Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialPretreatment with remifentanil is associated with less succinylcholine-induced fasciculation.
Succinylcholine is a popular muscle relaxant and one of its most common side effects is muscle fasciculation. The purpose of this study was to evaluate the efficacy of remifentanil in preventing succinylcholine-induced fasciculation in patients undergoing general anesthesia. ⋯ Our findings indicate that remifentanil can reduce the duration and the intensity of succinylcholine induced fasciculation. However, it induces greater bradycardia.
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Middle East J Anaesthesiol · Feb 2010
ReviewUpdate on anesthesia considerations for electroconvulsive therapy.
Depression is diagnosed in 14 million Americans every year, and pharmacotherapy is the standard treatment. However, in approximately 50% of patients, pharmacology intervention does not resolve depression. Electroconvulsive therapy (ECT) has been a mainstay as a treatment option for treatment-resistant major depression since its inception in the 1930s. ⋯ The clinical anesthesiologist must be aware of these changes as well as have an understanding of perioperative pharmacological interventions. ECT is a proven therapy for select psychiatric patients, and appropriate anesthesia is a critical part of successful ECT. Careful review of the patient's medical history may reveal pertinent anesthetic considerations.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled Trial Comparative StudyDexamethasone with either granisetron or ondansetron for postoperative nausea and vomiting in laparoscopic surgery.
In a prospective randomized double-blind study, we compared the effectiveness of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery. Hundred ASA I and II patients scheduled for laparoscopic surgery were enrolled in the study and 84 patients completed it. Following induction of anesthesia, group I (n=42) received granisetron 1 mg and dexamethasone 8 mg, group II (n=42) received ondansetron 4 mg and dexamethasone 8 mg. ⋯ At 6-24 hours no vomiting occurred in 97.6% of patients in group I and 100% in group II. Total response was 95.2% in both groups, and metoclopramide was used in 2.38% of patients in both groups. In conclusion, the combination of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg following induction of anesthesia in patients undergoing laparoscopic surgery showed no statistically significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialPreoperative oral dextromethorphan does not reduce pain or morphine consumption after open cholecystectomy.
Dextromethorphan (DM), the D-isomer of the codeine analogue levorphanol, is a weak, noncompetitive N-Methyl-D-Aspartate (NMDA) receptor antagonist. It has been suggested that NMDA receptor antagonists induce preemptive analgesia when administrated before tissue injury occurs, thus decreasing the subsequent sensation of pain. ⋯ Dextromethorphan, 45 and 90 mg orally administrated 2 h before surgery had no effect on postoperative morphine requirement and pain intensity.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialThe effect of addition of low dose atracurium to local anesthetic in retrobulbar block for cataract surgery.
Addition of some neuromuscular blockers to local anesthetics proved to be effective in improving the quality of anesthesia in different regional techniques. This study was carried out to determine whether the addition of low-dose atracurium to a local anesthetic has any effect on the onset and duration of akinesia in retrobulbar block. ⋯ This study demonstrated that atracurium had a local action on the extraocular muscles. It shortened the onset period of retrobulbar block, prolonged its duration, and provided excellent surgical conditions without any specific complications.