Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_58_21
Amarjeet Kumar, C. Sinha, Kunal Singh, Gayatri D Sagdeo
{"title":"COVID-19 era: rethinking the approach to delivering airway training","authors":"Amarjeet Kumar, C. Sinha, Kunal Singh, Gayatri D Sagdeo","doi":"10.4103/roaic.roaic_58_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_58_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121542532","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_60_21
S. Sabri, Ahmed Abdelbasset, A. Yassien, A. Nashaat
Introduction Accurate estimation of intravascular volume status is important in the resuscitation of patients in ICUs. Although intensive fluid therapy in patients with life-threatening volume depletion can prevent death and end-organ damage, volume overload is known to result in increased mortality, morbidity, and duration of hospital stay. Ultrasonography has become a common diagnostic choice in assessment of fluid status in septic patients. This method is noninvasive, easy to learn, and provides real-time assessment at the patient’s bedside. Various ultrasound modalities have been developed to provide accurate and minimally invasive assessment of volume status. In this regard, one of the most promising methods is the evaluation of the blood flow velocity waveform in the descending thoracic aorta via a nonimaging Doppler probe. This modality is based on calculating the systolic flow time with cycle time correction [corrected flow time (FTc)]. FTc is known to be directly associated with volume status. FTc measurement in carotid artery is a completely noninvasive and much more feasible approach. Aim To compare the use of ultrasonography in the measurement of the changes in carotid FTc with echocardiography in the assessment of changes in heart dynamics to assess changes in volume status before and after passive leg raising (PLR) in septic patients. Patients and methods A total of 40 septic patients, including 18 (45.5%) patients as fluid responders and 22 (54.5%) patients as nonfluid responders, were included. Increased FTc by 7 ms, as well as 10% increase in stroke volume was considered to be fluid responsive. Results Our study results showed that 45.5% (n=18) of study population were fluid responders. The PLR test could assess fluid responsiveness with a specificity of 100% and sensitivity of 95% at a cutoff of 10.6% change in CO to predict fluid responsiveness. The study showed a statistically significant moderate positive correlation between CCA FTc and the percent of change in CO measured by echocardiography. An agreement analysis was formed. We concluded that there was a strong relation between change in carotid corrected blood flow and change in COP before and after PLR, with P value less than 0.001. Therefore, we can use this parameter to predict fluid responsiveness after PLR. Conclusions Carotid artery blood flow is a promising noninvasive and easy-to-perform tool for the evaluation of fluid responsiveness in critically ill septic patients. The PLR maneuver has demonstrated excellent performance for predicting fluid responsiveness. It is simple to perform but requires a reliable system of carotid corrected blood flow (COP) monitoring able to quantify the short-term changes.
{"title":"Changes in carotid corrected flow time in guiding fluid resuscitation in septic patients","authors":"S. Sabri, Ahmed Abdelbasset, A. Yassien, A. Nashaat","doi":"10.4103/roaic.roaic_60_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_60_21","url":null,"abstract":"Introduction Accurate estimation of intravascular volume status is important in the resuscitation of patients in ICUs. Although intensive fluid therapy in patients with life-threatening volume depletion can prevent death and end-organ damage, volume overload is known to result in increased mortality, morbidity, and duration of hospital stay. Ultrasonography has become a common diagnostic choice in assessment of fluid status in septic patients. This method is noninvasive, easy to learn, and provides real-time assessment at the patient’s bedside. Various ultrasound modalities have been developed to provide accurate and minimally invasive assessment of volume status. In this regard, one of the most promising methods is the evaluation of the blood flow velocity waveform in the descending thoracic aorta via a nonimaging Doppler probe. This modality is based on calculating the systolic flow time with cycle time correction [corrected flow time (FTc)]. FTc is known to be directly associated with volume status. FTc measurement in carotid artery is a completely noninvasive and much more feasible approach. Aim To compare the use of ultrasonography in the measurement of the changes in carotid FTc with echocardiography in the assessment of changes in heart dynamics to assess changes in volume status before and after passive leg raising (PLR) in septic patients. Patients and methods A total of 40 septic patients, including 18 (45.5%) patients as fluid responders and 22 (54.5%) patients as nonfluid responders, were included. Increased FTc by 7 ms, as well as 10% increase in stroke volume was considered to be fluid responsive. Results Our study results showed that 45.5% (n=18) of study population were fluid responders. The PLR test could