Middle East Journal of Anesthesiology最新文献_第4页

A COMPARATIVE STUDY OF THE ANALGESIC EFFECT OF INTRAVENOUS PETHIDINE VS. KETOROLAC AFTER INGUINAL HERNIA SURGERY IN CHILDREN UNDER GENERAL ANESTHESIA. 全麻儿童腹股沟疝术后静脉滴注哌替啶与酮咯酸镇痛效果的比较研究。

Middle East Journal of Anesthesiology Pub Date : 2016-06-01

Hamid Hajigholam Saryazdi, Omid Aghadavoudi, Amir Shafa, Amin Masoumi, Parnian Saberian

{"title":"A COMPARATIVE STUDY OF THE ANALGESIC EFFECT OF INTRAVENOUS PETHIDINE VS. KETOROLAC AFTER INGUINAL HERNIA SURGERY IN CHILDREN UNDER GENERAL ANESTHESIA.","authors":"Hamid Hajigholam Saryazdi, Omid Aghadavoudi, Amir Shafa, Amin Masoumi, Parnian Saberian","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Postoperative pain due to tissue damage caused during surgery not only causes discomfort for the patients, but can also result in prolonged hospitalization, increased morbidity and respiratory disorders, and readmission to the hospital. For postoperative pain control, numerous methods and medications have been suggested, such as non-steroidal anti-inflammatory drugs (NSAIDs) and narcotics. Pethidine, as a narcotic analgesic, and ketorolac, as an NSAID, are widely used for pain control. Thus, in this study, the effects of these two drugs were studied and compared in terms of pain control after inguinal hernia surgery in children of 1-12 years of age.Materials and methods: Sixty-six children undergoing inguinal herniorrhaphy were selected and randomly divided into 2 groups. The first group received 0.5 mg/kg ketorolac and the second group received 1 mg/kg pethidine during extubation. Postoperative pain (using Wong Baker pain scale) and complications were measured until 24 hours after surgery.Results: Mean and standard deviations of postoperative pain 1 hour after surgery in the pethidin and ketorolac groups were 5.06 ± 1.41 and 3.88 ± 0.93, respectively. The scale was significantly lower in the ketorolac group (P < 0.001). Postoperative pain intensity 2 hours after surgery in these two groups was 4.48 ± 1.52 and 3.55 ± 1.15, respectively, and the difference between the two groups was significant (P = 0.006). The variation in postoperative pain intensity in the ketorolac group was statistically lower than the pethidin group (P = 0.020). CONCLUSION.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 5","pages":"527-33"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34632510","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}

引用次数: 0

ANESTHETIC MANAGEMENT DURING COMBINED LIVER AND KIDNEY TRANSPLANTATION. 肝肾联合移植的麻醉管理。

Middle East Journal of Anesthesiology Pub Date : 2016-06-01

Amr El Kouny, Mohammed Harbi, Hesham Ismail, Chadi Abouras, Abdulatif Basha, Ibrahim Abojeesh, Annas Naeim, Sami Kashkoush, Abdullah Khalid, Wael Ohali, Vassilios Dimitriou

引用次数: 0

LOEYS-DIETZ SYNDROME: PERIOPERATIVE ANESTHESIA CONSIDERATIONS. Loeys-dietz综合征:围手术期麻醉注意事项。

Middle East Journal of Anesthesiology Pub Date : 2016-06-01

Judy G Johnson, Jacob P Bray, William H Risher, Alan David Kaye

{"title":"LOEYS-DIETZ SYNDROME: PERIOPERATIVE ANESTHESIA CONSIDERATIONS.","authors":"Judy G Johnson, Jacob P Bray, William H Risher, Alan David Kaye","doi":"","DOIUrl":"","url":null,"abstract":"Loeys-Dietz syndrome (LDS) is a rare autosomal dominant disease related to genetic mutations in receptors for the cytokine transforming growth factor-receptor type 1 (TGFB-R1) or 2 gene (TGFB-R2) on the cell surface. LDS results in abnormal protein synthesis and dysfunctional connective tissue, which can result in unique cardiovascular anesthesia challenges related to perioperative management. Patients with LDS may manifest hypertelorism, bifid uvula or cleft palate, and arterial tortuosity. Virtually all LDS patients show some type of abnormal skin findings and bleeding tendency. These patients may show a rapid progression of aortic dilation, regurgitation, and a propensity towards rupture and/or dissection at a much earlier age and smaller aneurysm size. LDS patients who require surgical intervention require meticulous vigilance from the anesthesiologist. We describe a 26 year old patient with documented LDS type 1 who presented for repair of an ascending/root aneurysm in this case report. Recognition of LDS and intra-operative management of the cardiovascular manifestations of this disease is paramount in ensuring successful surgical outcome and to limit morbidity and mortality.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 5","pages":"569-76"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34632516","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}

