Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2010
Comparative StudyComparing two methods of LMA insertion; classic versus simplified (airway).
The aim of this study is to compare two methods of LMA insertion, "classic" versus "simplified" (AIRWAY), due to factors such as: time to insertion, number of attempts, blood stained LMA, air leak around LMA, and gastric inflation. The word "AIR WAY" refers to the similarity of this method to oropharyngeal airway insertion. ⋯ Comparison of the whole advantages and disadvantages of both groups, mention that, by putting the LMA insertion time together with the low complication rates, the AIRWAY method can be assumed as a preferred simplified method with few complications for inserting LMA.
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Middle East J Anaesthesiol · Feb 2010
Case ReportsThe use of remifentanil in general anesthesia for cesarean section in a parturient with severe mitral stenosis and pulmonary edema.
Valvular heart diseases have adverse effects on hemodynamic condition in the parturients during pregnancy. Cesarean section with an opioid based general anesthesia has been used to alleviate these deleterious effects. We hereby describe the effective application of remifentanil, for cesarean section under general anesthesia, in a 30 yr. old primigravida suffering of severe multivalvular heart disease and pulmonary hypertension presenting with pulmonary edema who was in active labor and without neonatal respiratory depression.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled Trial Comparative StudyDexamethasone with either granisetron or ondansetron for postoperative nausea and vomiting in laparoscopic surgery.
In a prospective randomized double-blind study, we compared the effectiveness of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery. Hundred ASA I and II patients scheduled for laparoscopic surgery were enrolled in the study and 84 patients completed it. Following induction of anesthesia, group I (n=42) received granisetron 1 mg and dexamethasone 8 mg, group II (n=42) received ondansetron 4 mg and dexamethasone 8 mg. ⋯ At 6-24 hours no vomiting occurred in 97.6% of patients in group I and 100% in group II. Total response was 95.2% in both groups, and metoclopramide was used in 2.38% of patients in both groups. In conclusion, the combination of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg following induction of anesthesia in patients undergoing laparoscopic surgery showed no statistically significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialSpinal anesthesia for transurethral resection operations: levobupivacaine with or without fentanyl.
The objective ofthe present study was double fold; to compare the characteristics of spinal blocks produced by 0.5% levobupivacaine with and without fentanyl in transurethral resection and to test the hypothesis that, fentanyl added to levobupivacaine, may be used as an alternative to pure levobupivacaine solution, in spinal anesthesia. ⋯ Both regimes are effective, and the addition of fentanyl to levobupivacaine may offers the advantage of shorter duration of motor block and may be used as an alternative to pure levobupivacaine solution in spinal anesthesia, for transurethral resections.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialPreoperative oral dextromethorphan does not reduce pain or morphine consumption after open cholecystectomy.
Dextromethorphan (DM), the D-isomer of the codeine analogue levorphanol, is a weak, noncompetitive N-Methyl-D-Aspartate (NMDA) receptor antagonist. It has been suggested that NMDA receptor antagonists induce preemptive analgesia when administrated before tissue injury occurs, thus decreasing the subsequent sensation of pain. ⋯ Dextromethorphan, 45 and 90 mg orally administrated 2 h before surgery had no effect on postoperative morphine requirement and pain intensity.