assess fluid responsiveness with a specificity of 100% and sensitivity of 95% at a cutoff of 10.6% change in CO to predict fluid responsiveness. The study showed a statistically significant moderate positive correlation between CCA FTc and the percent of change in CO measured by echocardiography. An agreement analysis was formed. We concluded that there was a strong relation between change in carotid corrected blood flow and change in COP before and after PLR, with P value less than 0.001. Therefore, we can use this parameter to predict fluid responsiveness after PLR. Conclusions Carotid artery blood flow is a promising noninvasive and easy-to-perform tool for the evaluation of fluid responsiveness in critically ill septic patients. The PLR maneuver has demonstrated excellent performance for predicting fluid responsiveness. It is simple to perform but requires a reliable system of carotid corrected blood flow (COP) monitoring able to quantify the short-term changes.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126429053","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_91_21
M. Dhar, Anirban Brahma Adhikary, R. Roopesh, M. Shajahan, Abhishek Kumar Singh
{"title":"Dilemma of perioperative steroid use in diabetic mucormycosis patients undergoing airway-related surgeries: a letter to the editor","authors":"M. Dhar, Anirban Brahma Adhikary, R. Roopesh, M. Shajahan, Abhishek Kumar Singh","doi":"10.4103/roaic.roaic_91_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_91_21","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114285485","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_8_22
T. Khair, M. Ahmed, A. Mohamed, I. Sayed, Tamer Saafan
Aims To compare the safety and efficacy of 1 and 3 mg of granisetron in the prevention of postoperative nausea and vomiting (PONV) in strabismus surgeries under general anesthesia. Settings and design This single-blinded, randomized, controlled trial was conducted at the ophthalmology operating theater of Kasr Al-Ainy Hospitals. Patients and methods We recruited 210 patients and allocated them randomly to receive either granisetron 1 mg (n=105) or 3 mg (n=105). The two groups were compared regarding demographic data, hemodynamic parameters, and percentage of patients with no complaints of PONV during the first 24 h. Results There was no statistically significant difference upon comparison of the two groups regarding PONV (P>0.05). The two doses (1 and 3 mg) provided total control of nausea and vomiting in 46.7 and 43.8% of patients during the first 24 h postoperatively, respectively. Moreover, we found no significant difference between the two groups regarding mean values of the heart rate or mean arterial pressure both preoperatively and intraoperatively (P>0.05). However, during the postoperative 24 h, both groups had significant differences regarding mean values of heart rate and mean arterial pressure at 2–4 h, 8–12 h, and 12–24 h postoperatively. Conclusions The comparison between two doses of granisetron (1 and 3 mg) showed no statistical difference regarding the total control of nausea and vomiting for 24 h postoperatively but showed a statistical difference regarding some postoperative vital sign readings.
{"title":"A comparative study between 1 and 3 mg of granisetron in the prevention of postoperative nausea and vomiting in strabismus ophthalmic surgeries during general anesthesia","authors":"T. Khair, M. Ahmed, A. Mohamed, I. Sayed, Tamer Saafan","doi":"10.4103/roaic.roaic_8_22","DOIUrl":"https://doi.org/10.4103/roaic.roaic_8_22","url":null,"abstract":"Aims To compare the safety and efficacy of 1 and 3 mg of granisetron in the prevention of postoperative nausea and vomiting (PONV) in strabismus surgeries under general anesthesia. Settings and design This single-blinded, randomized, controlled trial was conducted at the ophthalmology operating theater of Kasr Al-Ainy Hospitals. Patients and methods We recruited 210 patients and allocated them randomly to receive either granisetron 1 mg (n=105) or 3 mg (n=105). The two groups were compared regarding demographic data, hemodynamic parameters, and percentage of patients with no complaints of PONV during the first 24 h. Results There was no statistically significant difference upon comparison of the two groups regarding PONV (P>0.05). The two doses (1 and 3 mg) provided total control of nausea and vomiting in 46.7 and 43.8% of patients during the first 24 h postoperatively, respectively. Moreover, we found no significant difference between the two groups regarding mean values of the heart rate or mean arterial pressure both preoperatively and intraoperatively (P>0.05). However, during the postoperative 24 h, both groups had significant differences regarding mean values of heart rate and mean arterial pressure at 2–4 h, 8–12 h, and 12–24 h postoperatively. Conclusions The comparison between two doses of granisetron (1 and 3 mg) showed no statistical difference regarding the total control of nausea and vomiting for 24 h postoperatively but showed a statistical difference regarding some postoperative vital sign readings.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124292912","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_61_21
Said M. El-Medany, Hisham Shaaban, Kareem Ateba, A. Abdel Razek
