Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2006
Randomized Controlled TrialLactate and acid base changes during laparoscopic cholecystectomy.
The observation of hemodynamic and metabolic impairment related to CO2 pneumoperitoneum and postoperative mesenteric ischemia reports following laparoscopic procedures have raised concern about local and systemic effects of increase intraabdominal pressure during laparoscopic procedures. The present study aims to evaluate the metabolic and acid base responses of using high pressure versus low pressure pneumoperitonium in patients undergoing laparoscopic cholecystectomy in a prospective randomized clinical trial. ⋯ High-pressure pneumoperitonium causes statistically significant elevation in the arterial lactate level intraoperatively until one hour post operatively. It also causes higher pain score and shoulder tip pain.
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Middle East J Anaesthesiol · Feb 2006
Hemodynamic profile during laparoscopic cholecystectomy versus laparoscopic bariatric surgery--the impact of morbid obesity.
The present study investigated the hemodynamic profile using impedance cardiography (ICG) monitor during pneumoperitoneum for laparoscopic cholecystectomy versus bariatric surgery in order to determine the impact of body weight on hemodynamics. ⋯ Cardiac index showed significant decreasing trend in morbid obese patients compared to nonobese, which may reflect the effect of body weight on hemodynamics. On the other hand, other hemodynamic parameters was not altered by body weight. We believe that hemodynamics should be closely monitored during laparoscopic surgery with pneumoperitoneum.
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Middle East J Anaesthesiol · Oct 2005
Randomized Controlled Trial Comparative StudyEpidural for labour analgesia--bupivacaine + fentanyl vs bupivacaine + fentanyl + epinephrine.
A prospective and randomized study was conducted on 50 full term parturients undergoing labour analgesia at Panna Dai Hospital, R. N. T. ⋯ The incidence of spontaneous delivery was 92% in each group. Parturients in group BEF demonstrated a higher incidence of side effects like nausea and vomiting (4% v/s 0%); hypotension (4% v/s 0%); paresis (8% v/s 0%) and retention of urine (12% v/s 8%) as compared to BF group. To conclude, the addition of epidural epinephrine (1:600,000) to bupivacaine and fentanyl does not affect the duration or quantity of labour analgesia.
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Middle East J Anaesthesiol · Oct 2005
Randomized Controlled TrialDoes pancuronium or cisatracurium delay the rate of arousal following remifentanil-based anesthesia?
The present report investigates the rate of arousal following remifentanil-based anesthesia associated with the coadministration of pancuronium, which inhibits butyrylcholinesterase, or cisatracurium, which is partially metabolized by nonspecific esterases, versus vecuronium that is eliminated independently of ester hydrolysis. ⋯ The results suggest that recovery following remifentanil-based anesthesia is not delayed by the coadministration of pancuronium, cisatracurium versus vecuronium; and by the use of neostigmine for reversal of neuromuscular blockade.