The Open Anesthesiology Journal最新文献

{"title":"Are Combined Techniques using Video Laryngoscopes and Dynamic Stylets Superior to Fiberoptic Techniques for Anticipating Difficult Intubations? A Retrospective Single-center Comparative Analysis","authors":"Ashka R. Shah, L. Knecht, Kathyrn M. Durnford, Cameron Jacobson, Sean T. Runnels","doi":"10.2174/18743218-v17-230906-2023-11","DOIUrl":"https://doi.org/10.2174/18743218-v17-230906-2023-11","url":null,"abstract":"\u0000 \u0000 Studies point to the potential advantages of a combined technique using video laryngoscopes (VL) and dynamic stylets for difficult intubations. This study compares the outcomes of three advanced intubation techniques: combined technique (video laryngoscope + dynamic stylet), awake fiberoptic bronchoscope (FOB), and asleep FOB when used as the primary intubation technique.\u0000 \u0000 \u0000 \u0000 Airway notes of 138,387 consecutive anesthesia cases at a single academic medical center were filtered for the use of awake FOB, asleep FOB, or combined technique as the primary approach for potentially difficult intubations. The combined technique was defined as VL + dynamic stylet. The dynamic stylets available were FOB or TCITM (Total Control Introducer). The primary endpoint was the first pass success rate. Secondary endpoints included: failure to intubate with the primary technique, anesthesia “in room to intubation” time, “traumatic” intubation rate, and ease of intubation.\u0000 \u0000 \u0000 \u0000 The first pass success rate was highest for combined techniques (88.7%) followed by awake FOB (74.2%, P<0.001) and asleep FOB (80.7%, P=0.06). “Failure to intubate” was lowest in the combined technique (1.8%), compared to awake FOB (9.2%, P=0.002). “In room to intubation” time was fastest for the combined techniques (13.0 minutes) followed by asleep FOB (15.1 minutes, P=0.002) and awake FOB (21.2 minutes, P<0.001). Combined techniques were recorded as “easy” significantly more often (72%) than awake FOB (38.2%, P<0.001). Combined techniques were recorded as “atraumatic” significantly more often (91.1%) than awake FOB (75.8%, P<0.001). Subgroup analysis of the combined techniques, VL + FOB vs. VL + TCITM, revealed that VL + TCITM was rated as “easy” and “atraumatic” significantly more often. It also achieved higher first pass success, lower “failure to intubate” rate, and faster “in room to intubated” time when compared with VL + FOB, although none reached significance.\u0000 \u0000 \u0000 \u0000 In this retrospective single-center comparative analysis, the combined techniques outperformed FOB techniques in effectiveness, speed, ease of use, and trauma.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125973173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Reality versus Mass or Self-directed Training for Adolescents’ Basic Life Support Instruction: A Prospective, Randomized Pilot Study","authors":"Francesco Giacomini, Lorenzo Querci, Boaz Gedaliahu Samolsky Dekel","doi":"10.2174/18743218-v17-230822-2023-20","DOIUrl":"https://doi.org/10.2174/18743218-v17-230822-2023-20","url":null,"abstract":"\u0000 \u0000 There is limited information about adolescents' Basic-Life-Support (BLS) training.\u0000 \u0000 \u0000 \u0000 In this study, adolescents' BLS training proficiency and knowledge retention of the Mixed Reality (MR), Mass-Training (MT), and Self-Directed Learning (SDL) methods were prospectively compared, following the training-outcomes levels-model classification.\u0000 \u0000 \u0000 \u0000 First-year secondary-school students were randomized into the MR, MT, and SDL groups, and after baseline evaluation, at T0, they received congruent BLS theoretical and Cardiopulmonary-Resuscitation (CPR) training. Knowledge, skills retention, and trainees' training-activity self-evaluation were evaluated utilizing ten (knowledge) and five-items (self-evaluation) questionnaires, a BLS-sequence checklist, and chest compressions recording mannequin one and three months after T0. We used the Kruskal-Wallis test for median comparison.\u0000 \u0000 \u0000 \u0000 At all times, the MR group knowledge answers' median (≥6/10) was significantly higher (p<0.05) than groups MT and SDL (≤6/10), with no significant differences between the latter. The MR CPR skills and BLS checklist acquisition and retention were significantly superior (p<0.05) to the other groups; the SDL group showed limited results. Hands position and chest recoil showed excellent outcomes in all groups and at all times. At all times, trainees positively evaluated the BLS-training importance. Pre-training low self-confidence in BLS practice improved over time, yet not significantly, in group MT. The trainees' majority (62%) preferred the MR method.