引用次数: 0

EFFECT OF YOKUKANSAN, JAPANESE HERBAL MEDICINE, ON PHANTOM-LIMB PAIN. 日本中草药横山对幻肢痛的影响。

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Yusuke Sugasawa

引用次数: 0

PERIPHERAL INTRAVENOUS CATHETER PROBLEMS IN INFANTS AND CHILDREN PRESENTING FOR ANESTHESIA AND SURGERY. 外周静脉导管问题的婴儿和儿童提出麻醉和手术。

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Paul A Tripi, Susan Thomas, Anna Clebone, Mark M Goldfinger, Joseph D Tobias

{"title":"PERIPHERAL INTRAVENOUS CATHETER PROBLEMS IN INFANTS AND CHILDREN PRESENTING FOR ANESTHESIA AND SURGERY.","authors":"Paul A Tripi, Susan Thomas, Anna Clebone, Mark M Goldfinger, Joseph D Tobias","doi":"","DOIUrl":"","url":null,"abstract":"Background: Anesthesia providers frequently rely upon in-situ peripheral intravenous catheters (IVs) during the perioperative care of pediatric patients. IV dysfunction can result in complications including inability to administer medications for resuscitation, extravasation of tissue-toxic medications, and incomplete induction of anesthesia. This study was performed to prospectively assess the frequency of IV dysfunction in children presenting for anesthesia care.Methods: A survey of IV patency and integrity was completed in patients less than 18 years of age arriving at the preoperative holding area for anesthesia evaluation. Prior to the induction of anesthesia, an anesthesiologist examined the IV for patency and evidence of infiltration. Demographic information, catheter site and size, condition of skin, elapsed time since insertion, and hospital site of catheter insertion were recorded.Results: Over a 14-month period, 108 IVs were evaluated in 106 patients. One or more problems were identified with 35% of the IVs. Problems included erythema or pain to palpation at insertion site (29%), difficulty with injection of saline (45%), pain on injection of saline (50%), infiltrate at insertion site (13%), no flow or poor flow to gravity (42%), and kinked catheter (11%). The frequency of IV dysfunction was higher in infants (50%), with 24 gauge catheters (59%), with lower extremity IVs (50%), and with IVs in place for more than 3 three days (75%).Conclusions: Approximately one-third of pre-existing IVs were dysfunctional in children presenting for anesthesia and surgery. Inspection for the integrity of the IV should occur prior to and during use, and a plan should be in place for readily replacing the IV in cases of dysfunction or for using an alternative route for the induction of anesthesia.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 4","pages":"411-4"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34641475","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}

引用次数: 0

PERI-ANESTHESIA ANAPHYLAXIS (PAA): WE STILL HAVE NOT STARTED POST-PAA TESTING FOR INCITING ANESTHESIA-RELATED ALLERGENS. 麻醉期过敏反应(paa):我们仍然没有开始对刺激麻醉相关过敏原的paa后测试。

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Taghreed Alshaeri, Deepak Gupta, Ananthamurthy Nagabhushana

{"title":"PERI-ANESTHESIA ANAPHYLAXIS (PAA): WE STILL HAVE NOT STARTED POST-PAA TESTING FOR INCITING ANESTHESIA-RELATED ALLERGENS.","authors":"Taghreed Alshaeri, Deepak Gupta, Ananthamurthy Nagabhushana","doi":"","DOIUrl":"","url":null,"abstract":"Anaphylaxis during anesthesia is uncommon. Diagnosis of peri-anesthesia anaphylaxis (PAA) requires anesthesia providers' vigilance for prompt diagnosis and treatment. In this case report, we present a challenging case with suspected PAA including its perioperative management, intensive care unit (ICU) course, and post-discharge follow-up. A 44-year-old female (body mass index = 26) presented for elective abdominal panniculectomy. Post-intubation, severe bronchospasm occurred that was non-responsive to nebulized albuterol and intravenous epinephrine. Continuous infusion of epinephrine was initiated. After aborting surgical procedure, the patient was transferred to ICU on continuous intravenous infusion of epinephrine. Venous blood sampling showed elevated troponin level. Echocardiography revealed ejection fraction of 25% suspicious of Takotsubo cardiomyopathy (mid cavitary variant). Tracheal extubation was only possible after three days. Subsequently, patient was discharged home with a cardiology follow-up appointment and a referral to an allergy specialist. Unfortunately at our institution (an academic university hospital in United States) along with neighboring institutions in near-by areas, the only allergy skin tests available are for local anesthetics and antibiotics, while neuromuscular blocking agents (NMBAs) cannot be tested (the suspected anaphylactic agent in our case was presumably rocuronium). In summary, PAA requires and responds to emergent diagnosis and immediate treatment; however there is still a long way to go to ensure post-PAA testing for inciting anesthesia-related allergens.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 4","pages":"465-9"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34531433","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}

