Anesthesia, essays and researches
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Caudal analgesia is the most commonly used technique providing intra- and postoperative analgesia for various pediatric infraumbilical surgical procedures but with the disadvantage of short duration of action after single injection. Caudal dexamethasone and magnesium could offer significant analgesic benefits. We compared the analgesic effects and side-effects of dexamethasone or magnesium added to caudal ropivacaine in pediatric patients undergoing inguinal hernia repair. ⋯ The addition of dexamethasone or magnesium to caudal ropivacaine significantly prolonged the duration of postoperative analgesia in children undergoing inguinal hernia repair. Also the time to 1(st) analgesic dose was longer and the need for rescue postoperative analgesic was reduced and without increase in incidence of side effects.
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Midazolam and clonidine are preferred premedicants whose effects are not restricted to the preoperative period. In addition, these premedicants significantly modulate not only the intraoperative requirements of the anesthetic agents, but also the postoperative outcome. We aim to compare the efficacy of both the agents in view of premedication, induction characteristics, hemodynamic changes and postoperative complications utilizing bispectral index (BIS) using propofol anesthesia. ⋯ Both clonidine and midazolam contributed equally in lowering propofol consumption. Reduction in the induction dosage of propofol and hemodynamic variations were also observed to be similar with the use of midazolam or clonidine as premedicants. Both provide a beneficial effect in relation to recovery and less postoperative complications. However clonidine premedication was found to be more effective in preventing post operative shivering and can be recommended in routine practice.
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The case report here is a case of cesarean operation under subarachnoid block, which resulted after a failed lumber puncture, known to be "dry tap." The result is that it was uneventful surgery without any additive anesthetics being required after injecting 2.2 ml Bupivacaine 0.5% (H). Although cases have been reported with mixed experiences of dry tap and different causes are also explained, but still there is a need to find few other reasons for "dry tap." Hence, thought to present the case for putting forward a question that if there is any more cause for dry tap.
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The thoracic spinal anesthesia was first described in 1909 and recently revised for various surgical procedures. This is a prospective study aims to evaluate the parameters of the thoracic spinal anesthesia (latency, motor block and paresthesia), the incidence of cardiovascular changes and complications comparing low doses of isobaric and hyperbaric bupivacaine. ⋯ The beginning of the block is fast regardless of the solution used. By providing a sensory block of longer duration than the motor block hyperbaric bupivacaine is reflected in a better indication. Thoracic spinal anesthesia provides excellent anesthesia for lower limb orthopedic surgery.