Middle East Journal of Anesthesiology最新文献

{"title":"The NuMask® is as Effective as the Face Mask in Achieving Maximal Preoxygentation.","authors":"Usharani Nimmagadda,&nbsp;M Ramez Salem,&nbsp;Dimitry Voronov,&nbsp;Nebojsa Nick Knezevic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background: Preoxygenation before anesthetic induction is a widely accepted maneuver to\u0000increase oxygen reserves and delay desaturation during apnea. There is limited data regarding the\u0000use of the NuMask® in the perioperative setting, and no data as to its efficacy in achieving maximal\u0000preoxygenation. We hypothesize that the NuMask® may be a useful alternative to the face mask in\u0000achieving maximal preoxygenation.\u0000Methods: After IRB approval, the NuMask® was compared with the classic face mask\u0000with respect to achieving maximal pre-oxygenation in 30 healthy volunteers using tidal volume\u0000breathing. All volunteers were tested for three periods of 5 minutes intervals and the following\u0000parameters were recorded every 30 seconds: inspired, and end-tidal oxygen concentration and endtidal\u0000carbon dioxide concentration.\u0000Results: The mean ETO2 of ≥90% was achieved with both masks at 3.5 minutes (SD =\u00001.62 and 1.98 for facemask and NuMask® respectively) and thereafter the ETO2 remained above\u000090%. There were no statistical differences noted in FiO2 and ETO2 between the face mask and the\u0000NuMask® in the same time periods. ETCO2 values were also not statistically different between the\u0000two masks.\u0000Conclusions: The study showed that the NuMask® is as effective as the classic face mask in\u0000achieving maximal pre-oxygenation during tidal volume breathing.\u0000Introduction</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"605-9"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254825","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":"Dose-Dependent Anti-Inflammatory Effect of Ketamine in Liver Ischemia-Reperfusion Injury.","authors":"Zafer Gundogdu,&nbsp;Ismail Demirel,&nbsp;Mustafa Kemal Bayar,&nbsp;Zeynep Ozkan,&nbsp;Serpil Bayindir,&nbsp;Fatma Kocyigit,&nbsp;Onur Hanbeyoglu,&nbsp;Mustafa Kahraman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatic ischemia-reperfusion (I/R) injury is commonly observed in severe\u0000sepsis, hemorrhagic shock, liver transplantation, hepatic resection, and major trauma. Ketamine\u0000suppresses the production of cytokines, such as IL-6 and TNF-α, via NF-κB inhibition. We\u0000investigated the anti-inflammatory effects of ketamine in liver I/R injury.</p><p><strong>Materials and methods: </strong>Female Wistar-Albino rats (n = 18), weighing 150-200g, were\u0000divided into three groups (n = 6 each). Group I underwent reperfusion for 4h following 30 min\u0000of ischemia. Group II received 2.5 mg/kg ketamine IM following 30 min of ischemia and 4h of\u0000reperfusion and Group III received 10 mg/kg ketamine IM following 30 min of ischemia and 4h of\u0000reperfusion. Blood samples were obtained before and after ischemia and reperfusion. MDA, AST,\u0000ALT, TNF-α, IL-1β, IL-6, and NO levels were determined. Liver tissue samples were evaluated\u0000histologically.</p><p><strong>Results: </strong>Increased TNF-α, IL-1β, and IL-6 levels were observed in all groups post-ischemia\u0000versus pre-ischemia (p <0.05). The TNF-α, IL-1β, and IL-6 levels in Group III increased less than\u0000they did in Groups I and II (p <0.05). Higher MDA, NO, AST, and ALT levels were found during\u0000the ischemia and reperfusion periods compared with during the pre-ischemia period in all groups (p\u0000<0.05). The MDA, NO, AST, and ALT levels of rats that received ketamine increased less than did\u0000those of Group I (p <0.05). Significantly less injury was observed in the histopathological analysis\u0000of livers of rats administered ketamine (p <0.05).</p><p><strong>Conclusions: </strong>Ketamine showed a dose-dependent anti-inflammatory effect in I/R injury in\u0000the liver when administered after ischemia.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"655-663"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254799","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":"Post-Partum Malignant Hypertension in a Patient with Preeclampsia and Abruptio Placenta.","authors":"Anthony K Woodall,&nbsp;Amir O El Hassan,&nbsp;Alan D Kaye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"675-77"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254801","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":"Anesthetic Management of Advanced Stage Ludwig's Angina: A Case Report and Review With Emphasis on Compromised Airway Management.","authors":"Mohammed Al Harbi,&nbsp;Jubil Thomas,&nbsp;Nancy Khalil Hassan,&nbsp;Nermeen Said Hassanin,&nbsp;Salah Wannous,&nbsp;Chadi Abouras,&nbsp;Ahmed Al Harthi,&nbsp;Vassilios Dimitrou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ludwig’s angina, although uncommon, remains a potentially life-threatening condition because of the risk of impending airway obstruction. Effective treatment is based on early recognition of the clinical process, with the appropriate use of parenteral antibiotics, securing the airway, and formal surgical drainage of the infection. Awake fiberoptic intubation under topical anesthesia may be the preferred method to secure the airway. Flexible nasotracheal intubation requires skill and experience. When fiberoptic bronchoscopy is not feasible, not available, or has failed, an elective awake cricothyrotomy and tracheostomy are the options. Furthermore, the introduction of newer advanced airway techniques, such as video-assissted laryngoscopy, may allow the clinician additional flexibility in nonsurgical airway management. We present a recent case of a patient with Ludwig’s angina, successfully managed at our hospital, with a brief review of airway management options.