\u0000 \u0000 \u0000 \u0000 In an adolescent cohort, MR methods' BLS/CPR knowledge and skills acquisition and retention were comparable, if not better, than the MT method and superior to the SDL one. Future multicenter randomized and controlled studies with larger sample sizes and more limited instructor-to-participant ratios are warranted to generalize findings.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128872002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tube-first Technique as a Conduit for Easy and Fast Nasal Fiberoptic Intubation","authors":"A. Shoukry, A. Sharaf","doi":"10.2174/18743218-v17-230810-2023-7","DOIUrl":"https://doi.org/10.2174/18743218-v17-230810-2023-7","url":null,"abstract":"\u0000 \u0000 Classical nasal fiberoptic bronchoscope intubation may be a challenging and lengthy procedure with a 1-10% failure rate.\u0000 \u0000 \u0000 \u0000 This study aimed to compare among patients with difficult airway intubation undergoing general anesthesia, the safety, and efficacy of Tube-First (TF) nasal fiberoptic bronchoscope intubation against the Classic (CL) procedure.\u0000 \u0000 \u0000 \u0000 This single-blinded, parallel-group, randomized trial enrolled 40 adult patients with known difficult airways and scheduled for surgery under general anesthesia. The patients were randomly allocated into two (n=20 each) patient groups. In the CL group, the endotracheal tube and fiberoptic bronchoscope were inserted together through the nostril; in the TF group, the endotracheal tube insertion preceded the fiberoptic bronchoscope. In both groups, the bronchoscope was used to visualize the vocal cords and removed after ensuring the endotracheal tube position. The primary (efficacy) outcomes were the time elapsing from the bronchoscope insertion and visualizing the vocal cords (T1) and the time elapsing from the bronchoscope advancing initiation to its removal (T2). The secondary (safety) outcomes included oxygen saturation and hemodynamic parameters during the procedure.\u0000 \u0000 \u0000 \u0000 The TF group showed a significant T1 and T2 mean reduction compared to those of the CL group (37.15 ± 3.87 and 64.25 ± 8.28 vs. 55.05±4.52 and 88.25±5.49 seconds, respectively; p < 0.0001). The oxygen saturation was comparable in both groups with no desaturation (SpO2 < 90%) cases. The heart rate and mean arterial blood pressure changes were significantly lower in the TF group compared to the CL group.\u0000 \u0000 \u0000 \u0000 \u0000 Among patients with difficult airway intubation undergoing general anesthesia, we found the Tube-First intubation approach was quicker and safer compared to the classical intubation technique.\u0000 \u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128485316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Frequency of Gastrointestinal Bleeding Complications Resulting from the use of Ketorolac after Gastrointestinal Cancer Surgery with or without Gastric Ulcer Prophylaxis - A Case Control Study","authors":"Mehran Kouchek, Sadegh Zarei, Reza Hosseiniara, M. Miri","doi":"10.2174/18743218-v17-e230505-2022-29","DOIUrl":"https://doi.org/10.2174/18743218-v17-e230505-2022-29","url":null,"abstract":"\u0000 \u0000 Gastrointestinal (GI) bleeding after GI cancer surgery is not very common, but the use of NSAIDs such as Ketorolac can aggravate it, and if not controlled properly, it may be life-threatening. Therefore, an NSAID/PPI combination (ketorolac and Pantoprazole) that reduces the adverse effect of ketorolac on GI bleeding can be very important.\u0000 \u0000 \u0000 \u0000 The aim of this observational study is to compare the frequency of GI bleeding complications resulting from the use of Ketorolac after GI cancer surgery with or without gastric ulcer prophylaxis (Pantoprazole).\u0000 \u0000 \u0000 \u0000 In this retrospective case-control study, the medical files of adult patients aged 18-60 years undergoing GI cancer surgery referred to 3 hospitals in Iran in 2022 were reviewed. The case group consisted of patients who received ketorolac (30 mg every 8 hours, intravenously) with preventive Pantoprazole (40 mg daily). The control group consisted of patients who only received ketorolac (30 mg every 8 hours, intravenously). Patients were matched in groups based on demographic and clinical variables. Outcomes, including GI bleeding (melena, ...), length of hospital and ICU stay, receiving packed cells, intubation, hematocrit and hemoglobin, were compared between the groups.