Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Feb 2012
Randomized Controlled Trial Comparative StudyEfficacy of three IV non-opioid-analgesics on opioid consumption for postoperative pain relief after total thyroidectomy: a randomised, double-blind trial.
In a randomized, double-blind trial, the synergistic action of intravenous parecoxib, metamizol or paracetamol on postoperative piritramide consumption was compared in patients recovering from total thyroidectomy during the first 24 h while evaluating pain intensity and patient satisfaction. ⋯ There is no clear-cut difference between the non-opioid drugs used, even though parecoxib seems to be superior in regard to VAS scores and piritramide consumption. However, the clinical significance is debatable.
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Middle East J Anaesthesiol · Feb 2012
Randomized Controlled Trial Comparative StudyA randomized evaluation of intravenous dexamethasone versus oral acetaminophen codeine in pediatric adenotonsillectomy: emergence agitation and analgesia.
Adenotonsillectomy is the most frequently performed ambulatory surgical procedure in children. Post operative agitation and inadequate pain control, for children undergoing adenotonsillectomy, can be a challenge. The aim of this study was to assess the effect of intravenous dexamethasone and oral acetaminophen codeine on emergence agitation and pain after adenotonsillectomy in children. ⋯ The results of this study suggest that the administration of intravenous dexamethasone (0.2 mg/kg) and oral acetaminophen codeine (20 mg/kg) thirty minutes before anesthesia can significantly decrease the incidence and severity of agitation but does not have an effect on postoperative pain.
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Middle East J Anaesthesiol · Feb 2012
Case ReportsAirway management in submandibular abscess patient with awake fibreoptic intubation--a case report.
Securing the airway is a core skill in anaesthesia, the gold standard of which is tracheal intubation. Normally this is achieved after induction of anaesthesia. However, some circumstances demand an awake approach. ⋯ Chances of rupture of abscess intraorally and aspiration under GA is a major threat. During GA, there is no change in mouth opening and loss of airway under muscle relaxation, "difficult to ventilate, difficult to intubate" makes these cases most challenging. On the basis of our experience case was successfully intubated by awake fibreoptic intubation.
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Middle East J Anaesthesiol · Feb 2012
Randomized Controlled Trial Comparative StudyComparison of the anesthetic effects of intrathecal levobupivacaine + fentanyl and bupivacaine + fentanyl during caesarean section.
Regional anesthesia techniques are increasingly preferred for caesarean section. The aim of the present study was to compare the anesthetic effects of levobupivacaine + fentanyl and bupivacaine + fentanyl on the mother and newborn during elective caesarean section under spinal anesthesia. ⋯ Time to sensory and maximum motor block was shorter in the bupivacaine + fentanyl group. On the other hand, a longer duration of analgesia was achieved in the levobupivacaine + fentanyl group. Although levobupivacaine is a novel drug, it is a good alternative for bupivacaine.
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Middle East J Anaesthesiol · Feb 2012
Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces.
The ongoing conflict in the Eastern Republic of the Congo (DRC) has claimed up to 5.4 million lives by 2008. Whereas few deaths were directly due to violence, most victims died from medical conditions such as infectious diseases. This survey investigates the availability of resources required to provide adequate sepsis care in Eastern DRC. ⋯ None of the respondents reported to have constant access to piperacillin, carbapenems, fresh frozen plasma, platelets, dobutamine, activated protein C, echocardiography or equipment to measure lactate levels, invasive blood pressure, central venous pressure, cardiac output, pulmonary artery pressure or endtidal carbon dioxide. No respondent stated that a mechanical ventilator, syringe pump, fluid infuser, peritoneal dialysis or haemodialysis/hemofiltration machine was constantly available at his/her hospital. Resources required for consistent implementation of the SSC guidelines were not available in any hospital. care and implement the SSC guidelines in a cluster of hospitals in the Eastern DRC.