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"665-73"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254803","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":"Clinical exposure and organization of the Critical Care rotation during the Hajj periods in 1434-1435; perspectives of Arabian Saudi Anesthesiology\u0000Program Residents.","authors":"Abdulaziz M Boker","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Background: The nature of massive mass gathering during Hajj was expected to provide a\u0000challenging and stimulating working experience for anesthesiology training program residents. An\u0000new rotation arrangement was reached between the Ministry of Health and the Saudi Commission\u0000of Health Specialties to recruit anesthesia resident to provide critical care services during the Hajj\u0000seasons in 1434 and 1435.</p><p><strong>Objectives: </strong>This study aimed to explore the perspectives of anesthesia residents on their\u0000experience working among critical care teams during Hajj seasons in 1434H and 1435H at various\u0000locations of Makkah city and Al-Mashaer.</p><p><strong>Subjects and methods: </strong>This cross-sectional study was conducted using a self-administered\u0000questionnaire distributed to all residents (n = 35) enrolled in anesthesia residency training program\u0000of the SCFHS and participated in critical care areas as locum during the Hajj seasons of 1434H and\u00001435H. Data was analyzed by using the statistical package of social science.</p><p><strong>Results: </strong>The mean score of residents agreement on being treated with respect from both\u0000nurses and administration was the highest among the surveyed item (6.13 and 6.22 respectively). It\u0000was observed that, satisfaction of the residents with the direct observations and feedback provided\u0000to them (p = 0.01), the adequacy of the services components (p = 0.01) being treated with respect\u0000by the senior doctors and nurses (p = 0.03, p = 0.002) was significantly increased in the year 1435\u0000compared to that of the year 1434. The satisfaction was generally higher in Makkah hospitals when\u0000compared to that of Al-Mashaer (Arafat and Menna) hospitals although this difference was of no statistical significance.</p><p><strong>Conclusion: </strong>Hajj critical care rotations in 1434 and 1435 were well perceived by anesthesia\u0000residents. They found them useful as they give them the chance to gain self-confidence and\u0000experience the provision of healthcare services for mass gathering sessions.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"639-45"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254826","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 induced acute mild arterial hypertension on postoperative analgesic requirements after laparoscopic ovarian cystectomy: a randomized double blinded study.","authors":"Atef K Salama,&nbsp;Nasr M Abdalla","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of inducing acute hypertension during laparoscopic\u0000ovarian cystectomy on postoperative nalbuphine analgesic requirements.</p><p><strong>Methods: </strong>The total dose of nalbuphine used in the hypertension group was significantly lower\u0000than that in the control group (p <0.001). The VAS score was significantly lower in the hypertension\u0000group on arrival to PACU and during the period between 1 and 6 hours postoperatively.</p><p><strong>Results: </strong>The total dose of nalbuphine used in the hypertension group was significantly lower\u0000than that in the control group (p <0.001). The VAS score was significantly lower in the hypertension\u0000group on arrival to PACU and during the period between 1 and 6 hours postoperatively.</p><p><strong>Conclusion: </strong>This study demonstrates that pharmacologically induced mild acute\u0000intraoperative hypertension significantly reduces postoperative nalbuphine consumption and pain\u0000scores following laparoscopic ovarian cystectomy. Trial registration in Pan African Clinical Trial\u0000Registry: identification number for the registry is PACTR201508001247179.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"611-17"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254828","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":"Nasotracheal Intubation with Parker Flex-Tip Versus Preformed Nasal Endotracheal Tubes for Children Undergoing Adenotonsillectomy.","authors":"Moustafa Abdelaziz Moustafa,&nbsp;Yasser Mohamed Ossman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>The design of the endotracheal tube might be an important factor in the incidence of injurious complications during nasotracheal intubation.</p><p><strong>Aim of the work: </strong>Primary aim: to compare the parker flex tip (PFT) and the preformed nasal\u0000(PNT) tubes regarding the ease of insertion during nasotracheal intubation in children undergoing\u0000adenotonsillectomy. Secondary aim: to verify the incidence of traumatic complications of both\u0000types of tubes during nasotracheal intubation in children undergoing adenotonsillectomy.