\u0000 \u0000 \u0000 \u0000 Two groups were matched in terms of age, gender, comorbidities, type of surgery, duration of surgery (hours), and surgical bleeding (ml) (P>0.05). Examination of clinical outcomes showed that GI bleeding complications were not significantly different in the two groups. Although in the case group that received ketorolac and Pantoprazole combination, GI bleeding complications were reported in a smaller number of people. The hospital stay (days) was significantly lower in the case group than in the control group. The ICU stay (hours), packed cells, intubation, hematocrit, and hemoglobin were not significantly different between the two groups.\u0000 \u0000 \u0000 \u0000 The findings of the current study showed that the administration of Pantoprazole plus ketorolac might be effective in controlling bleeding in GI cancer surgery patients, which, of course, requires detailed and multicenter interventional studies.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121849948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Ergotamine versus Theophylline as Treatment of Post-dural Puncture Headache (PDPH) in Cesarean Section: A Randomized Clinical Trial","authors":"N. Manouchehrian, Nasrin Jiriaii, Pourandokht Ghorbani Sepehri","doi":"10.2174/18743218-v17-e230403-2022-31","DOIUrl":"https://doi.org/10.2174/18743218-v17-e230403-2022-31","url":null,"abstract":"\u0000 \u0000 Post Dural Puncture Headache is (PDPH) a relatively common complication of spinal anesthesia. This study aimed to compare the effect of oral administration of ergotamine and theophylline on PDPH in patients undergoing a cesarean section.\u0000 \u0000 \u0000 \u0000 This clinical trial was performed on 60 parturients undergoing cesarean section with PDPH. A tablet of theophylline (100 mg) or methyl ergotamine C (1 mg plus 100 mg caffeine) every 8 hours for 24 hours was administered randomly to patients referred to the hospital with PDPH. Using a checklist, demographic information, history of previous PDPH, number of punctures and intensity, location, and onset time of headache were collected. Intensity and duration of PDPH in the first 24 hours after surgery were the primary outcomes and nausea, vomiting, and vertigo were considered secondary outcomes. The intensity of the headache was assessed using Visual Analog Scale (VAS) before and within the first 24 hours after drug administration.\u0000 \u0000 \u0000 \u0000 In both groups, the VAS of headache significantly decreased at 2, 8, and 24 hours after administration of theophylline and ergotamine compared to pre-intervention time (theophylline from 8.6 ± 1.1 to 0.2 ± 0.1 and ergotamine from 8.6 ± 1.5 to 0.4 ± 0.2). However, the intensity of headaches was not different between the two groups at 2, 8, and 24 hours after the intervention. Duration of headache was similar in both groups (15.7 ± 5.9 in the theophylline group versus 17.5 ± 14.2 ergotamine group). In terms of secondary outcomes of nausea, vomiting, and vertigo, both groups were comparable.\u0000 \u0000 \u0000 \u0000 Oral administration of theophylline and ergotamine are similarly effective in reducing PDPH in cesarean sections.\u0000 \u0000 \u0000 \u0000 IRCT20120915010841N14.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"49 31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125975128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Bronchoscopy on the Outcome of Patients with Severe Sepsis, Acute Respiratory Distress Syndrome and Complicated by Ventilator Associated Pneumonia from Prolonged Ventilation","authors":"M. Allam","doi":"10.2174/18743218-v17-e230110-2022-16","DOIUrl":"https://doi.org/10.2174/18743218-v17-e230110-2022-16","url":null,"abstract":"\u0000 \u0000 65% of patients in intensive Care Units (ICU)with severe sepsis and/or severe traumatic lung contusion are complicated with pneumonia and respiratory failure which need long-term ventilation. Sepsis is a common finding in such patients, it is either a cause of ventilator associated pneumonia(VAP) or a complication of VAP. VAP is one of the most common complications of prolonged ventilation. Both diagnostic and therapeutic bronchoscopy could be used to improve the outcome in those patients by controlling septic reactions and improve lung mechanics through clearing of the small airways from purulent discharge.\u0000 \u0000 \u0000 \u0000 To evaluate the effect of the use of bronchoscopy in patients with Acute respiratory distress syndrome(ARDS), severe sepsis and complicated by VAP as regards, improve the general condition of those patients, improve lung mechanics, control all signs of both VAP and sepsis, accelerate weaning from the ventilator, shorten the duration of ICU stays and its effect on mortality rate in those patients.