BMC anesthesiology
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Randomized Controlled Trial
Role of dexamethasone in the para-vertebral block for pediatric patients undergoing aortic coarctation repair. randomized, double-blinded controlled study.
Surgery for aortic coarctation requires special care during anesthesia due to severe pain during the lateral thoracotomy incision, intraoperative hemodynamic instability and the need for large doses of intra- and postoperative analgesics and vasodilators. Additionally, the postoperative care of patients is very important. ⋯ The use of dexamethasone as an adjuvant in ultrasound-guided paravertebral block in paediatric patients undergoing surgery for aortic coarctation increased the duration of postoperative analgesia with a prolonged time to the first request for analgesics It was also associated with a decreased incidence of postoperative complications.
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Randomized Controlled Trial Comparative Study
Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial.
Regional anesthesia could affect the homeostatic system functions resulting frequently in perioperative hypothermia and consequently shivering. The objective of this trial was to evaluate the efficacy of dexmedetomidine and ondansetron to reduce the incidence and severity of shivering after intrathecal blocks. ⋯ Prophylactic administrations of dexmedetomidine or ondansetron efficiently decrease the incidence and severity of shivering after spinal anesthesia as compared to placebo without significant difference between their efficacies when compared to each other.
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Observational Study
Glycated hemoglobin A1c level on the day of emergency surgery is a marker of premorbid glycemic control: a retrospective observational study.
Current international guideline recommends to maintain blood glucose level ≤ 180 mg/dL in acute ill patients, irrespective of presence of premorbid diabetes. However, there are studies suggested that optimal acute glycemic control should be adjusted according to premorbid glycemic control in patients with chronic hyperglycemia. Accordingly, to obtain the information of premorbid glycemic control would be relevant. However, the HbA1c level on the day of the emergency operation (HbA1c-ope) might not be useful as a surrogate of premorbid chronic glycemic control, since glucose metabolism can be affected by inflammation, severity of illness and surgical invasion. ⋯ We found that there was a significant correlation between HbA1c-ope and HbA1c-pre. Our findings suggest that HbA1c-ope can be used to estimate previous glycemic control with an acceptable degree of accuracy, enabling personalized glycemic control in the perioperative period.
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Epidural catheter re-siting in parturients receiving labour epidural analgesia is distressing to the parturient and places them at increased complications from a repeat procedure. The aim of this study was to develop and validate a clinical risk factor model to predict the incidence of epidural catheter re-siting in labour analgesia. ⋯ Our predictive model of epidural re-siting in parturients receiving labour epidural analgesia could provide timely identification of high-risk paturients required epidural re-siting.
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Case Reports
A case report of multiple anesthesia for pediatric surgery: 80 anesthesia applications in a period of 6 years.
The side and adverse effects of anesthesia and its neurotoxicity to children have become major concerns of anesthesiologists in recent years. Currently, no clinical trials have provided clear evidence indicating the suitable minimum age for a patient's first anesthetic application, importance of anesthesia duration, number of anesthetic applications or interval between two consecutive anesthesia applications. A very rare case concerning the side, adverse and neurotoxic effects of multiple anesthesia in a child is presented. ⋯ In our case, there were no permanent side or adverse effects due to multiple anesthesia. The minimal psychological and scholastic problems of our case were tied to frequent hospitalization by the pediatric psychiatry consultation.