Anesthesiology and pain medicine
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Sufentanil and alfentanil have pharmacokinetic and dynamic properties which make them favourable substances for total intravenous anesthesia (TIVA) in combination with propofol. ⋯ Both protocols provide excellent anesthesia, but patients receiving sufentnail had more stable anesthesia and less postoperative pain.
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Alterations in taste and smell, including but not limited to anosmia, ageusia, hypogeusia, and dysgeusia, have been described in association with various medications, including anesthetic agents. Frequently, these symptoms occur 1-2 weeks after medication administration and last several months. While such a phenomenon is a rare occurrence, it nonetheless can significantly impact patients' satisfaction and quality of life. ⋯ Based on available literature recommendations for anesthesiologists caring for patients at risk for this occurrence are presented in this review. The symptoms are usually temporary as in the majority of the patients the sensory receptor cells are able to regenerate themselves after injury. Anesthesia providers need to aware of this phenomenon to be able to reassure patients and possibly avoid anesthetic techniques associated with anosmia and ageusia.
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Simple and efficient way of pain management after Coronary Artery Bypass Graft (CABG) surgery is an important aspect of patients' care. ⋯ Both morphine and diclofenac suppositories reduced pain significantly and similarly after CABG surgery.
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Cognitive disorder is a fluctuating cognitive destruction and a common problem for hospitalized patients, which leads to loss of consciousness. It is usually accompanied with increased mortality, prolonged hospital stay, and decreased rehabilitation. ⋯ Given the significant prevalence of postoperative cognitive disorder and significant associatio n between the history of high blood pressure, C-reactive protein and preoperative creatinine and cognitive disorder, detection of patient's clinical symptoms may improve diagnosis, treatment and prevention of this disorder.
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Spinal anesthesia has been associated with intraoperative nausea and vomiting (IONV), especially during cesarean section, which is attributed to several mechanisms. ⋯ Subhypnotic doses of midazolam or propofol are effective in the prevention of nausea and vomiting during and after cesarean section with spinal anesthesia and does not significantly influence hemodynamic of the patients.