\u0000 \u0000 \u0000 \u0000 200 patients were selected after 4 days of ventilation because of ARDS due to either severe traumatic lung contusion or severe lung infection. Those who still showed unresolved ARDS (diagnosed by hypoxic index less than 200, bilateral parenchymatous lung infiltration on the chest X ray , ABG showed PH > 7.30), Severe sepsis diagnosed in our study by >12 SOFA score(Sequential Organ Failure Assessment) and developed VAP diagnosed by >6 CPIS score(clinical pulmonary infection score) included in two groups 100 patients in each. Only patients of group B did three bronchoscopies and BAL sent for culture, while patients of group A continued on the traditional way of management and sputum sent for culture. Improvement of ARDS &VAP, weaning from ventilation, duration of ICU stay, improvement of one/all parameters of both SOFA & CPIS scores, morbidity, and mortality were recorded and compared within 14 days.\u0000 \u0000 \u0000 \u0000 Patients of group B showed significant improvement in APACHII score(acute physiological assessment and chronic health evaluation score), GCS (Glasgow coma scale) , parameters of both SOFA score and CPIS score, hemodynamics parameters, LDH(lactate dehydrogenase), and C-Reactive protein levels. A significant higher number of patients were weaned from the ventilator and discharged from ICU. There was no significant difference between the two groups regarding the mortality rate.\u0000 \u0000 \u0000 \u0000 The use of bronchoscopy can improve general conditions, control all signs of severe sepsis ,VAP, improve lung mechanics, improve ARDS, accelerate weaning from the ventilator, and shorten the ICU stay but has no effect on mortality rate in those patients with severe sepsis with ARDS and complicated by VAP from prolonged ventilation\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127702726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracolumbar Interfascial Plane Block (TLIP) Modified Technique for Lumbar Decompression Surgery in Cirrhotic Hepatic Patients with Thrombocytopenia: A Case Report","authors":"A. Tantri, Christella Natali, Erlina Soebroto, K. Ferdiana","doi":"10.2174/18743218-v16-e221226-2022-13","DOIUrl":"https://doi.org/10.2174/18743218-v16-e221226-2022-13","url":null,"abstract":"\u0000 \u0000 As one of the top ranks in the pain-producing procedure, spinal surgery requires adequate perioperative pain management to improve outcomes. Likewise, perioperative pain management in cirrhotic hepatic patients with thrombocytopenia is quite challenging. Modified TLIP block can be an option for perioperative pain management in the lumbar decompression surgery for a cirrhotic hepatic patient with thrombocytopenia.\u0000 \u0000 \u0000 \u0000 A man, 67 years old, who suffered from cirrhosis hepatic with thrombocytopenia underwent endoscopic spinal decompression with laminotomy and flavectomy of L4-L5. After induction of general anesthesia with midazolam 1,5 mg, fentanyl 150 mcg, propofol 100 mg, and rocuronium 1mg/kg, patient was intubated. The lungs were ventilated with a pressure control mode with tidal volume 8 ml/kg BW, respiratory rate 12/min, and PEEP 5 cmH2O with FiO2 50%. and 1% sevoflurane. Modified TLIP block was performed at L3 level. Twenty ml of bupivacaine 0,5% was administered between the longissimus and iliocostalis muscles on both sides.\u0000 \u0000 \u0000 \u0000 Intraoperative, modified TLIP block provide adequate analgesia with stable hemodynamics. The visual Analog Scale (VAS) of pain was 1-2 in 24h postoperative. No additional opioid was required within 24 hours postoperatively. There were no neurological complications or bleeding due to modified TLIP block found in this patient.\u0000 \u0000 \u0000 \u0000 Modified TLIP block can be an effective and safe analgesic technique for hepatic cirrhosis patients with thrombocytopenia. However, further research is needed to determine the safety limits of modified TLIP block in patients with coagulation disorder or anticoagulant use.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122370506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the BBraun BSmartTM Pressure Manometer to Prevent Unsafe Injection Pressures During Simulated Peripheral Nerve Blockade: A Pilot Study","authors":"Rebecca-Lea Smith, S. West, Jason Wilson","doi":"10.2174/2589645802115010049","DOIUrl":"https://doi.org/10.2174/2589645802115010049","url":null,"abstract":"\u0000 \u0000 Peripheral nerve injury during regional anaesthesia may result from accidental intraneural placement of the needle, or forceful needle nerve contact. Intraneural injections are associated with increased resistance to injection, typically >15 psi. The BBraun BSmart™ is an inline mechanical manometer, offering a visual display of injection pressures.\u0000 \u0000 \u0000 \u0000 The primary objective of this study was to determine if using the BBraun BSmartTM manometer successfully prevents 90% of anaesthetists and anaesthetic assistants from injecting at pressures > 15 psi during simulated nerve block.