Saudi journal of anaesthesia
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Electroencephalography can detect both cerebral ischemia/hypoxia and seizures and can measure hypnotic effects. The author reported two patients with left main coronary artery disease and myocardial infarction scheduled for urgent coronary artery bypass grafting surgery; they developed abrupt decreases in response entropy (RE) and state entropy (SE) values to isoelectric silence during target-controlled propofol-sufentanil anesthesia. ⋯ Both patients showed delayed awakening after surgery and brain CT revealed nonhemorrhagic tempro-parietal cerebral infarctions. Intraoperative entropy-based monitoring could predict poor neurological outcome after cardiac surgery during target-controlled propofol and sufentanil anesthesia.
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Ultrasound (US) guidance is strongly recommended when performing peripheral nerve blocks in infants and children. ⋯ US-guided II/IH nerve blocks is an ideal postoperative analgesic for unilateral groin surgery in children, particularly hernia repairs and is as effective as caudal block, with a lower volume of local anesthetics.
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Paravertebral block is a popular regional anesthetic technique used for perioperative analgesia in multiple surgical procedures. There are very few randomized trials of its use in laparoscopic cholecystectomy in medical literature. This study was aimed at assessing its efficacy and opioid-sparing potential in this surgery. ⋯ Pre-induction PVB resulted in improved analgesia for 24 hours following laparoscopic cholecystectomy in this study, along with a significant reduction in perioperative opioid consumption and opioid-related side effects.
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The reliability and success of caudal epidural anesthesia depends on anatomic variations of sacral hiatus (SH) as observed by various authors. SH is an important landmark during caudal epidural block (CEB).The purpose of the present study was to clarify the morphometric characteristics of the SH in human Egyptian dry sacra and pelvic radiographs and identification of nearest ony landmarks to permit correct and uncomplicated caudal epidural accesses. ⋯ Sacrum and SH showed morphometric variations in adult Egyptians. The equilateral triangle is an important guide to detect SH easily and increases the success rate of CEB. Insertion of a needle into the SH for caudal block is suggested to be done at its base to avoid the anatomic variations of its apex.