Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Oct 2018
ReviewA comparative analysis of femoral nerve block with adductor canal block following total knee arthroplasty: A systematic literature review.
Patients undergoing total knee arthroplasty suffer from moderate-to-severe postoperative pain resulting in immobility-related complications and prolonged hospitalization. Femoral nerve block is associated with reduction in the quadriceps strength and increasing incidence of falls. Adductor canal block has been shown to be as effective as femoral nerve block without causing quadriceps weakness. ⋯ Mobilization and ambulation, which are both important for recovery after total knee arthroplasty are both inhibited less by adductor canal block.
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J Anaesthesiol Clin Pharmacol · Oct 2018
Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial.
The study was conceived to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in cerebello-pontine angle (CPA) surgeries. ⋯ Dexmedetomidine-fentanyl-propofol anesthesia compares favorably with fentanyl-propofol anesthesia during CPA neurosurgical procedures with regard to anesthesia recovery times, but with lower intraoperative opioid and hypnotic utilization rates.
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J Anaesthesiol Clin Pharmacol · Oct 2018
Assessment of awake i-gel™ insertion for fiberoptic-guided intubation in patients with predicted difficult airway: A prospective, observational study.
Orotracheal intubation (OTI) with fiberoptic bronchoscope (FOB) in spontaneous ventilation is one of the main techniques for patients with predicted difficult airway. Latest generation supraglottic airway devices have been designed to allow OTI through them. We assessed the safety and effectiveness of FOB-guided OTI through i-gel™ device which was inserted in spontaneously breathing patients with predicted difficult airway. ⋯ I-gel insertion in spontaneous ventilation secures the airway before achieving fiberoptic intubation without the occurrence of adverse events. More studies might be necessary in order to confirm the results presented, but we consider that the technique described is a safe and effective alternative to classic OTI with FOB in spontaneously breathing patients with predicted difficult airway.
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J Anaesthesiol Clin Pharmacol · Oct 2018
Ratio of height to thyromental distance as a predictor of difficult laryngoscopy: A prospective observational study.
Various airway indices are used either singly or in combination to predict difficult laryngoscopy. Recently introduced ratio of height to thyromental distance (RHTMD) is reported to have better predictability. We aimed to assess the prediction of difficult laryngoscopy by RHTMD and compared it with other indices. ⋯ RHTMD is a single best preoperative test for predicting difficult laryngoscopy. A combination of tests has higher sensitivity and specificity with better discriminative power. Therefore indices should be used in combination in the preoperative airway assessment of adult patients.
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J Anaesthesiol Clin Pharmacol · Oct 2018
Transcoccygeal neurolytic ganglion impar block for perineal pain: A case series.
Chronic perineal pain (CPP) is a poorly localized pain. Its etiology may be benign or malignant. The ganglion impar is a solitary retroperitoneal structure at sacrococcygeal junction. It provides the nociceptive and sympathetic supply to the perineal structures. CPP has been effectively managed by ganglion impar block. Here, we describe a case series of neurolytic ganglion impar block by transcoccygeal approach, analyzing its safety and efficacy. ⋯ Transcoccygeal ganglion impar block may offer a safe and effective treatment option for CPP as compared to opioids. This approach for neurolysis of the ganglion impar may be recommended in view of the direct course, appreciable end point, and smaller volume of neurolytic requirement.