</p><p><strong>Patients and methods: </strong>100 patients aged between 4 and 10 years ASA physical status I-II\u0000scheduled for adenotonsillectomy were divided into two groups; Group PFT: Patients were nasally\u0000intubated using the parker flex-tip endotracheal tube, Group PNT: Patients were nasally intubated\u0000using the preformed nasal tube. Ease of insertion of the ETT, degree of trauma and the time of\u0000intubation was measured.</p><p><strong>Results: </strong>ETT was easily inserted without any resistance in 24% of patients of the PFT group\u0000versus 12% of patients in the PNT group. ETT could not be passed through the right or left nostrils\u0000in 20% of patients of the PNT group relative to only 4% of patients of the PFT group. Incidence of\u0000trauma to the nasal mucosa was significantly higher in patients of the PNT group than patients of\u0000the PFT group. Duration of intubation was statistically significantly longer among patients of the\u0000PNT group than patients of the PFT group.</p><p><strong>Conclusions: </strong>It seems that the flexible tapered tip of the PFT tube has led to easier\u0000insertion through the nasal passages as well as less trauma to the nasal mucosa in children having\u0000nasopharyngeal pathology in the form of adenoids. At the same time, the duration of intubation was\u0000less in the PFT group relative to the control group in spite of the more familiarity of the investigator\u0000with the standard portex tube.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"625-29"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36254829","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":"Efficacy of Cervical Epidural Steroid Injections for Cervical Radiculopathy.","authors":"Samaresh Das,&nbsp;Neelam Suri,&nbsp;Adil Suleiman Al Kharausi,&nbsp;Nilay Chatterjee","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 6","pages":"691-92"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36255229","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 EFFECTS OF PREEMPTIVE INTRAVENOUS AND RECTAL ACETAMINOPHEN ON PAIN MANAGEMENT AFTER INGUINAL HERNIORRHAPHY IN CHILDREN: A PLACEBO-CONTROLLED STUDY.","authors":"Gholam Reza Khalili,&nbsp;Amir Shafa,&nbsp;Ramin Yousefi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain management is a critical concern in pediatric surgery. Acetaminophen is the safest and most widely used analgesic in children. The present study compared the analgesic efficacy of intravenous (IV) and rectal acetaminophen versus placebo in children undergoing inguinal herniorrhaphy.</p><p><strong>Methods: </strong>A total of 120 children, who were candidate for elective surgical repair of unilateral inguinal hernia, were enrolled and randomly allocated to four groups of 30 patients each to receive IV acetaminophen, acetaminophen suppository, IV placebo, and placebo suppository during surgery. Postoperative pain scores, measured on the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, were recorded and compared.</p><p><strong>Results: </strong>The four groups had no significant differences in the mean age, weight, length of stay in the recovery room, and duration of operation. The frequency of postoperative vomiting was significantly lower in the IV and rectal acetaminophen groups compared to the two placebo groups (P = 0.04). The mean pain scores of the two acetaminophen groups were similar during the first two hours after surgery. These scores were significantly lower than the scores of the placebo groups. However, the four groups were not significantly different in terms of pain scores at the fourth, sixth, and 12th postoperative hours. During the first hour after surgery, IV acetaminophen had the largest analgesic effect. Moreover, among all four groups, the IV acetaminophen group had the highest sedation level in the recovery room.</p><p><strong>Conclusion: </strong>Both IV and rectal acetaminophen were more effective than placebo in pain relief after inguinal hernia repair in children. They were also associated with lower frequencies of postoperative vomiting. The greatest analgesic efficacy of both forms was observed during the first two hours after surgery.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 5","pages":"543-8"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34632512","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":"ECG-ELECTRODE INDUCED HYPOPIGMENTATION.","authors":"Paul A Tripi,&nbsp;Supraja N Parthasarathy,&nbsp;Kord Honda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Skin reactions following the application of electrocardiography (ECG) electrodes have been reported in adults and children, and are postulated to result from contact with the conductive gel or adhesive used on the electrodes. Although contact dermatitis is the usual cause of such reactions, contact depigmentation or hypopigmentation may also occur. We report a case of hypopigmentation in a healthy boy following continuous electrocardiography monitoring during general anesthesia for dental rehabilitation.</p>","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 5","pages":"577-9"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34632517","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}