Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Oct 2013
Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy.
The aim of preemptive analgesia is to reduce central sensitization that arises from noxious inputs across the entire perioperative period. N-methyl d-aspartate receptor antagonists have the potential for attenuating central sensitization and preventing central neuroplasticity. ⋯ Preemptive ketamine has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. The lower dose of 0.5 mg/kg being devoid of any adverse effects and hemodynamic changes is an optimal dose for preemptive analgesia in patients undergoing laparoscopic cholecystectomy.
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J Anaesthesiol Clin Pharmacol · Oct 2013
Pre-operative pain sensitivity: A prediction of post-operative outcome in the obstetric population.
Experimental assessments can determine pain threshold and tolerance, which mirror sensitivity to pain. This, in turn, influences the post-operative experience. ⋯ The predictive power of pain sensitivity assessments, particularly electrical pain threshold, may portend post-cesarean outcomes, including opioid requirements.
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J Anaesthesiol Clin Pharmacol · Oct 2013
ReviewRegional anesthesia in patients with pregnancy induced hypertension.
Pregnancy induced hypertension is a hypertensive disorder, which occurs in 5% to 7% of all pregnancies. These parturients present to the labour and delivery unit ranging from gestational hypertension to HELLP syndrome. It is essential to understand the various clinical conditions that may mimic preeclampsia and the urgency of cesarean delivery, which may improve perinatal outcome. ⋯ The provision of regional anesthesia when possible maintains uteroplacental blood flow, avoids the complications with GA, improves maternal and neonatal outcome. The use of ultrasound may increase the success rate. This review emphasizes on the regional anesthetic considerations when such parturients present to the labor and delivery unit.
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J Anaesthesiol Clin Pharmacol · Oct 2013
Caffeine for the prevention of postoperative nausea and vomiting.
Postoperative nausea and vomiting (PONV) is common after ambulatory surgery performed under general anesthesia. Anecdotal evidence suggests that caffeine may be useful in preventing PONV. ⋯ Caffeine was not effective in the prevention of PONV or headache, and did not improve time-to-discharge or patient satisfaction.
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J Anaesthesiol Clin Pharmacol · Oct 2013
Intrathecal sufentanil or fentanyl as adjuvants to low dose bupivacaine in endoscopic urological procedures.
Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. ⋯ Spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.