Anesthesia, essays and researches
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Stress-induced neuroendocrine and metabolic changes lead to intraoperative hyperglycemia which is related to surgery and the type of intravenous fluids used. ⋯ Nondiabetic patients undergoing major abdominal surgeries who received acetate-based fluids had relatively higher intraoperative blood sugar levels as compared to those receiving lactated solutions, but the incidence of hyperglycemia was comparable. When the duration of surgery exceeded 6 h, acetate-based solutions resulted in significantly higher lactate levels with progressive metabolic acidosis.
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Apneic mass movement of oxygen by applying continuous positive airway pressure (CPAP) is possible only when the airway is kept patent which helps to reduce the rate of desaturation. ⋯ Preoxygenation with CPAP of 5 cmH2O followed by apneic oxygenation with CPAP keeping the airway patent with an oropharyngeal airway results in significantly higher PaO2 after preoxygenation and slower reduction in PaO2 during apnea.
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Abdominal hysterectomy is associated with sever postoperative pain. Quadratus lumborum (QL) block is a regional analgesic technique which has an evolving role in postoperative analgesia. ⋯ Bilateral QL block provided better intraoperative and postoperative analgesia with less opioids consumption compared with bilateral TAP block, in patients undergoing total abdominal hysterectomy.
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Shivering is a common problem in patients undergoing surgery under spinal anesthesia. ⋯ Clonidine provides early relief from shivering than tramadol with fewer side effects in patients undergoing surgery under spinal anesthesia.
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In patients undergoing laparoscopic surgeries, postoperative nausea and vomiting (PONV) is a serious concern. With an incidence of 46%-72%, PONV hampers the postoperative recovery in spite of the availability of many antiemetic drugs. The purpose of this study was to prospectively evaluate the efficacy of palonosetron and granisetron for the prevention of PONV in patients undergoing laparoscopic abdominal surgery. ⋯ There were no significant differences in the overall incidence of PONV and complete responders for palonosetron and granisetron group in the early recovery period. However, due to its prolonged duration of action, palonosetron was more effective than granisetron for long-term prevention of PONV after laparoscopic abdominal surgery.