Middle East journal of anaesthesiology
-
Middle East J Anaesthesiol · Jun 2008
Randomized Controlled TrialThe combined effect of ketamine and remifentanil infusions as total intravenous anesthesia for scoliosis surgery in children.
This study was designed to assess the effect of combination of ketamine and remifentanil infusions as total intravenous anesthesia (TIVA) during scoliosis surgery in children. ⋯ These data demonstrate that during posterior spinal fusion surgery in children, the combination of ketamine and remifentanil infusions as TIVA may provide hemodynamic stability, satisfactory surgical requirements with reliable electrophysiological monitoring and adequate post operative pain relief supplemented by PCA morphine.
-
Middle East J Anaesthesiol · Jun 2008
Randomized Controlled TrialEffects of butorphanol and fentanyl on cerebral pressures and cardiovascular hemodynamics during tunneling phase for ventriculoperitoneal shunt insertion.
Subcutaneous tunneling for ventriculoperitoneal shunt insertion is the most painful step of this surgery. It is associated with intense hemodynamic response, may influence the intracranial pressure, and thus may worsen the existing intracranial pathology. The purpose of this report is to evaluate the commonly used opioid fentanyl, along with butorphanol, an agonist-antagonist compound. ⋯ Butorphanol must be used with caution in neurosurgical patients. The ventricular end of the shunt catheter should preferably be put before the tunneling phase to avoid rise in intracranial pressure.
-
Middle East J Anaesthesiol · Jun 2008
Randomized Controlled TrialAnalgesic requirements for patients undergoing lower extremity orthopedic surgery--the effect of combined spinal and epidural magnesium.
Polypharmacological approach is the most common practice to treat perioperative pain, as no single agent has yet been identified to specifically inhibit nociception without associated side effects. Opioids such as Fentanyl is commonly added to local anesthetics to produce spinal and epidural anesthesia. However, significant adverse effects, such as pruritus, respiratory depression, hemodynamic instability and occasionally severe nausea and vomiting, may limit their use. Our present study was designed to assess the effectiveness of using combined intrathecal and epidural magnesium (Mg) in reducing intra-and postoperative analgesic requirements and improving the quality of analgesia. ⋯ For lower extremity orthopedic procedure, supplementation of spinal anesthesia with combined intrathecally injected and epidurally infused Mg, considerably reduced the perioperative analgesic requirements without any side effects.