Background Brachial plexus block is a well-studied method of providing reliable anesthesia or analgesia for the upper extremity. Many approaches for brachial plexus block are present. These approaches are classified according to the level of local anesthetic injection into interscalene, supraclavicular, infraclavicular, and axillary blocks. By providing a rapid onset of dense anesthesia of the arm with a single injection, the supraclavicular block is perfect for operations involving the arm and forearm, from the distal humerus down to the hand. Ultrasound guidance has resulted in a better practice of supraclavicular approach to the brachial plexus, with decreasing the risk of complications. There has always been a search for adjuvants to local anesthetics used in regional nerve block with drugs that prolong the duration of analgesia but with lesser adverse effects. Objective To compare the effect of nalbuphine as an additive to bupivacaine versus bupivacaine alone in supraclavicular brachial plexus block with ultrasound guidance in upper limb surgeries regarding onset and duration of sensory and motor blocks, duration of analgesia, and postoperative analgesic requirements, as well as the effects on hemodynamics and possible complications with each technique. Patients and methods This study was carried out in Alexandria Main University Hospital on 50 adult patients of both sexes, American Society of Anesthesiology I and II, scheduled for surgeries of the hand and forearm under supraclavicular brachial plexus block with ultrasound guidance. Patients were randomly categorized into two equal groups (25 patients each) using the sealed envelope technique. Group I patients received bupivacaine only for the block, and group II patients received bupivacaine and nalbuphine as an adjuvant for the block. Results The results of our study showed that patients in nalbuphine group (group II) had significantly longer sensory and motor blocks duration, with longer duration of postoperative analgesia, when compared with patients in group I, who were received bupivacaine only for the block. Conclusion Coadministration of nalbuphine with bupivacaine in supraclavicular brachial plexus block leads to a significant increase in the duration of sensory and motor blocks and provides prolonged postoperative analgesia without causing adverse hemodynamic instability.
{"title":"Comparative study between the use of bupivacaine alone or with nalbuphine in ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries","authors":"Said M. El-Medany, Hisham Shaaban, Kareem Ateba, A. Abdel Razek","doi":"10.4103/roaic.roaic_61_21","DOIUrl":"https://doi.org/10.4103/roaic.roaic_61_21","url":null,"abstract":"Background Brachial plexus block is a well-studied method of providing reliable anesthesia or analgesia for the upper extremity. Many approaches for brachial plexus block are present. These approaches are classified according to the level of local anesthetic injection into interscalene, supraclavicular, infraclavicular, and axillary blocks. By providing a rapid onset of dense anesthesia of the arm with a single injection, the supraclavicular block is perfect for operations involving the arm and forearm, from the distal humerus down to the hand. Ultrasound guidance has resulted in a better practice of supraclavicular approach to the brachial plexus, with decreasing the risk of complications. There has always been a search for adjuvants to local anesthetics used in regional nerve block with drugs that prolong the duration of analgesia but with lesser adverse effects. Objective To compare the effect of nalbuphine as an additive to bupivacaine versus bupivacaine alone in supraclavicular brachial plexus block with ultrasound guidance in upper limb surgeries regarding onset and duration of sensory and motor blocks, duration of analgesia, and postoperative analgesic requirements, as well as the effects on hemodynamics and possible complications with each technique. Patients and methods This study was carried out in Alexandria Main University Hospital on 50 adult patients of both sexes, American Society of Anesthesiology I and II, scheduled for surgeries of the hand and forearm under supraclavicular brachial plexus block with ultrasound guidance. Patients were randomly categorized into two equal groups (25 patients each) using the sealed envelope technique. Group I patients received bupivacaine only for the block, and group II patients received bupivacaine and nalbuphine as an adjuvant for the block. Results The results of our study showed that patients in nalbuphine group (group II) had significantly longer sensory and motor blocks duration, with longer duration of postoperative analgesia, when compared with patients in group I, who were received bupivacaine only for the block. Conclusion Coadministration of nalbuphine with bupivacaine in supraclavicular brachial plexus block leads to a significant increase in the duration of sensory and motor blocks and provides prolonged postoperative analgesia without causing adverse hemodynamic instability.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132494448","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_12_22
A. Hassan, B. Refaie, Islam Ahmed, A. Abdelkareem
