Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Apr 2013
A prospective randomized double-blind study comparing dexmedetomidine vs. combination of midazolam-fentanyl for tympanoplasty surgery under monitored anesthesia care.
Analgesia and sedation are usually required for the comfort of the patient and surgeon during tympanoplasty surgery done under local anesthesia. In this study, satisfaction scores and effectiveness of sedation and analgesia with dexmedetomidine were compared with a combination of midazolam-fentanyl. ⋯ Dexmedetomidine is comparable to midazolam-fentanyl for sedation and analgesia in tympanoplasty with better surgeon and patient satisfaction. Hemodynamics need to be closely monitored.
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J Anaesthesiol Clin Pharmacol · Apr 2013
The prediction of difficult intubation in obese patients using mirror indirect laryngoscopy: A prospective pilot study.
The incidence of difficult laryngoscopy and intubation in obese patients is higher than in the general population. Classical predictors of difficult laryngoscopy and intubation have been shown to be unreliable. We prospectively evaluated indirect mirror laryngoscopy as a predictor of difficult laryngoscopy in obese patients. ⋯ This study is consistent with previous studies, which have demonstrated that no one individual traditional test has proven to be adequate in predicting difficult airways in the obese population. However, the new application of an old test - indirect mirror laryngoscopy - could be a useful additional test to predict difficult laryngoscopy in obese patients.
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J Anaesthesiol Clin Pharmacol · Apr 2013
A surgeon's assessment of inadequate neuromuscular antagonism in a case of prolonged neuromuscular blockade.
Evaluation of the degree of neuromuscular blockade by the surgeon using clinical criteria alone is unreliable. We report a case of prolonged neuromuscular blockade lasting 5.5 h, where an additional intra-operative dose of neuromuscular relaxant was given at the request of the surgical team. Possible causes of prolonged neuromuscular antagonism are discussed, as is the importance of neuromuscular assessment prior to the administration of additional neuromuscular blocking agents when receiving a surgeon request for additional neuromuscularblockade.
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J Anaesthesiol Clin Pharmacol · Apr 2013
Betahistine as an add-on: The magic bullet for postoperative nausea, vomiting and dizziness after middle ear surgery?
Patients undergoing middle ear surgery experience variable degrees of postoperative nausea and vomiting (PONV) despite prophylaxis and treatment with ondansetron or other 5HT3 receptor antagonists. Furthermore vertigo or dizziness are not well controlled perioperatively. Role of betahistine was tested as an add-on to ondansetron in control of PONV and vertigo in middle ear surgery cases. ⋯ Betahistine as an add-on to ondansetron can significantly attenuate PONV and perioperative vertigo, following middle ear surgeries.
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J Anaesthesiol Clin Pharmacol · Apr 2013
Rural perspective about anesthesia and anesthesiologist: A cross-sectional study.
More than 3/4(th) of Indian population resides in rural areas. The public awareness towards "Anesthesia and Anesthesiologist" is limited even in urban population. There is no data available from rural India on this perspective. Our cross-sectional analysis highlights this lack of public awareness and discusses possible remedies to overcome these limitations. ⋯ The rural awareness about anesthesia is extremely low likely because of low literacy rates and lack of pre-operative counseling by anesthesiologist. Both patient and anesthesiologist must understand the importance of consent, as it is not only a legal binding but can eliminate pre-operative factitious fears of patients and can improve patient satisfaction towards surgery.