Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Oct 2011
A systematic review of the effects of sedatives and anesthetics in patients with obstructive sleep apnea.
The objective of this review is to determine the effects of perioperative sedatives and anesthetics in surgical patients with obstructive sleep apnea (OSA) on respiratory events, medication requirements, hemodynamics, pain, emergence, and hospital stay. We searched The Cochrane CENTRAL Register of Controlled Trials, Medline, Embase, and Cochrane Database of Systematic Reviews from 1950 to June 2010 for relevant articles. All prospective and retrospective studies were eligible for inclusion if the effects of perioperative administration of sedation and anesthetics on medication requirements, pain, emergence, hemodynamics, respiratory events, and length of hospital stay in OSA patients were reported. ⋯ Adverse events were reported with midazolam. However, the quality and number of patients in the studies were limited. There is a need for further trials with large numbers and uniform reporting of outcomes.
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J Anaesthesiol Clin Pharmacol · Oct 2011
Case ReportsTransient brachial monoparesis following epidural anesthesia for cesarean section.
Monoparesis following lumbar epidural block is a rare occurrence, with few cases reported in the literature. We report development of transient brachial monoparesis following epidural anesthesia in a parturient for cesarean section. The patient received a mixture of 15 mL of 2% lignocaine with 50 mcg fentanyl epidurally to achieve a blockade up to T6 level. ⋯ However, near the end of surgery, she developed weakness in the right upper limb. The weakness lasted for 90 min, followed by complete neurological recovery. Subsequent hospital stay was uneventful.
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J Anaesthesiol Clin Pharmacol · Oct 2011
Case ReportsForeign body removal with repair of iatrogenic tracheo-bronchial tear repair: An anesthetic challenge.
Foreign body aspiration into the airway is common in the pediatric age group and its anesthetic management is a challenge. Iatrogenic tracheo-bronchial injury further worsens the situation. Flexible pediatric fiberscope is the gold standard for securing the airway in cases of airway injury. ⋯ To repair the airway tear, thoracotomy was planned necessitating one lung ventilation. A pediatric flexible fiberscope was not available, so left endobronchial intubation for one lung ventilation was done with the help of an airway exchange catheter using a rigid bronchoscope as a conduit. Subsequent intra-operative and post-operative period were uneventful.
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J Anaesthesiol Clin Pharmacol · Oct 2011
Case ReportsRemifentanil apnea: Case report and review of the literature.
Remifentanil is an opioid analgesic frequently used in intensive care patients because of its rapid onset of action, potency, and ultra-short duration. If an excessive dose is given, it leads to rapid, short lasting, potentially life-threatening side effects such as apnea, bradycadia, hypotension, and rigidity, following rapid peak serum levels. ⋯ She became fully awake, heart rate and blood pressure returned to normal, and oxygen saturation improved to 100%. Acute care physicians, intensivists, anesthesiologists, and critical care nurses should be aware of this clinical problem in order prevent it as much as possible and to initiate immediate resuscitative measures.
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J Anaesthesiol Clin Pharmacol · Jul 2011
Pre-induction low dose pethidine does not decrease incidence of postoperative shivering in laparoscopic gynecological surgeries.
The incidence of shivering in patients undergoing a laparoscopic procedure is stated to be about 40%. A majority of laparoscopic gynecological procedures are taken up on an outpatient basis. Postoperative shivering may delay hospital discharge and is a common cause of discomfort in patients recovering from anesthesia. ⋯ Prophylactic pre-induction, low-dose pethidine does not have major role in preventing postoperative shivering.