Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2009
Jaw thrust as a predictor of insertion conditions for the proseal laryngeal mask airway.
We test the hypothesis that the response to jaw thrust is an effective predictor of insertion conditions for the ProSeal laryngeal mask airway (ProSeal LMA). One hundred and sixty patients (ASA grade 1-3, aged >18 yr) were studied. Five anesthetists blinded to the response to jaw thrust participated in the study, each performed >30 insertions. ⋯ The accuracy, sensitivity and specificity were 0.82, 0.95 and 0.44, respectively. We conclude thatjaw thrust is a reliable predictor of insertion conditions for the ProSeal LMA with the digital insertion technique after induction of anesthesia with propofol. We suggest that clinicians learn how to apply the correct amount of jaw thrust and perform this test routinely.
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Middle East J Anaesthesiol · Feb 2009
Comparative StudyIs I-gel a new revolution among supraglottic airway devices?--a comparative evaluation.
In an attempt to reduce the pressor responses subsequent to laryngoscopy and intubation in normotensive anesthetized paralysed patients, the hemodynamic effects of three supraglottic devices were compared: I-gel, SLIPA, and LMA, The I-gel produced the least hemodynamic changes.
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Middle East J Anaesthesiol · Feb 2009
Comparative StudyCan preoperative anesthesia consultation clinic help to reduce operating room cancellation rate of cardiac surgery on the day of surgery?
Many surgical procedures are delayed or cancelled due to inadequate preoperative assessment and preparation. Case cancellations can be decreased by improved preoperative patient evaluation, improved communication between physician and patient, and modified schedule design. Because of importance of the high cost associated with operating room cancellations; healthcare providers have exerted efforts to decrease case cancellations on the day of surgery. The aim of this study was to evaluate the role of"pre-anesthesia consultation clinic" in reducing operating room cancellation. ⋯ Since the most common cause of cancellation in the two groups was incomplete medical work-up, then visitation of patients to the pre-anesthesia consultation clinic would minimize cancellation rate on the day of surgery.
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Middle East J Anaesthesiol · Oct 2008
ReviewChronic obstructive lung disease: perioperative management.
Inflammatory mediators play a major role in pulmonary and extra pulmonary manifestations of COPD. In the preoperative risk evaluation, composite scoring systems like ASA physical status are more efficacious than any single risk factor. ⋯ Preoperative optimization of respiratory status and use of postoperative lung expansion maneuvers are effective measures for prevention of PPCs. Lastly, anesthesiologists need to evolve strategies based on the pathophysiology of the disease to ensure that their patients receive optimal perioperative care.
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Middle East J Anaesthesiol · Oct 2008
Randomized Controlled Trial Comparative StudyFetal responses to epidural analgesia as evidenced by Doppler indices.
This study was designed to evaluate the maternal effects ofepidural analgesia by different local anesthetics and their impact on placental and fetal blood flow. ⋯ All local anesthetics produced excellent analgesia during labor. The Doppler indices were improved in the three groups with the best results in levobupivacaine group.