Anesthesia, essays and researches
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A double-blinded, prospective, and randomized study was designed to determine the efficacy and tolerability of intravenous (IV) magnesium sulfate (MgSO4) to facilitate fiberoptic bronchoscopic (FOB) nasotracheal intubations. ⋯ Intravenous MgSO4 improved awaken FOB intubation without adverse hemodynamic or respiratory effects.
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Inhalation anesthetics have many advantages for outpatient general anesthesia, such as minimal postoperative side-effects and rapid and full recovery. The aim of this randomized study was to compare the postoperative recovery time of sevoflurane and desflurane and to observe the effects of anesthesia on mental, psychomotor and cognitive functions and pain in outpatients undergoing arthroscopic surgery. ⋯ It has been determined that desflurane provided better quality and more rapid recovery than sevoflurane, and the return of cognitive functions in the early postoperative period was faster. In conclusion, both agents can apparently be used safely in outpatient anesthetic procedures.
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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.
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Laryngoscopy and endotracheal intubation activates the sympathetic nervous system, causing tachycardia and hypertension. Dexmedetomidine has an affinity for alpha2 receptors 8 times greater than that of clonidine. It diminishes norepinephrine release and inhibits sympathetic activity leading to decreased heart rate (HR) and blood pressure. ⋯ It was found that attenuating response to hemodynamic changes were observed with dexmedetomidine and clonidine IV infusion. The early onset of dexmedetomidine makes it a promising choice. Hence premedication with IV infusion of dexmedetomidine can safely be recommended for attenuation of hemodynamic response to endotracheal intubation.
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Spinal anesthesia though gaining popularity in children, the misconceptions regarding its safety and feasibility can be better known with greater use and experience. The objective of this study was to evaluate the success rate, complications and hemodynamic stability related to pediatric spinal anesthesia. ⋯ Pediatric spinal anesthesia is a safe and effective anesthetic technique for lower abdominal and lower limb surgeries of shorter duration (<90 min) with high success rate. Owing to, its early motor recovery, it can be a preferred technique for day case surgeries in the pediatric population.