Introduction The postdural puncture headache (PDPH) is one of the spinal and epidural anesthesia complications. It can be induced by using large gauge-cutting needles or performing numerous trials. Conservative treatment was the primary option for the management of PDPH, sphenopalatine ganglion block (SPGB) can be a suitable and safe option for the treatment of PDPH. Aim The aim was to verify the efficacy and safety of transnasal SPGB using either lidocaine 2% or bupivacaine 0.5% as a treatment line for PDPH versus the conventional conservative treatment. Patients and methods In total, 120 patients with PDPH following cesarean section under spinal anesthesia were assigned and divided into three groups. Group L (n=40) received transnasal SPGB (lidocaine 2%), group B (n=40) received transnasal SPGB (bupivacaine 0.5%), and group C (n=40) received conservative treatment for 24 h [intravenous (IV) paracetamol 1 g/8 h]. The headache severity was measured by the visual analog scale (VAS) at 0 min, 30 min, 6 h, 12 h, and 24 h post treatment. Results No significant difference in the VAS from the baseline between the groups L and B was observed. VAS values were significantly lower in both groups when compared with patients in group C (P<0.05). No significant differences from baseline mean blood pressure, heart rate, or other complications (such as bleeding), were observed between the three groups at any timepoint. Conclusion The headache severity in PDPH cases might be reduced more efficiently through SPGB using either lidocaine or bupivacaine, unlike other conservative treatments such as paracetamol.
{"title":"Comparative study between different approaches for the management of postdural puncture headache","authors":"A. Hassan, B. Refaie, Islam Ahmed, A. Abdelkareem","doi":"10.4103/roaic.roaic_12_22","DOIUrl":"https://doi.org/10.4103/roaic.roaic_12_22","url":null,"abstract":"Introduction The postdural puncture headache (PDPH) is one of the spinal and epidural anesthesia complications. It can be induced by using large gauge-cutting needles or performing numerous trials. Conservative treatment was the primary option for the management of PDPH, sphenopalatine ganglion block (SPGB) can be a suitable and safe option for the treatment of PDPH. Aim The aim was to verify the efficacy and safety of transnasal SPGB using either lidocaine 2% or bupivacaine 0.5% as a treatment line for PDPH versus the conventional conservative treatment. Patients and methods In total, 120 patients with PDPH following cesarean section under spinal anesthesia were assigned and divided into three groups. Group L (n=40) received transnasal SPGB (lidocaine 2%), group B (n=40) received transnasal SPGB (bupivacaine 0.5%), and group C (n=40) received conservative treatment for 24 h [intravenous (IV) paracetamol 1 g/8 h]. The headache severity was measured by the visual analog scale (VAS) at 0 min, 30 min, 6 h, 12 h, and 24 h post treatment. Results No significant difference in the VAS from the baseline between the groups L and B was observed. VAS values were significantly lower in both groups when compared with patients in group C (P<0.05). No significant differences from baseline mean blood pressure, heart rate, or other complications (such as bleeding), were observed between the three groups at any timepoint. Conclusion The headache severity in PDPH cases might be reduced more efficiently through SPGB using either lidocaine or bupivacaine, unlike other conservative treatments such as paracetamol.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128132213","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_31_22
Heba Fathi, M. Medhat
Background Intravenous milrinone has been investigated for management of vasospasm after aneurysmal subarachnoid hemorrhage (SAH); however, its role in vasospasm after traumatic SAH is still under evaluation. Patients and methods A total of 30 patients with cerebral vascular spasm after traumatic SAH were randomly divided into two equal groups. Group H was given nimodipine (60 mg/4 h) orally or via nasogastric tube and then combination of induced hypertension, hypervolemia, and hemodilution (triple-H therapy). Group M was given nimodipine (60 mg/4 h) orally or in the nasogastric tube and then intravenous milrinone bolus of 0.1–0.2 mg/kg followed by intravenous infusion of 0.75–1.25 μg/k/min. The infusion was continued for 72 h before gradual discontinuation at a rate of 0.25 μg/kg/min every 24 h until complete weaning. For refractory cases in both groups, emergency angioplasty was done. Primary outcome was the transcutaneous cerebral regional oxygen saturation 14 days after starting treatment. Secondary outcomes were the Glasgow coma score 14 days after starting treatment, infarction rate, ICU and hospital stays, and modified Rankin scale and Glasgow outcome scale at 3 and 6 months after starting treatment. Results Group M showed significant increase in regional oxygen saturation and Glasgow coma score; decrease in infarction rate, ICU stay, and hospital stay; and improvement in modified Rankin scale and Glasgow outcome scale. Significance was set at P value less than 0.05. Conclusion The combination of oral nimodipine and intravenous milrinone improves the outcome of vasospasm in posttraumatic SAH.
