Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Oct 2011
Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine.
No drug, used as adjuvant to spinal bupivacaine, has yet been identified that specifically inhibits nociception without its associated side-effects. ⋯ It was found that onset of anesthesia was rapid and of prolonged duration in the dexmedetomidine group (D). However, in the magnesium sulfate group (M), although onset of block was delayed, the duration was significantly prolonged as compared with the control group (C), but to a lesser degree than in the dexmedetomidine group (D). The groups were similar with respect to hemodynamic variables and there were no significant side-effects in either of the groups.
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J Anaesthesiol Clin Pharmacol · Oct 2011
Preventive analgesia: Effect of small dose of ketamine on morphine requirement after renal surgery.
N-methyl D-Aspartate (NMDA) receptors seem to be responsible for pain memory and their blockade can contribute significantly in prevention of pain. This study was conducted to evaluate the preventive effect of small dose of ketamine, a NMDA receptor blocker, given before skin incision in renal surgery, with the aim to compare analgesic efficacy, intra operative and post-operative side effects. ⋯ Our results demonstrate that small dose of ketamine decreases post-operative pain, reduces morphine consumption, and delays patients request for analgesia beyond the clinical duration of action of ketamine after open renal surgery.
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J Anaesthesiol Clin Pharmacol · Oct 2011
Use of intubating laryngeal mask airway in a morbidly obese patient with chest trauma in an emergency setting.
A morbidly obese male who sustained blunt trauma chest with bilateral pneumothorax was referred to the intensive care unit for management of his condition. Problems encountered in managing the patient were gradually increasing hypoxemia (chest trauma with multiple rib fractures with lung contusions) and difficult mask ventilation and intubation (morbid obesity, heavy jaw, short and thick neck). We performed awake endotracheal intubation using an intubating laryngeal mask airway (ILMA) size 4 and provided mechanical ventilation to the patient. This report suggests that ILMA can be very useful in the management of difficult airway outside the operating room and can help in preventing adverse events in an emergency setting.
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J Anaesthesiol Clin Pharmacol · Oct 2011
The analgesic efficacy of peritubal infiltration of 0.25% bupivacaine in percutaneous nephrolithotomy - A prospective randomized study.
Percutaneous nephrolithotomy is a routine endourologic procedure in patients with renal stones. Although it is less painful than open surgery, good postoperative analgesia is required to alleviate pain around nephrostomy tube. ⋯ Peritubal infiltration of 0.25% bupivacaine is efficient in alleviating postoperative pain after PCNL.
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J Anaesthesiol Clin Pharmacol · Oct 2011
Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study.
Intraoperative depth of anesthesia may affect postoperative pain relief. This prospective, randomized, and observer-blinded study assessed the effect of intraoperative depth of anesthesia on the postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy. ⋯ Maintaining BIS to a value of 45 to 40 throughout the surgery results in better postoperative pain relief and decreased requirement of rescue analgesic without any untoward effect.