Anesthesia, essays and researches
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Neuromonitoring aims to detect harmful physiologic events, early enough to guide the treatment instituted. Evidences encourage us to implement multimodal monitoring, as no single monitor is capable of providing a complete picture of dynamic cerebral state. ⋯ Nevertheless, the diverse range of data obtained from these monitors needs to be integrated and simplified for the clinician. Hence, the future research should focus on identification of a most useful monitor for integration into multimodal system.
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A prospective randomized clinical study was conducted to study the efficacy and safety of ropivacaine with bupivacaine intrathecally for lower abdominal and lower limb surgeries. ⋯ Hence ropivacaine was safe and equally effective as bupivacaine for lower abdominal and lower limb surgeries with early motor recovery, providing early ambulation.
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Thoracic spinal anesthesia has been used for laparoscopic cholecystectomy and abdominal surgeries, but not in breast surgery. The present study compared this technique with general anesthesia in breast cancer surgeries. ⋯ Segmental thoracic spinal anesthesia has some advantages when compared with general anesthesia and can be considered as a sole anesthetic in breast cancer surgery with axillary lymph node clearance.
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Sevoflurane and propofol are considered to be the agents of choice in surgeries of short duration due to their better recovery profile and few post-operative complications. This study was designed to compare the early recovery profile of sevoflurane and propofol anesthesia in patients undergoing open cholecystectomy. ⋯ Propofol is as good as sevoflurane for maintenance of anesthesia in surgeries like open cholecystectomy with an added advantage of lower incidence of PONV owing to its intrinsic antiemetic properties.
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Sugammadex (ORG 25969) is a unique neuromuscular reversal drug; a novel cyclodextrin, the first in a new class of selective relaxant binding agents, which reverse neuromuscular blockade (NMB) with the aminosteroid non-depolarizing muscle relaxants rocuronium and vecuronium. Sugammadex can reverse moderate or deep NMB. The clinical use of sugammadex promises to eliminate many of the shortcomings in current anesthetic practice with regard to antagonism of rocuronium and other aminosteroid muscle relaxants.