Anesthesia, essays and researches
-
Various adjuvants have been introduced to decrease the dose of volatile agents and their side effects. Dexmedetomidine a potent alpha-2 adrenoreceptor agonist is one such agent. Our objective is to assess the effect of preanesthetic dexmedetomidine on isoflurane consumption and its effect on intraoperative hemodynamic stability and recovery profile. ⋯ Preanesthetic bolus dose of dexmedetomidine is a useful adjuvant to reduce isoflurane consumption.
-
Cooling of local anesthetic potentiates its action and increases its duration. Magnesium sulfate (MgSo4) added to local anesthetic prolongs the duration of anesthesia and postoperative analgesia with minimal side effects. ⋯ The use of cold 0.5% bupivacaine or the addition of Mg to normal temperature 0.5% bupivacaine prolongs the sensory and motor block duration without increasing side effects and enhances the quality of intra- and post-operative analgesia with better patient satisfaction in sonar-guided femoral and sciatic nerve block for arthroscopic ACL reconstruction surgery.
-
To study the efficacy and safety of intrathecal neostigmine at dose of 50 μg and 150 μg as an adjuvant to bupivacaine for postoperative analgesia under spinal anesthesia. ⋯ The administration of intrathecal neostigmine in dose of 50 μg as an adjuvant to bupivacaine produces hemodynamically stable analgesia with minimal side effects.
-
Postoperative nausea and vomiting (PONV) is one of the complex and significant problems in anesthesia practice, with growing trend toward ambulatory and day care surgeries. This review focuses on pathophysiology, pharmacological prophylaxis, and rescue therapy for PONV. We searched the Medline and PubMed database for articles published in English from 1991 to 2014 while writing this review using "postoperative nausea and vomiting, PONV, nausea-vomiting, PONV prophylaxis, and rescue" as keywords. ⋯ Newer drugs such as neurokinin-1 receptor antagonist (aprepitant) are used along with serotonin (5-hydroxytryptamine subtype 3) receptor antagonist, corticosteroids, anticholinergics, antihistaminics, and butyrophenones for PONV prophylaxis. Combination of drugs from different classes with different mechanism of action are administered for optimized efficacy in adults with moderate risk for PONV. Multimodal approach with combination of pharmacological and nonpharmacological prophylaxis along with interventions that reduce baseline risk is employed in patients with high PONV risk.
-
Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others. ⋯ CRF with steroid seems to be better for treatment of chronic discogenic low back pain than PRF with steroid.