Anesthesiology and pain medicine
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Because blood pressure and heart rate (HR) elevations during tracheal extubation are common, different medications have been studied to prevent such complications. ⋯ Both remifentanil and magnesium had favorable outcomes in preventing HR and MAP elevation after tracheal extubation. However, remifentanil was associated with more rapid regaining of consciousness and reversal of muscular relaxation.
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Preoperative anxiety is associated with adverse clinical, behavioral, and psychological outcomes. Various effective interventions targeting preoperative anxiety in children exist. ⋯ In this study, the preoperative anxiety was reduced by explaining anesthesia and surgery to the mothers and children (in mothers it was significant P < 0.05). Since there is a direct relation between mothers' and their children's anxiety, using an effective method to reduce anxiety in children and their mothers together at the same time would be very useful for children and their mothers.
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Supraglottic devices could be used to reduce postoperative respiratory complications, but there are few studies focused on their use in more prolonged surgeries. ⋯ LMA in prolonged ENT surgeries was associated with reduced respiratory complications.
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Intrathecal adjutants can be used for regional anesthesia (RA) in cesarean section to improve its quality in terms of time and complications. Some previous studies focused on the effects of adding sufentanil and/or midazolam to bupivacaine and compared each with using bupivacaine alone. However, there has been no study to assess the effects of using sufentanil and midazolam in combination with bupivacaine. ⋯ The findings showed that adding sufentanil or midazolam to bupivacaine shortens the onset of spinal anesthesia and increases the time duration of anesthesia; however it does not change the motor block recovery time. Adding sufentanil delays the first request for narcotic analgesics while adding midazolam leads to a decrease in nausea and hypotension. Adding sufentanil or midazolam does not have any deleterious effect on infants' Apgar scores. However, increases shivering in patients.
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Many papers have reported that TAP block provides effective postoperative analgesia, but the sole use of TAP block for surgical anesthesia has been rarely reported. ⋯ Open gastrostomy was successfully performed under subcostal TAP block with small dose fentanyl supplementation. The subcostal TAP block is considered a useful anesthetic choice in surgery for high risk patients.