Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Oct 2014
Comparison of subarachnoid block with bupivacaine and bupivacaine with fentanyl on entropy and sedation: A prospective randomized double-blind study.
We studied the state entropy to monitor the sedative effect of subarachnoid block (SAB) using bupivacaine alone or combination of bupivacaine and fentanyl. The effect of use of fentanyl via the subarachnoid route on the sedation level was also studied using the entropy scores and the decrease in the requirement of propofol used as an adjuvant sedative drug. ⋯ Subarachnoid block causes sedation per se, but the level of sedation is not clinically significant and the sedation caused is not enough to avoid sedative agents for allaying anxiety in patients intraoperatively. The sedative effect of SAB was enhanced by adding intrathecal fentanyl probably because of better quality of SAB. SE showed good correlation with RS scaling system. Therefore, SE may be used as reliable tool to titrate sedation in patients undergoing surgery under SAB.
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J Anaesthesiol Clin Pharmacol · Oct 2014
Bonfils assisted double lumen endobronchial tube placement in an anticipated difficult airway.
The role of various airway adjuncts in the management of difficult airway has been described in the literature. Bonfils rigid fiberscope is one of the airway assist devices widely used for endotracheal intubation in the individuals with cervical instability warranting limited neck movements. ⋯ The double lumen tube has to be modified by decreasing the length of DLT to accommodate the Bonfils fiberscope and this is applicable only in certain type of double lumen tubes for e.g. Bronchocath.
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J Anaesthesiol Clin Pharmacol · Oct 2014
A comparative study of magnesium sulfate vs dexmedetomidine as an adjunct to epidural bupivacaine.
This prospective, randomized, double-blind study was undertaken to establish the effect of addition of magnesium or dexmedetomidine, as an adjuvant, to epidural bupivacaine in lower limb surgeries. ⋯ Hence, addition of dexemedetomidine to epidural bupivacaine can be advantageous with respect to increased duration of motor and sensory blockade and arousable sedation.
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J Anaesthesiol Clin Pharmacol · Oct 2014
Management of an anticipated difficult airway in Hurler's syndrome.
Management of an anticipated difficult airway in Hurler syndrome. Hurler syndrome is a subtype of Mucopolysaccharidosis (MPS) type 1. ⋯ Administration of general anaesthesia in patients who have congenital syndromes such as Hurler's is often a challenge because of progressive airway, craniofacial and skeletal abnormalities that may make both the ventilation and intubation difficult. We encountered difficult mask ventilation and endotracheal intubation was not possible and finally ventilated with laryngeal mask airway in a known case of Hurler syndrome posted for umbilical hernia repair.