Saudi journal of anaesthesia
-
To compare the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging procedures. ⋯ We conclude that although propofol provided faster anesthetic induction and recovery times, it caused hypotension and desaturation. Dexmedetomidine could be an alternative, reliable sedative drug to propofol in selected patients.
-
Healthcare expenditure is a serious concern, with escalating costs failing to meet the expectations of quality care. The treatment capacities are limited in a hospital setting and the operating rooms (ORs). Their optimal utilization is vital in efficient hospital management. Starting late means considerable wait time for staff, patients and waste of resources. We planned an audit to assess different perspectives of the residents in surgical specialities and anesthesia and OR staff nurses so as to know the causative factors of operative delay. This can help develop a practical model to decrease start time delays in operating room (ORs). ⋯ The preparation of the equipment and required material for the OR cases must be done well in advance. Utilization of newer technology enables timely booking and scheduling of cases. Improved inter-departmental coordination and compliance with preanesthetic instructions needs to be ensured. It is essential that the anesthesiologists perform their work promptly, well in time . and supervise the proceedings as the OR manager. This audit is a step forward in defining the need of effective OR planning for continuous quality improvement.
-
Negative pressure pulmonary edema (NPPE) is a dangerous and potentially fatal condition with a multifactorial pathogenesis. Frequently, NPPE is a manifestation of upper airway obstruction, the large negative intrathoracic pressure generated by forced inspiration against an obstructed airway is thought to be the principal mechanism involved. ⋯ The early detection of the signs of this syndrome is vital to the treatment and to patient outcome. The purpose of this review is to highlight the available literature on NPPE, while probing the pathophysiological mechanisms relevant in both the development of this condition and that involved in its resolution.
-
Tetrology of Fallot (TOF) is the most commonly encountered congenital cardiac lesion in pregnancy. Although there are controversies regarding safe anesthetic technique for parturient with TOF, we use low-dose sequential combined-spinal epidural anesthesia in such a case posted for Cesarean section and found that low dose (0.5 ml of 0.5%) intrathecal bupivacaine and fentanyl with sequential epidural bupivacaine supplementation was adequate for the performance of an uncomplicated Cesarean section with minimal side effects and good fetal outcome. Thus, though the choice of anesthesia can vary in such patients, low-dose sequential combined-spinal epidural can be a safe alternate to achieve good anesthesia with impressive cardiovascular stability.
-
Ropivacaine is a long-acting amide local anesthetic, which is structurally very similar to bupivacaine but produces less motor block and less cardiac and central nervous system toxicity. It is also about 40% less potent than bupivacaine. Our double blind study was designed to compare the clinical efficacy of the equipotent doses of ropivacaine 0.75% and bupivacaine 0.5% for epidural anesthesia and ropivacaine 0.2% and bupivacaine 0.125% for post-operative analgesia in patients undergoing bilateral mesh hernioplasty. ⋯ The equipotent doses of ropivacaine and bupivacaine provided good quality epidural anesthesia and post-operative analgesia.