\u0000 \u0000 \u0000 \u0000 This was a prospective observational study involving anaesthetists and anaesthetic assistants. Two 20 ml injections were performed by each participant, once when the BBraun BSmartTM manometer was obscured from view, and once with the manometer visible. A PendoTech PressureMATTMS recorded injection pressures.\u0000 \u0000 \u0000 \u0000 39 participants completed the study, with a total of 78 injections recorded. During the study, 32 peak pressures during the 78 procedures were recorded above the recommended upper limit of 15 psi, 41% of the total injections. The peak pressure rose above 15 psi in 24/39 (62%) injections when the BBraun Bsmart™ manometer was obscured, but only in 8/39 (21%) injections when the manometer was visible.\u0000 \u0000 \u0000 \u0000 The BBraun Bsmart™ manometer did not successfully prevent 90% of anaesthetists or anaesthetic assistants from injecting at unsafe pressures. However, using the BBraun BSmart™ did reduce the number of unsafe injection pressures generated by participants. When utilised in conjunction with PNS and ultrasound guidance, this may offer additional safety during peripheral nerve blockade.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121324536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Ropivacaine-Fentanyl with Bupivacaine-Fentanyl for Labour Epidural Analgesia","authors":"Kalpana Rajendra R Kulkarni, R. Patil","doi":"10.2174/2589645802014010108","DOIUrl":"https://doi.org/10.2174/2589645802014010108","url":null,"abstract":"\u0000 \u0000 Bupivacaine with opioid is commonly used for labour epidural analgesia. Ropivacaine is considered as an alternative to bupivacaine due to its lower cardiovascular complications. However, there is a controversy regarding the efficacy of these drugs as some studies suggest equivalent action, whereas others report that ropivacaine produces less motor blockade. The study aimed to compare the effect of ropivacaine-fentanyl and bupivacaine-fentanyl for labour analgesia.\u0000 \u0000 \u0000 \u0000 The prospective randomized study was performed on 60 parturients, divided into two groups of 30 subjects each. Group I received 10ml of bupivacaine 0.1% + fentanyl 2µg/ml and Group II received 10ml of ropivacaine 0.1% + fentanyl 2µg/ml by epidural catheter. Pre-anaesthetic evaluation was performed on all the participants and all were administered metoclopramide 0.25mg/kg and ondansetron 0.08-0.1mg/kg intravenously as premedication. The baseline and post anaesthesia systolic, diastolic blood pressure, heart rate, VAS score, degree of motor block, sedation and APGAR score of the baby were recorded. The data were tabulated and statistically analyzed.\u0000 \u0000 \u0000 \u0000 When compared, there was no significant difference in systolic/diastolic blood pressure in two groups except at 360 min where diastolic pressure was low in group II. Significantly higher heart rate at 30 min (P=0.0003), 120 min (0.006), and 300 min (P=0.001) was observed in group I subjects. VAS score was significantly less at 180 min (P=0.019) and 300 min (P=0.019) in group II. Adverse effects such as fetal bradycardia, nausea/vomiting and hypotension observed were clinically insignificance when compared in two groups.\u0000 \u0000 \u0000 \u0000 Bupivacaine and ropivacaine produce an equal degree of analgesia and hemodynamic stability in 0.1% of concentration when added with 2µg/ml fentanyl . However, heart rate was well maintained with lower VAS scores in group II receiving ropivacaine. No significant difference in the side effects between the two groups. Hence, Ropivacaine can be used as a safe alternative to bupivacaine for labour epidural analgesia.\u0000","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124706019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse-oximetry Derived Perfusion Index as a Predictor of the Efficacy of Rescue Analgesia After Major Abdominal Surgeries","authors":"A. Saleh, R. Mostafa, A. N. Hamdy, Amr Fouad Hafez","doi":"10.2174/2589645802014010101","DOIUrl":"https://doi.org/10.2174/2589645802014010101","url":null,"abstract":"Data were collected from 40 non-intubated adult patients admitted to the surgical intensive care unit postoperatively. The Masimo pulse cooximetry perfusion index (PI) probe was attached to the patient. At the time of the first request for analgesia (T1), the Behavioural pain scale nonintubated scoring system (BPS-NI) was recorded with the PI and patients' haemodynamics following which rescue analgesia was given. Thirty minutes thereafter (T2), second measurements for the mentioned parameters were taken.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121831547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}