Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2007
ReviewOffice-based surgery: expanding the role of the anesthesiologist.
Office-based anesthesia (OBA) has developed in the United States as an important field for the anesthesia provider. Both the numbers and types of procedures performed in offices around the country have steadily increased, as has the invasiveness of these procedures. New anesthetic considerations arise. ⋯ As the 'safety' of many surgical offices where anesthesia care is provided has been challenged, medical societies have begun to issue recommendations as to the standards of care that should exist. Different anesthetic techniques are also emerging that are appropriate to the office setting. But as office-based anesthesia continues to mature as a specialty, we the anesthesia providers, must be proactive in establishing guidelines and recommendations to ensure safe practice.
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Middle East J Anaesthesiol · Jun 2007
Changing sedation practices in the intensive care unit--protocol implementation, multifaceted multidisciplinary approach and teamwork.
Sedation protocols have demonstrated effectiveness in improving ICU sedation practices. However, the importance of multifaceted multidisciplinary approach on the success of such protocols has not been fully examined. ⋯ The implementation of a multifaceted multidisciplinary approach including the use of point of use reminders, directed educational efforts, and opinion leaders along with sedation protocol led to significant changes in sedation practices and improvement in patients' outcomes. Such approach appears to be critical for the success of ICU sedation protocol.
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Middle East J Anaesthesiol · Jun 2007
Randomized Controlled Trial Comparative StudyHyperbaric spinal for elective Cesarean section--ropivacaine vs bupivacaine.
To compare hyperbaric spinal ropivacaine to hyperbaric spinal bupivacaine for elective cesarean delivery in a prospective, randomized, double blinded study. ⋯ 15 mg of hyperbaric ropivacaine with 0.1 mg morphine and 0.01 mg fentanyl provided excellent anesthesia for cesarean delivery. The advantages of hyperbaric ropivacaine consist of faster regression of the block and higher patient satisfaction.
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Middle East J Anaesthesiol · Jun 2007
Randomized Controlled Trial Comparative StudySpinal anesthesia for endoscopic urological surgery--low dose vs. varying doses of hyperbaric bupivacaine.
The aim of this study is to compare the efficiency of low dose vs. varying doses of hyperbaric bupivacaine in spinal anesthesia for endoscopic urological procedures. ⋯ These results suggest that the use of a low dose of bupivacaine (5 mg) added to fentanyl (25 microg) for endoscopic urological surgery, resulted in short-acting sensory block, without motor block and a lower incidence of cardiovascular side effects, as compared to either of 7.5 or 10 mg bupivacaine with 25 microg fentanyl.
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Middle East J Anaesthesiol · Jun 2007
Randomized Controlled TrialIntrathecal fentanyl added to lidocaine for Cesarean delivery under spinal anesthesia--a randomised clinical trial.
The addition of opioids to local anesthetics improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 15 microg when added to lidocaine 80 mg in patients undergoing Cesarean section under spinal anesthesia. Forty healthy parturients scheduled for elective Cesarean section using 80 mg of 5% lidocaine were randomly allocated to additionally 0.9% receive intrathecal fentanyl 15 or saline, as control. ⋯ Incidence of side effects did not differ between groups. Duration of complete analgesia (140.2 +/- 29.06 minutes vs 77.90 +/- 20.21 minutes: P < 0.001) and effective analgesia (195.50 +/- 34.06 minutes vs 98.05 +/- 23.48 minutes: P < 0.001) were prolonged in fentanyl group. Adding fentanyl 15 microg to lidocaine 80 mg for spinal anesthesia for Cesarean section, improves the quality of intraoperative analgesia and increases the duration of analgesia in the early postoperative period without increasing maternal or neonatal side effects.