Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2009
Randomized Controlled Trial Comparative StudyLow dose intravenous midazolam for prevention of PONV, in lower abdominal surgery--preoperative vs intraoperative administration.
The aim of the present study was to compare anti-emetic efficacy of low dose midazolam premedication (35 microg/kg) 15 minutes before induction of anesthesia with midazolam (35 microg/kg) administered intravenously 30 min before conclusion of surgery, in patients undergoing lower abdominal surgery under general anesthesia. ⋯ Our results indicated that midazolam 35 microg/kg (2 mg) given intravenously 30 minutes before the end of surgery was more effective in decreasing the incidence of PONV than midazolam premedication 35 microg/kg.
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Middle East J Anaesthesiol · Feb 2009
Comparative StudyCan preoperative anesthesia consultation clinic help to reduce operating room cancellation rate of cardiac surgery on the day of surgery?
Many surgical procedures are delayed or cancelled due to inadequate preoperative assessment and preparation. Case cancellations can be decreased by improved preoperative patient evaluation, improved communication between physician and patient, and modified schedule design. Because of importance of the high cost associated with operating room cancellations; healthcare providers have exerted efforts to decrease case cancellations on the day of surgery. The aim of this study was to evaluate the role of"pre-anesthesia consultation clinic" in reducing operating room cancellation. ⋯ Since the most common cause of cancellation in the two groups was incomplete medical work-up, then visitation of patients to the pre-anesthesia consultation clinic would minimize cancellation rate on the day of surgery.
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Middle East J Anaesthesiol · Feb 2009
Jaw thrust as a predictor of insertion conditions for the proseal laryngeal mask airway.
We test the hypothesis that the response to jaw thrust is an effective predictor of insertion conditions for the ProSeal laryngeal mask airway (ProSeal LMA). One hundred and sixty patients (ASA grade 1-3, aged >18 yr) were studied. Five anesthetists blinded to the response to jaw thrust participated in the study, each performed >30 insertions. ⋯ The accuracy, sensitivity and specificity were 0.82, 0.95 and 0.44, respectively. We conclude thatjaw thrust is a reliable predictor of insertion conditions for the ProSeal LMA with the digital insertion technique after induction of anesthesia with propofol. We suggest that clinicians learn how to apply the correct amount of jaw thrust and perform this test routinely.
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Middle East J Anaesthesiol · Feb 2009
Comparative StudyIs I-gel a new revolution among supraglottic airway devices?--a comparative evaluation.
In an attempt to reduce the pressor responses subsequent to laryngoscopy and intubation in normotensive anesthetized paralysed patients, the hemodynamic effects of three supraglottic devices were compared: I-gel, SLIPA, and LMA, The I-gel produced the least hemodynamic changes.
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Middle East J Anaesthesiol · Feb 2009
Anesthesia and electrocorticography for epilepsy surgery: a Jordanian experience.
Electrocorticography (ECoG) may be used to guide epilepsy surgery. However, anesthetics can suppress epileptiform activity or induce confounding burst-suppression patterns and the relationship between ECoG results and seizure outcome is controversial. In this study, we evaluated the ECoG activity under several different anesthetics and examined the relationship between ECoG and outcome. ⋯ Satisfactory ECoG is possible using isoflurane or sevoflurane with nitrous oxide and fentanyl or remifentanil or using propofol and remifentanil. However, one of eleven ECoGs under propofol was negative for epileptiform activity. The amount of post-resection ECoG epileptiform activity does not significantly correlate with seizure outcome.