Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jan 2020
Efficacy of multimodal analgesia with perineural buprenorphine or dexmedetomidine for surgeries performed under ultrasound-guided infraclavicular brachial plexus block.
Perineural adjuvants when used as a part of multimodal analgesia (MMA) will maximize the quality and duration of analgesia of the nerve blocks. In the present study, we compared the duration of postoperative analgesia and other block characteristics of two groups of MMA comprising either perineural buprenorphine or dexmedetomidine in the upper limb surgeries performed under ultrasound-guided (US-guided) infraclavicular brachial plexus blocks. ⋯ For surgeries under brachial plexus block, perineural dexmedetomidine when used as a part of MMA provided a prolonged duration of postoperative analgesia and improved block characteristics than perineural buprenorphine.
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J Anaesthesiol Clin Pharmacol · Jan 2020
Efficacy of Baska mask and Laryngeal mask airway supreme during positive pressure ventilation - A comparative study.
Supraglottic airway devices have several roles including maintenance of a clear upper airway during general anesthesia. We primarily compared the efficacy of Baska mask (BM) and laryngeal mask airway supreme (LMAS) for the rate of first time successful placement and the seal pressure. The secondary outcome measures included laryngopharyngeal morbidity and the correct positioning of the gastric port. ⋯ From the present study, it is concluded that the BM creates a higher oropharyngeal seal pressure than the LMAS. However, the BM is more difficult to insert. The incidence of postoperative laryngopharyngeal morbidity is similar in both groups.
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J Anaesthesiol Clin Pharmacol · Oct 2019
Predictors of difficult epidural placement in pregnant women: A trainees' perspective.
Epidural analgesia is believed to be the most difficult technique to learn for a trainee. The reason for this is not only inexperience of the provider and the complexity of the technique but also patient factors like obesity, spinal deformity and others which makes the epidural placement difficult. The aim of this study was to evaluate some of the common risk factors for difficult epidural placement as perceived by the anesthesia providers during training, with varying level of experience. ⋯ Inability to palpate the spinous process contributes to multiple attempts at epidural placement when performed by a trainee.
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J Anaesthesiol Clin Pharmacol · Oct 2019
Pressure-controlled ventilation could decrease intraoperative blood loss and improve airway pressure measures during lumbar discectomy in the prone position: A comparison with volume-controlled ventilation mode.
Prone positioning may induce alterations of hemodynamic and airway pressure parameters that may affect intraoperative (IO) blood loss. Pressure-controlled ventilation (PCV) may modify these alterations. To observe the relation between ventilation mode and hemodynamic, airway pressure changes, and blood loss during lumbar discectomy performed in the prone position. ⋯ Prone positioning and VCV were associated with increased CVP and IO blood loss, while PCV could lessen these effects and significantly improve airway pressures.
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J Anaesthesiol Clin Pharmacol · Oct 2019
A cohort study of anatomical landmark-guided midline versus pre-procedure ultrasound-guided midline technique of spinal anesthesia in elderly patients undergoing orthopedic surgery.
The primary objective of the study was to compare the number of attempts and number of passes of spinal needle insertion and secondary objective was to compare complications, bloody tap, and patient discomfort in anatomical landmark-guided versus pre-procedure USG-guided midline technique of spinal anesthesia in elderly patients posted for orthopedic surgery. ⋯ Preprocedure ultrasound imaging is a very useful tool to facilitate the performance of central neuraxial blockade in patients with difficult anatomical landmarks, especially in elderly patients.