{"title":"Management of cerebral vascular spasm in posttraumatic subarachnoid hemorrhage using a combination therapy of oral nimodipine and intravenous milrinone: a randomized clinical trial","authors":"Heba Fathi, M. Medhat","doi":"10.4103/roaic.roaic_31_22","DOIUrl":"https://doi.org/10.4103/roaic.roaic_31_22","url":null,"abstract":"Background Intravenous milrinone has been investigated for management of vasospasm after aneurysmal subarachnoid hemorrhage (SAH); however, its role in vasospasm after traumatic SAH is still under evaluation. Patients and methods A total of 30 patients with cerebral vascular spasm after traumatic SAH were randomly divided into two equal groups. Group H was given nimodipine (60 mg/4 h) orally or via nasogastric tube and then combination of induced hypertension, hypervolemia, and hemodilution (triple-H therapy). Group M was given nimodipine (60 mg/4 h) orally or in the nasogastric tube and then intravenous milrinone bolus of 0.1–0.2 mg/kg followed by intravenous infusion of 0.75–1.25 μg/k/min. The infusion was continued for 72 h before gradual discontinuation at a rate of 0.25 μg/kg/min every 24 h until complete weaning. For refractory cases in both groups, emergency angioplasty was done. Primary outcome was the transcutaneous cerebral regional oxygen saturation 14 days after starting treatment. Secondary outcomes were the Glasgow coma score 14 days after starting treatment, infarction rate, ICU and hospital stays, and modified Rankin scale and Glasgow outcome scale at 3 and 6 months after starting treatment. Results Group M showed significant increase in regional oxygen saturation and Glasgow coma score; decrease in infarction rate, ICU stay, and hospital stay; and improvement in modified Rankin scale and Glasgow outcome scale. Significance was set at P value less than 0.05. Conclusion The combination of oral nimodipine and intravenous milrinone improves the outcome of vasospasm in posttraumatic SAH.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121470048","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_13_22
J. Attia, A. Hassanine
Background Awake fiber-optic intubation is one of the recommended strategies for surgical patients with suspected difficult airway, especially when simultaneous difficult ventilation is anticipated. Patients and methods In all, 90 patients of both sexes aged between 20 and 55 years, American Society of Anesthesiologist I and II stages were scheduled for elective abdominal surgeries. Patients were randomized into three equal groups. Group A: oral agomelatine at a dose of 10 mg administered with a sip of water 120 min before surgery. Group B: agomelatine+dexmedetomidine. Group C: dexmedetomidine infused at a dose of 1 μg/kg loading infusion per 10 min followed by a continuous infusion of 0.2 μg/kg/h. The following variables (mean arterial pressure, heart rate, oxygen saturation, cough score, postintubation score) and Richmond agitation sedation scale score were recorded in addition to the serum level of norepinephrine. Conclusion Agomelatine is more effective than dexmedetomidine in making better intubation state with sedation, less desaturation, and hemodynamic stability during awake fiber-optic intubation. Synergestic effect between agomelatine and dexmedetomidine was detected.
