Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jul 2014
Entropy as an indicator of cerebral perfusion in patients with increased intracranial pressure.
Changes in electroencephalogram (EEG) patterns correlate well with changes in cerebral perfusion pressure (CPP) and hence entropy and bispectral index values may also correlate with CPP. To highlight the potential application of entropy, an EEG-based anesthetic depth monitor, on indicating cerebral perfusion in patients with increased intracranial pressure (ICP), we report two cases of emergency neurosurgical procedure in patients with raised ICP where anesthesia was titrated to entropy values and the entropy values suddenly increased after cranial decompression, reflecting the increase in CPP. Maintaining systemic blood pressure in order to maintain the CPP is the anesthetic goal while managing patients with raised ICP. EEG-based anesthetic depth monitors may hold valuable information on guiding anesthetic management in patients with decreased CPP for better neurological outcome.
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J Anaesthesiol Clin Pharmacol · Jul 2014
A prospective controlled study to assess the antiemetic effect of midazolam following intragastric balloon insertion.
Obesity is a chronic disease with considerable morbidity and mortality. The intragastric balloon appears attractive for a group of patients who do not respond to medical therapy and who are not surgical candidates. Postoperative nausea and vomiting (PONV) are distressing adverse effects for these patients. Midazolam has been used as an antiemetic, both as a preventive or rescue medication. The study aims at studying effect of combined use of ondansetron and midazolam to decrease the PONV following intragastric balloon insertion. ⋯ Use of midazolam combined with ondansetron provides significant reduction and therefore better outcome regarding nausea and vomiting following intragastric balloon insertion.
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J Anaesthesiol Clin Pharmacol · Jul 2014
Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery.
In an attempt to improve the recovery and early rehabilitation after arthroscopic knee surgery, various medications have been administered via intra-articular route to prolong the duration and improve the quality of postoperative analgesia. Among the potentially effective substances, steroids like dexamethasone could be of particular interest. ⋯ Dexamethasone, used as adjunct to levobupivacaine in patients undergoing arthroscopic knee surgery, improves the quality and prolongs the duration of postoperative analgesia.
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J Anaesthesiol Clin Pharmacol · Jul 2014
A comparison of effect of preemptive use of oral gabapentin and pregabalin for acute post-operative pain after surgery under spinal anesthesia.
Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered processing of afferent input. Pregabalin has been claimed to be more effective in preventing neuropathic component of acute nociceptive pain of surgery. We conducted a study to compare the effect of oral gabapentin and pregabalin with control group for post-operative analgesia. ⋯ We conclude that preemptive use of gabapentin 600mg and pregabalin 150 mg orally significantly reduces the postoperative rescue analgesic requirement and increases the duration of postoperative analgesia in patients undergoing elective gynecological surgeries under spinal anesthesia.