Current Issue : July - September Volume : 2015 Issue Number : 3 Articles : 8 Articles
Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of\nsingle low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH) pain relief under balanced general\nanesthesia. Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N = 20) and\nnormal saline (N = 20) groups randomly. The magnesium group received magnesium sulfate 50 mg?kg?1 in 100mL of normal\nsaline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100mL\nof 0.9% sodium chloride solution at the same time.The same balanced general anesthesia was induced for two groups. Pethidine\nconsumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale\n(NRS) at 0, 6, 12, and 24 hours after the surgeries. Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24\nhours after the operations significantly (P < 0.05). Pethidine requirement was significantly lower in magnesium group throughout\n24 hours after the surgeries (P = 0.0001). Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could\nbe considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH....
Background. Orthopedic procedures are among the commonest surgeries in the elderly. On the other hand, those patients have\nmany risk factors suitable for development of postoperative complication due to prolonged postoperative recumbent that decrease\nby using anesthesia technique allowed early ambulation as far as possible. Aim of the Work.The aim of this study was to evaluate\nwhether washout of the local anesthesia with 0.9% normal saline with bicarbonate through the epidural catheter could provide early\nambulation throughout the faster recovery of the motor block. Patient and Methods. Sixty adult patients were included in this study\nand divided into three groups. In group I, epidural injection of bupivacaine was carried out without wash (control group). In group\nII, epidural injection of bupivacaine was followed by wash. In group III, epidural injection of both bupivacaine and nalbuphine\nwas followed by wash. Results.They were significantly faster in both group II and group III as compared with group I. In group I,\nsensory recovery was insignificantly faster than the motor recovery. In group II motor recovery was significantly faster than sensory\nrecovery. In group III motor recovery was significantly faster than the sensory recovery. Conclusions.These results suggested that\nearly ambulation with an adequate postoperative analgesia was reported in patient receiving epidural injection of both bupivacaine\nand nalbuphine....
Objective. The aim of this study was to evaluate the arterial to end-tidal partial pressure gradient of carbon dioxide according to\nage in the supine position during general anesthesia. Methods. From January 2001 to December 2013, we evaluated 596 patients\naged ?16 years who underwent general anesthesia in the supine position.The anesthetic charts of these 596 patients, all classified\nas American Society of Anesthesiologists physical status I or II, were retrospectively reviewed to investigate the accuracy of PaCO2\nand ETCO2. Results.The a-ETCO2 was 3.0 �± 2.1mmHg for patients aged 16 to <65 years and 4.1�±3.1mmHg for patients ?65 years.\nThe a-ETCO2 was 2.4 �± 3.1mmHg for patients aged 16 to 25 years, 3.1 �± 2.2mmHg for patients aged 26 to 35 years, 3.0 �± 2.2mmHg\nfor patients aged 36 to 45 years, 3.4 �± 2.0mmHg for patients aged 46 to 55 years, 3.2 �± 2.0mmHg for patients aged 56 to 64 years,\n4.3 �± 3.2mmHg for patients aged 65 to 74 years, and 3.7 �± 2.8mmHg for patients aged 75 to 84 years. Conclusion. The arterial to\nend-tidal partial pressure gradient of carbon dioxide tended to increase with increasing age....
Voltage-gated sodium channels (NaV) play a crucial role in development and propagation of action potentials in neurons and muscle\ncells. NaV1.7 channels take a special place in modern science since it is believed that they contribute to nerve hyper excitability.\nMutations of the gene SCN9A, which codes the ???? subunit of NaV1.7 channels, are associated with pain perception disorders\n(primary erythermalgia, congenital analgesia, and paroxysmal pain disorder). It is considered that the SCN9A gene mutations\nmay cause variations in sensitivity to pain, from complete insensitivity to extreme sensitivity. Further research of the SCN9A gene\npolymorphism influence on pain sensitivity is essential for the understanding of the pathophysiology of pain and the development\nof the appropriate targeted pain treatment....
