Anesthesiology and pain medicine
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Spinal anesthesia is widely used for caesarean section. Addition of intrathecal magnesium sulfate to local anesthetics seems to improve the quality of block and prolong the duration of analgesia. ⋯ This study showed that the addition of intrathecal magnesium sulfate to bupivacaine is not desirable in patients undergoing cesarean section due to the delay in the onset of sensory blockade and the lack of significant effects of magnesium on post-operative pain.
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The use of Propofol often results in pain upon injection, which is sometimes very distressing for patients. Many patients report some degree of pain or discomfort on injection with propofol. Injection-induced pain during induction of anesthesia can result in patient's discomfort. ⋯ Nitroglycerine may be a safe and effective adjuvant therapeutic for pain reduction in patients under propofol injection. Hence, its use for reduction of propofol injection-induced pain is recommended.
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Pain following laparoscopy could be due to different causes requiring effective postoperative analgesia. ⋯ Intraperitoneal Infiltration of bupivacaine with meperidine following surgery provided more appropriate analgesia after gynecologic diagnostic laparoscopy than administration of IV paracetamol.
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Endotracheal Tube Cuff Pressure (ETCP) should be kept in the range of 20 - 30 cm H2O. Earlier studies suggested that ETCP assessment by palpation of pilot balloon results in overinflation or underinflation and subsequent complications such as tracheal wall damage and aspiration. ⋯ Implementing educational programs with the introduction of estimation techniques besides the use of manometer as a standard intraoperative monitoring will improve the safety of the practice.
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Anesthesia induction in patients with current substance abuse can be a challenge for anesthesiologists. ⋯ The length of sensory and motor blockade is shorter in chronic opioid abusers. Adding 10 µg sufentanil to hyperbaric bupivacaine in opium abusers lengthened the sensory and motor block duration.