Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jul 2016
Anesthesia for peroral endoscopic myotomy: A retrospective case series.
Peroral endoscopic myotomy (POEM) is a safe and minimally invasive modality regarded as the first-line management of all types of achalasia. POEM is performed under general anesthesia with endotracheal intubation using an orally inserted flexible fiberscope. The aim of this study is to describe the anesthetic management of POEM for achalasia. ⋯ For patients with achalasia, POEM offers the efficacy of surgery with the lower cost and morbidity of an endoscopic procedure. Prevention of aspiration and carbon dioxide insufflation-related complications are the two aspects that demand vigilance from the anesthesiologist.
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J Anaesthesiol Clin Pharmacol · Jul 2016
Tracheal intubation with volatile induction and target bispectral index of 25 versus 40: A randomized clinical trial.
A target bispectral index (BIS) value of 40 is considered adequate for depth of anesthesia, but no consensus exists regarding BIS value for tracheal intubation without neuromuscular blocking drugs. The aim of this randomized, double-blinded study was to compare the total duration from sevoflurane induction to tracheal intubation at a BIS value of 25 or 40. ⋯ The time to achieve target BIS value of 25 was greater as compared to target BIS value of 40 during sevoflurane induction but provided better intubating conditions in the absence of neuromuscular agents.
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J Anaesthesiol Clin Pharmacol · Apr 2016
Comparison of surgical conditions following premedication with oral clonidine versus oral diazepam for endoscopic sinus surgery: A randomized, double-blinded study.
Endoscopic sinus surgery (ESS) provides a challenge and an opportunity to the anesthesiologists to prove their mettle and give the surgeons a surgical field which can make their delicate surgery safer,more precise and faster. The aim of the study was to evaluate the surgical field and the rate of blood loss in patients premedicated with oral clonidine versus oral diazepam for endoscopic sinus surgery. ⋯ Premedication with clonidine as compared to diazepam, provides a better surgical field with less blood loss in patients undergoing ESS.
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J Anaesthesiol Clin Pharmacol · Apr 2016
Effect of dexamethasone in low volume supraclavicular brachial plexus block: A double-blinded randomized clinical study.
With the use of ultrasound, a minimal effective volume of 20 ml has been described for supraclavicular brachial plexus block. However achieving a long duration of analgesia with this minimal volume remains a challenge. We aimed to determine the effect of dexamethasone on onset and duration of analgesia in low volume supraclavicular brachial plexus block. ⋯ Dexamethasone addition significantly increases the duration of analgesia in patients receiving low volume supraclavicular brachial plexus block. No significant side-effects were seen in patients receiving dexamethasone as an adjunct.
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J Anaesthesiol Clin Pharmacol · Apr 2016
Intravenous dexmedetomidine versus propofol for intraoperative moderate sedation during spinal anesthesia: A comparative study.
There has been a paradigm shift of focus toward quality of spinal anesthesia with sedation being an integral aspect of this regional anesthesia technique. Thus, this study was designed to compare efficacy of intravenous dexmedetomidine and propofol for moderate sedation during spinal anesthesia. ⋯ Dexmedetomidine with its stable cardio-respiratory profile, better sedation, overall patient's satisfaction, and analgesia could be a valuable adjunct for intraoperative sedation during spinal anesthesia.