Cardiopulmonary resuscitation (CPR) is performed in order to restore oxygen delivery and prevent multi organ system failure and\ndeath. Prompt initiation of CPR with appropriate medical or surgical therapy may shorten arrest duration before irreversible organ\ninjury occurs. The brain is most susceptible to irreversible anoxic injury. Survival data suggests that children are more likely than\nadults to survive and have good neurologic outcomes following cardiac arrest. In this review of pediatric resuscitation, we discuss\nimportant predictors of postarrest outcomes as well as advances in resuscitation science focusing on the critical importance of\noxygen delivery during periarrest care....
Anaesthetists in the acute and chronic pain teams are often involved in treating Complex Regional Pain Syndromes. Current\nliterature about the risk factors for the onset of Complex Regional Pain Syndrome Type 1 (CRPS 1) remains sparse. This syndrome\nhas a low prevalence, a highly variable presentation, and no gold standard for diagnosis. In the research setting, the pathogenesis of\nthe syndrome continues to be elusive. There is a growing body of literature that addresses efficacy of a wide range of interventions\nas well as the likely mechanisms that contribute to the onset of CRPS 1. The objective for this systematic search of the literature\nfocuses on determining the potential risk factors for the onset of CRPS 1. Eligible articles were analysed, dated 1996 to April 2014,\nand potential risk factors for the onset of CRPS 1 were identified from 10 prospective and 6 retrospective studies. Potential risk\nfactors for the onset of CRPS 1 were found to include being female, particularly post menopausal female, ankle dislocation or in traarticular\nfracture, immobilisation, and a report of higher than usual levels of pain in the early phases of trauma. It is not possible\nto draw definite conclusions as this evidence is heterogeneous and of mixed quality, relevance, and weighting strength against bias\nand has not been confirmed across multiple trials or in homogenous studies....
Background. There is no consensus on the optimum management of failed tracheal intubation in emergency cesarean delivery\nperformed for fetal compromise. The decision making process on whether to wake the patient or continue anesthesia with a\nsupraglottic airway device is an under explored area. This survey explores perceptions and experiences of obstetric anesthetists\nmanaging failed intubation. Methods. Anesthetists attending the Group of Obstetric Anaesthetists London (GOAL) Meeting in\nApril 2014 were surveyed. Results. Ninety-three percent of anesthetists surveyed would not always wake the patient in the event of\nfailed intubation for emergency cesarean delivery performed for fetal compromise. The median (interquartile range) of perceived\nacceptability of continuing anesthesia with a well-fitting supraglottic airway device, assessed using a visual analogue scale (0ââ?¬â??100; 0\ncompletely unacceptable; 100 completely acceptable), was 90 [22.5]. Preoperative patient consent regarding the use of a supraglottic\nairway device for surgery in the event of failed intubation would affect the decision making of 40% of anaesthetists surveyed.\nConclusion.These results demonstrate that a significant body of anesthetists with a subspecialty interest in obstetric anesthesia in\nthe UK would not always wake up the patient and would continue with anesthesia and surgery with a supraglottic airway device in\nthis setting....
Fibreoptic intubation, high frequency jet ventilation, and videolaryngoscopy form part of the Royal College of Anaesthetists\ncompulsory higher airway training module. Curriculum delivery requires equipment availability and competent trainers. We\nsought to establish (1) availability of advanced airway equipment in UK hospitals (Survey I) and (2) if those interested in airway\nmanagement (Difficult Airway Society (DAS) members) had access to videolaryngoscopes, their basic skill levels and teaching\ncompetence with these devices and if they believed that videolaryngoscopy was replacing conventional or fibreoptic laryngoscopy\n(Survey II). Data was obtained from 212 hospitals (73.1%) and 554 DAS members (27.6%). Most hospitals (202, 99%) owned a\nfiberscope, 119 (57.5%) had a videolaryngoscope, yet only 62 (29.5%) had high frequency jet ventilators. DAS members had variable\naccess to videolaryngoscopes with Airtraq 319 (59.6%) and Glidescope 176 (32.9%) being the most common. More DAS members\nwere happy to teach or use videolaryngoscopes in a difficult airway than thosewho had used them more than ten times.The majority\nrated Macintosh laryngoscopy as the most important airway skill. Members rated fibreoptic intubation and videolaryngoscopy\nskills equally. Our surveys demonstrate widespread availability of fibreoptic scopes, limited availability of videolaryngoscopes, and\nlimited numbers of experienced videolaryngoscope tutors....
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