{"title":"Potential effect of agomelatine versus dexmedetomidine during awake fiberoptic intubation; role of catacholamine","authors":"J. Attia, A. Hassanine","doi":"10.4103/roaic.roaic_13_22","DOIUrl":"https://doi.org/10.4103/roaic.roaic_13_22","url":null,"abstract":"Background Awake fiber-optic intubation is one of the recommended strategies for surgical patients with suspected difficult airway, especially when simultaneous difficult ventilation is anticipated. Patients and methods In all, 90 patients of both sexes aged between 20 and 55 years, American Society of Anesthesiologist I and II stages were scheduled for elective abdominal surgeries. Patients were randomized into three equal groups. Group A: oral agomelatine at a dose of 10 mg administered with a sip of water 120 min before surgery. Group B: agomelatine+dexmedetomidine. Group C: dexmedetomidine infused at a dose of 1 μg/kg loading infusion per 10 min followed by a continuous infusion of 0.2 μg/kg/h. The following variables (mean arterial pressure, heart rate, oxygen saturation, cough score, postintubation score) and Richmond agitation sedation scale score were recorded in addition to the serum level of norepinephrine. Conclusion Agomelatine is more effective than dexmedetomidine in making better intubation state with sedation, less desaturation, and hemodynamic stability during awake fiber-optic intubation. Synergestic effect between agomelatine and dexmedetomidine was detected.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121610456","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}
Pub Date : 2022-10-01DOI: 10.4103/roaic.roaic_36_22
S. Hayes, Hisham Atef Ebada, Hanaa M. El Bendary
Purpose We evaluated the quality of analgesia produced by peritonsillar infiltration of levobupivacaine with either dexamethasone or dexmedetomidine in children undergoing tonsillectomy surgery. Patients and methods Patients scheduled for tonsillectomy were randomly allocated into three groups with 27 patients in each group. Group L received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine, while group D received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine mixed with dexamethasone 0.5 mg/kg and group X received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine mixed with dexmedetomidine 1 μg/kg (with infiltration of 2.5 ml in each tonsil in all groups) with the first postoperative analgesic request as the primary outcome. Results Postoperative time to first analgesic paracetamol request was prolonged in group D (19.51±2.34 h) compared with group L (4.15±0.53 h) and group X (15.74±2.29 h). Face, leg, activity, cry, consolability (FLACC) Behavioral Pain Assessment score at rest and during swallowing decreased in group D compared with group L and group X. Total postoperative analgesic consumption decreased in group D (581.48±165.7 mg) compared with group L (1303.51±90.10 mg) and group X (680.50±160.67 mg). Conclusions We concluded that peritonsillar infiltration of levobupivacaine when mixed with either dexamethasone or dexmedetomidine for patients undergoing tonsillectomy produced prolonged analgesia; however, dexamethasone was superior to dexmedetomidine with more prolonged time to first paracetamol request and prolonged late postoperative pain relief.
{"title":"Efficacy of peritonsillar infiltration of levobupivacaine-dexamethasone versus levobupivacaine-dexmedetomidine in children undergoing tonsillectomy surgery: a prospective, randomized double-blind study","authors":"S. Hayes, Hisham Atef Ebada, Hanaa M. El Bendary","doi":"10.4103/roaic.roaic_36_22","DOIUrl":"https://doi.org/10.4103/roaic.roaic_36_22","url":null,"abstract":"Purpose We evaluated the quality of analgesia produced by peritonsillar infiltration of levobupivacaine with either dexamethasone or dexmedetomidine in children undergoing tonsillectomy surgery. Patients and methods Patients scheduled for tonsillectomy were randomly allocated into three groups with 27 patients in each group. Group L received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine, while group D received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine mixed with dexamethasone 0.5 mg/kg and group X received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine mixed with dexmedetomidine 1 μg/kg (with infiltration of 2.5 ml in each tonsil in all groups) with the first postoperative analgesic request as the primary outcome. Results Postoperative time to first analgesic paracetamol request was prolonged in group D (19.51±2.34 h) compared with group L (4.15±0.53 h) and group X (15.74±2.29 h). Face, leg, activity, cry, consolability (FLACC) Behavioral Pain Assessment score at rest and during swallowing decreased in group D compared with group L and group X. Total postoperative analgesic consumption decreased in group D (581.48±165.7 mg) compared with group L (1303.51±90.10 mg) and group X (680.50±160.67 mg). Conclusions We concluded that peritonsillar infiltration of levobupivacaine when mixed with either dexamethasone or dexmedetomidine for patients undergoing tonsillectomy produced prolonged analgesia; however, dexamethasone was superior to dexmedetomidine with more prolonged time to first paracetamol request and prolonged late postoperative pain relief.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131331460","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}
Pub Date : 2022-07-01DOI: 10.4103/roaic.roaic_73_20
{"title":"Continuous sciatic nerve block as preoperative care for lowerlimb revascularization surgery: presenting a pain-reduction strategy","authors":"","doi":"10.4103/roaic.roaic_73_20","DOIUrl":"https://doi.org/10.4103/roaic.roaic_73_20","url":null,"abstract":"","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123046481","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}
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