. About 80-85% of cesarean sections are performed under spinal anesthesia in our centre. Our aim was to determine the incidence of TNS, risk factors and outcome of management in pregnant women undergoing cesarean section. ⋯ A follow-up for all patients that receive spinal anesthesia for cesarean section should constitute a standard practice.