Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2006
Clinical TrialRemifentanil preventing hemodynamic changes during laparoscopic adrenalectomy for pheochromocytoma.
In this prospective case-series study, a balanced anesthetic scheme of sevoflurane in nitrous oxide supplemented with remifentanil and sustained neuromuscular block was applied in nine patients scheduled for laparoscopic adrenalectomy for pheochromocytoma. Laparoscopic adrenalectomy to treat pheochromocytoma results in marked catecholamine release during pneumoperitoneum and tumor manipulation. ⋯ Increased infusion rate of remifentanil was used (up to 3 microg/kg/min) to prevent and treat marked hemodynamic changes from catecholamine release during tumor manipulation. Hpotension after tumor removal was treated with additional colloids fluids and decreasing the remifentanil infusion rate by 25-50%.
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Careful preoperative assessment and adequate planning of an appropriate anesthetic are the cornerstones safe pediatric anesthetic practice. A prospective study was carried out in pediatric surgical patients to identify and quantitate both intra-operative and post anesthesia recovery room complications, management and outcome. ⋯ Preterm infants are more prone to developing respiratory complications. Anesthesia-related morbidity and mortality can either be minimized or avoided with early identification and prompt management of any complication.
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The aim of this study was to investigate the rate, timing, the incidence of complications of percutaneous dilatational tracheostomy (PDT) and its effects by on nosocomial pneumonia. ⋯ Our results suggest that PDT was performed relatively early, with an acceptable complication rate and that our post-PDT nosocomial pneumonia incidence is low.