Anesthesia, essays and researches
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The aim of the study was to compare the effect of mannitol (M) and hypertonic saline (HTS) on brain relaxation and electrolyte balance. ⋯ We concluded that HTS provided better brain relaxation than mannitol during elective supratentorial brain tumor surgery, without affecting ICU and hospital stay.
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The aim of the present study is to substantiate and compare the quality and extent of nerve block by using intrathecal bupivacaine or extradural bupivacaine alone and in combined spinal-epidural (CSE) technique using smaller dose of intrathecal bupivacaine and extradural injection of a smaller dose of bupivacaine or normal saline. ⋯ Quality of nerve block in combined technique using bupivacaine both intrathecally and extradurally is better and associated with lower side-effect compared with intrathecal heavy bupivacaine or extradural isobaric bupivacaine alone.
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Post-operative nausea and vomiting (PONV) pose unique challenges in neurosurgical patients that warrant its study separate from other surgical groups. ⋯ Single dose administration of granisetron 1 mg or ondansetron 4 mg at the time of dural closure with dexamethasone 8 mg provide an effective and superior prophylaxis against vomiting compared with dexamethasone alone without interfering with post-operative recovery and neurocognitive monitoring and hence important in post-operative neurosurgical care.
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Vascular pain is a frequent and hypotension is most important complications of propofol administration. ⋯ Rapid propofol injection induced less vascular pain compared with slow injection, but 10 mg ephedrine was not more effective.
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An estimated 0.75-2% of pregnant women undergo nonobstetric surgery during pregnancy. Surgery is indicated during pregnancy only if it is absolutely essential for wellbeing of mother and fetus. A 25-year-old primigravida with 22 weeks gestation diagnosed with extra hepatic portal venous obstruction, hypersplenism, and refractory pancytopenia was posted for open splenectomy. ⋯ Patient was extubated with an uneventful postoperative course. A fetal ultrasound showed no variation from preprocedure baseline. Optimal anesthetic management requires an understanding into normal alterations in maternal physiology during pregnancy and potential fetal effects from anesthesia and surgery.