Articles: anesthetics.
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African health sciences · Dec 2023
Total intravenous anaesthesia in rural sub-Saharan Africa: report of 25 cases.
Total intravenous anesthesia (TIVA) is a potential solution for safe and effective anesthesia administration in rural regions of sub-Saharan Africa, where access to inhalational anesthesia may be limited. However, challenges such as equipment and medication availability, as well as a shortage of trained anesthesiologists, can limit the use of TIVA. In this study, the safety and efficacy of TIVA were evaluated in a case series of 25 female patients undergoing thyroid surgery in a rural area of sub-Saharan Africa. ⋯ The use of TIVA may offer advantages such as faster recovery times, reduced incidence of postoperative nausea and vomiting, and reduced risk of environmental pollution compared to inhalational anesthesia. However, the cost and monitoring requirements of TIVA may pose challenges in resource-limited settings. Further research is needed to determine the optimal use of TIVA in this context.
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Anesthesia-induced neurotoxicity is a major concern for anesthetists for more than 20 years. Many experimental and clinical studies have been conducted on this topic since late 1990s. However, bibliometric analysis of these papers has not been reported. ⋯ Anesthesia-induced neurotoxicity is very important, especially for pediatric anesthetists. This study is the first to conduct a bibliometric analysis of the most cited 100 publications on this field. Although there was a gap in the publications about this topic during COVID-19 pandemic, we believe that there will be many more publications on anesthesia-induced neurotoxicity since the mechanism, outcome and possible protection are still unknown.
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Case Reports
Acute cricopharyngeal achalasia after general anesthesia in myotonic dystrophy: A case report.
Myotonic dystrophy type 1 (DM-1) is a progressive multisystem genetic disorder that causes myotonia and both distal limb and facial/neck muscle weakness by expanding the CTG repeats of the DMPK gene in chromosome 19q13.3. General anesthesia is indicated in DM-1 patients owing to their sensitivity to anesthetic drugs such as opioids, hypnotics, and neuromuscular blocking agents. ⋯ Low body temperature and anesthetic medications such as opioids and hypnotic agents can induce myotonia in the cricopharyngeal muscle.
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Case Reports
Programmed Intermittent Intrathecal Bolus for Maintenance of Labor Analgesia in an Obstetric Patient: A Case Report.
Maintenance of labor analgesia with programmed intermittent epidural boluses (PIEBs) has demonstrated benefits over the use of continuous infusions. While programmed intermittent boluses have been used for the maintenance of epidural analgesia, it has not been reported for the maintenance of intrathecal analgesia. ⋯ She reported excellent pain relief without significant motor block, high anesthetic block, hypotension, or respiratory distress. This delivery modality may increase the rate of ITC after unintentional dural puncture (UDP).
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Observational Study
Quantification of muscle tone by using shear wave velocity during an anaesthetic induction: a prospective observational study.
The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale. ⋯ The present study suggested that the SWV as reference was 1.79 m/s and that the SWVs at rest and opioid-induced rigidity were ~ 10% and ~ 30% increase from the reference, respectively. The SWV adjusted for the subcutaneous fat thickness may be scale points for the assessment of muscle tone.