Saudi journal of anaesthesia
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This randomized study was conducted to compare the hemodynamic changes and emergence characteristics of sevoflurane versus propofol anesthesia for microlaryngeal surgery. ⋯ We found that sevoflurane showed advantage over propofol in respect of intraoperative cardiovascular stability without increasing recovery time.
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The Truview™ EVO2 laryngoscope, with its unique optical lens system and blade tip angulation, has proved its usefulness in providing adequate laryngeal exposure and intubation via the oral route. However, the same has not been evaluated for nasotracheal intubation. ⋯ The Truview™ EVO2 laryngoscope is a useful tool in performing nasotracheal intubation, ensuring a high level of success rate among patients with normal airway anatomy.
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Electroencephalography can detect both cerebral ischemia/hypoxia and seizures and can measure hypnotic effects. The author reported two patients with left main coronary artery disease and myocardial infarction scheduled for urgent coronary artery bypass grafting surgery; they developed abrupt decreases in response entropy (RE) and state entropy (SE) values to isoelectric silence during target-controlled propofol-sufentanil anesthesia. ⋯ Both patients showed delayed awakening after surgery and brain CT revealed nonhemorrhagic tempro-parietal cerebral infarctions. Intraoperative entropy-based monitoring could predict poor neurological outcome after cardiac surgery during target-controlled propofol and sufentanil anesthesia.
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Airtraq™ is an optical laryngoscope that allows viewing of the vocal cords without a direct line of sight. The main objective of this prospective, randomized, controlled trial was to evaluate Airtraq intubation characteristics, mainly intubation time and cardiovascular changes in the pediatric patients. ⋯ Airtraq decreases intubation time, number of attempts, and optimization maneuvers, less heart rate changes during intubation compared with Macintosh laryngoscope.
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Emergence delirium (ED) although a short-lived and self-limiting phenomenon, makes a child prone to injury in the immediate postoperative period and hence is a cause of concern not only to the pediatric anesthesiologist, surgeons, and post anesthesia care unit staff but also amongst parents. Additional medication to quieten the child offsets the potential benefits of rapid emergence and delays recovery in day care settings. There is conflicting evidence of influence of analgesia and sedation following anesthesia on emergence agitation. We hypothesized that an anesthetic technique which improves analgesia and prolongs emergence time will reduce the incidence of ED. We selected ketamine as adjuvant to caudal block for this purpose. ⋯ Emergence time as well as duration of analgesia have significant influence on incidence of emergence delirium. Ketamine, as caudal adjuvant is a promising agent to protect against ED in children, following sevoflurane anesthesia.