引用次数: 0

CONTINUOUS NON-INVASIVE ARTERIAL PRESSURE DEVICE AS AN ADJUNCT TO RECOGNIZE FLUCTUATING BLOOD PRESSURES DURING ELECTIVE CESAREAN SECTION UNDER SUBARACHNOID BLOCKADE (SAB). 在蛛网膜下腔阻滞(sab)下择期剖宫产术中，连续无创动脉压仪作为识别血压波动的辅助手段。

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Deepak Gupta, Vitaly Soskin, Milos Marjanovic, Hassan Amhaz, Ashish Mazumdar

{"title":"CONTINUOUS NON-INVASIVE ARTERIAL PRESSURE DEVICE AS AN ADJUNCT TO RECOGNIZE FLUCTUATING BLOOD PRESSURES DURING ELECTIVE CESAREAN SECTION UNDER SUBARACHNOID BLOCKADE (SAB).","authors":"Deepak Gupta, Vitaly Soskin, Milos Marjanovic, Hassan Amhaz, Ashish Mazumdar","doi":"","DOIUrl":"","url":null,"abstract":"Background: Measuring non-invasive blood pressure (NIBP) in less than one minute intervals (STAT NIBP measurements) is not always feasible. Therefore, large number of undetectable hypotension episodes can only be recognized with continuous beat to beat monitoring of blood pressure, for example, by continuous non-invasive arterial pressure monitor (CNAP).Objective: The purpose of the current study was to investigate whether CNAP correlates well with conventional intermittent oscillometric NIBP during elective cesarean sections under subarachnoid blockade (SAB) and whether CNAP based patient management results in improved immediate maternal vasopressor requirements and improved immediate fetal/neonatal outcomes compared with NIBP based patient management.Materials and methods: The CNAP finger cuff together with the CNAP arm cuff were placed on the same arm which also had the peripheral intravenous access.. On the contralateral arm the conventional NIBP arm cuff was placed. Study Group: The patients were managed by the anesthesia provider based on the CNAP monitor readings. Control Group: The patients were managed by the anesthesia provider based on the NIBP monitor readings. Results: The CNAP-based treatment (study) group had a statistically significant lower use of oxytocin and lower estimated blood loss than the NIBP-based treatment (control) group. The differences in incidences of vasopressors use and peri-operative nausea vomiting between study group and control group did not reach statistical significance. CNAP readings were more likely to be in systolic hypotensive phases (<l00mmHg) and diastolic hypertensive phases (>80mmHg) as compared to NIBP readings.Conclusion: Continuous non-invasive arterial pressure (CNAP) device may ONLY act as an adjunct to recognize fluctuating blood pressures during elective cesarean section under subarachnoid blockade (SAB).","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 4","pages":"385-400"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34641473","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}

引用次数: 0

PENTAZOCINE VERSUS PENTAZOCINE WITH RECTAL DICLOFENAC FOR POSTOPERATIVE PAIN RELIEF AFTER CESAREAN SECTION- A DOUBLE BLIND RANDOMIZED PLACEBO CONTROLLED TRIAL IN A LOW RESOURCE AREA. Pentazocine与Pentazocine联合直肠双氯芬酸缓解剖宫产术后疼痛——一项低资源地区的双盲随机安慰剂对照试验

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Simeon O Olateju, Anthony T Adenekan, Adeyemi J Olufolabi, Afolabi M Owojuyigbe, Adedapo O Adetoye, Kayode O Ajenifuja, Samuel A Olowookere, Aramide F Faponle

