Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2008
Randomized Controlled TrialPain relief following thoracoscopic sympathectomy for palmar hyperhidrosis: a prospective randomised double-blind study.
Acute pain management following thoracoscopic sympathectomy (TS) has been described in the literature. The combination of interpleural (IP) injection of bupivacaine and intramuscular injection. (I.M) NSAIDs has not been reported. Therefore we conducted this randomized controlled trial to compare this technique to other reported techniques described for postoperative analgesia following TS. ⋯ Combination of IP bupivacaine and I.M ketoprofen provided superior analgesia when compared to each modality alone and was better than intramuscular pethidine injection in terms of NRS and the consumption of rescue morphine postoperatively. Further studies are needed on large sample size to confirm our results.
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Middle East J Anaesthesiol · Feb 2008
Comparative StudyNeuromuscular effects of cisatracurium in morbidly obese patients.
Obesity is associated with significant changes in body composition and function that may alter the pharmacodynamics and pharmacokinetics of various drugs. In this study, we investigated the neuromuscular effects of cisatracurium in morbidly obese as compared to control group of normal body weight patients. In the morbidly obese group (n = 20), corrected weight was used to calculate the drug doses. ⋯ T25-75 was determined as 11 +/- 5 min and 14 +/- 6 min in the morbidly obese and control group, respectively (p < 0.05). Intubation conditions were determined as good in 13, excellent in 7 patients in the morbidly obese group, and as good in 4 and excellent in 16 patients in the control group (p < 0.05). As different neuromuscular effects of cisatracurium were detected, we conclude that ne uromuscular agents must be monitored in the morbidly obese patients.
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Middle East J Anaesthesiol · Feb 2008
Clinical TrialTracheostomy under jet-ventilation--an alternative approach to ventilating patients undergoing surgically created or percutaneous dilational tracheostomy.
In a prospective observational study we compared the results of 297 elective tracheostomies under jet-ventilation with regard to its complication rate and practicability. Of those, 156 patients underwent surgically created tracheostomy (SCT) and 141 patients percutaneous dilational tracheostomy (PDT). Initially, in 159 patients jet-ventilation was performed using a jet-cannula inserted intratracheally through the cricothyroid membrane. ⋯ The bronchoscope-guided gas stream, when compared to jet-cannula inserted intratracheally, offered more space for tracheostomy and safety for the patient. The permanent danger of mishappenings and dislocation involved with the jet-cannula could be avoided, since the bronchoscope was operating on under direct visualization. Under these circumstances, PDT is an acceptable approach to inserting a tracheostomy tube under jet-ventilation via bronchoscope, particularly for the management of difficult airway in critically ill patients.
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Middle East J Anaesthesiol · Feb 2008
Randomized Controlled TrialOpioid saving strategy: bilateral single-site thoracic paravertebral block in right lobe donor hepatectomy.
Postoperative analgesia after hepatectomy remains a challenge, mainly because of limited therapeutic index of the conventional opioids. The aim of this study is to evaluate the efficacy of bilateral single-site thoracic paravertebral block for the management of postoperative pain following right lobe donor hepatectomy (RLDH) using a prospective, randomized and controlled study design. ⋯ Bilateral single-site thoracic paravertebral block is easy, safe and efficient technique for postoperative pain management in patients undergoing right lobe donor hepatectomy.