Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jul 2014
Analgesic efficacy of transversus abdominis plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial.
Transversus abdominis plane (TAP) block has been shown to provide postoperative pain relief following various abdominal and inguinal surgeries, but few studies have evaluated its analgesic efficacy for intraoperative analgesia. We evaluated the efficacy of TAP block in providing effective perioperative analgesia in total abdominal hysterectomy in a randomized double-blind controlled clinical trial. ⋯ Preincisional TAP block decreases intraoperative fentanyl requirements, prevents hemodynamic responses to surgical stimuli and provides effective postoperative analgesia.
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J Anaesthesiol Clin Pharmacol · Jul 2014
Spinal anesthetic for emergency cesarean section in a parturient with uncorrected tetralogy of Fallot, presenting with abruptio placentae and gestational hypertension.
A subarachnoid block is an effective way of providing anesthesia for cesarean sections. However, it can be considered relatively contra-indicated in parturients with uncorrected tetralogy of Fallot (TOF). ⋯ The surgery was successfully conducted under a spinal anesthetic with a combination of low dose bupivacaine and fentanyl. Fentanyl combined with small-dose bupivacaine in the subarachnoid space can be considered as an alternative technique to general anesthesia, in selected parturients with uncorrected TOF presenting for cesarean section, especially in cases where the risks of administering a general anesthetic are deemed high.
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J Anaesthesiol Clin Pharmacol · Jul 2014
ReviewPrinciples of neuroanesthesia in aneurysmal subarachnoid hemorrhage.
Aneurysmal subarachnoid hemorrhage is associated with high mortality. Understanding of the underlying pathophysiology is important as early intervention can improve outcome. Increasing age, altered sensorium and poor Hunt and Hess grade are independent predictors of adverse outcome. ⋯ Patients with poor grades tolerate higher blood pressures, but are prone to ischemia whereas patients with lower grades tolerate lower blood pressure, but are prone to aneurysm rupture if blood pressure increases. Patients with Hunt and Hess Grade I or II with uneventful intraoperative course are extubated in operation theater, whereas, higher grades are kept electively ventilated. Postoperative management includes attention toward fluid status and early management of vasospasm.