Saudi journal of anaesthesia
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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.
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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.
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AIMS AND CONTEXT: To evaluate the efficacy of adding clonidine to bupivacaine in bilateral infraorbital nerve block for hemodynamic changes, requirement of opioids, volatile agent, and muscle relaxants intraoperatively and relief of pain postoperatively ⋯ Addition of clonidine as an adjunct to local anesthetic significantly decreased the requirement of other anesthetic drugs and significantly prolonged the duration of postoperative analgesia without any adverse effects.
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Supraglottic airway devices have been used as an alternative to tracheal intubation during laparoscopic surgery. ⋯ SLIPA can be used as a useful alternative to PLMA in patients undergoing lower abdominal laparoscopic surgery with muscle relaxant and controlled ventilation.
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Propofol is a commonly used short-acting intravenous anaesthetic agent. A major disadvantage of propofol is pain at injection site with high incidence up to 90%. Various modalities have been tried to obtund propofol-induced pain; however, search for an ideal agent continues. We assessed the effect of double and triple dilution of 1% propofol emulsion with normal saline on pain at injection site. ⋯ We found a significant decrease in both incidence and severity of pain during injection with a 0.33% propofol solution without significant adverse hemodynamic effects. The small size of data was a limitation in our study and a large-scale study will be needed to prove its therapeutic beneficence.