{"title":"PENTAZOCINE VERSUS PENTAZOCINE WITH RECTAL DICLOFENAC FOR POSTOPERATIVE PAIN RELIEF AFTER CESAREAN SECTION- A DOUBLE BLIND RANDOMIZED PLACEBO CONTROLLED TRIAL IN A LOW RESOURCE AREA.","authors":"Simeon O Olateju, Anthony T Adenekan, Adeyemi J Olufolabi, Afolabi M Owojuyigbe, Adedapo O Adetoye, Kayode O Ajenifuja, Samuel A Olowookere, Aramide F Faponle","doi":"","DOIUrl":"","url":null,"abstract":"Background: The unimodal approach of using pentazocine as post-cesarean section pain relief is inadequate, hence the need for a safer, easily available and more effective multimodal approach.Aim: To evaluate the effectiveness of rectal diclofenac combined with intramuscular pentazocine for postoperative pain following cesarean section.Methods: In this double blind clinical trial, 130 pregnant women scheduled for cesarean section under spinal anesthesia were randomly assigned to two groups. Group A received 100mg diclofenac suppository and group B received placebo suppository immediately following surgery, 12 and 24h later. Both groups also received intramuscular pentazocine 30mg immediately following surgery and 6 hourly postoperatively in the first 24 h. Postoperative pain was assessed by visual analogue scale at end of surgery and 2, 12 and 24 h after surgery. Patient satisfaction scores were also assessed.Results: One hundred and sixteen patients completed the study. Combining diclofenac and pentazocine had statistically significant reduction in pain intensity at 2, 12, and 24 hours postoperatively compared to pentazocine alone (p <0.05). No significant side effects were noted in both groups. The combined group also had significantly better patient satisfaction scores.Conclusion: The addition of diclofenac suppository to intramuscular pentazocine provides better pain relief after cesarean section and increased patient satisfaction.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 4","pages":"443-8"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34531430","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}

引用次数: 0

PATIENT-VENTILATION ASYNCHRONY CAUSING NEGATIVE PRESSURE PULMONARY EDEMA IN AN INTUBATED OBESE PATIENT. 患者-通气不同步导致插管肥胖患者负压肺水肿。

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Sahar M Siddik-Sayyid, Waseem AlFahel, Mohamad F El-Khatib

引用次数: 0

COMPARISON OF INTRAOPERATIVE KETAMINE VS. FENTANYL USE DECREASES POSTOPERATIVE OPIOID REQUIREMENTS IN TRAUMA PATIENTS UNDERGOING CERVICAL SPINE SURGERY. 术中氯胺酮与芬太尼使用的比较减少了颈椎手术创伤患者术后阿片类药物的需求。

Middle East Journal of Anesthesiology Pub Date : 2016-02-01

Aviva C Berkowitz, Aryeh M Ginsburg, Raymond M Pesso, George L D Angus, Amiee Kang, Dov B Ginsburg

{"title":"COMPARISON OF INTRAOPERATIVE KETAMINE VS. FENTANYL USE DECREASES POSTOPERATIVE OPIOID REQUIREMENTS IN TRAUMA PATIENTS UNDERGOING CERVICAL SPINE SURGERY.","authors":"Aviva C Berkowitz, Aryeh M Ginsburg, Raymond M Pesso, George L D Angus, Amiee Kang, Dov B Ginsburg","doi":"","DOIUrl":"","url":null,"abstract":"Background: Postoperative airway compromise following cervical spine surgery is a potentially serious adverse event. Residual effects of anesthesia and perioperative opioids that can cause both sedation and respiratory depression further increase this risk. Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that provides potent analgesia without noticeable respiratory depression. We investigated whether intraoperative ketamine administration could decrease perioperative opioid requirements in trauma patients undergoing cervical spine surgery.Methods: We retrospectively reviewed anesthesia records identifying cervical spine surgeries performed between March 2014 and February 2015. All patients received a balanced anesthetic technique utilizing sevoflurane 0.5 minimum alveolar concentration (MAC) and propofol infusion (50-100 mcg/kg/min). For intraoperative analgesia, one group of patients received ketamine (N=25) and a second group received fentanyl (N=27). Cumulative opioid doses in the recovery room and until 24 hours postoperatively were recorded.Results: Fewer patients in the ketamine group (11/25 [44%] vs. 20/27 [74%], respectively; p = 0.03) required analgesics in the recovery room. Additionally, the total cumulative opioid requirements in the ketamine group decreased postoperatively at both 3 and 6 hours (p = 0.01).Conclusion: Ketamine use during cervical spine surgery decreased opioid requirements in both the recovery room and in the first 6 hours postoperatively. This may have the potential to minimize opioid induced respiratory depression in a population at increased risk of airway complications related to the surgical procedure.","PeriodicalId":35975,"journal":{"name":"Middle East Journal of Anesthesiology","volume":"23 4","pages":"415-20"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34641476","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}

引用次数: 0