Pub Date : 2019-06-26DOI: 10.2174/2589645801913010040
D. Doyle
A synopsis of the latest research on the perioperative use of chewing gum by surgical patients is presented, focusing on the preoperative and postoperative periods. Current data now suggest that the preoperative use of chewing gum does not adversely affect gastric emptying and that the postoperative use of chewing gum may actually aid recovery from some forms of major surgery. Additionally, the use of chewing gum may increase alertness and serve to reduce stress, as well as offer important oral health benefits.
{"title":"Chewing Gum Use in the Perioperative Period","authors":"D. Doyle","doi":"10.2174/2589645801913010040","DOIUrl":"https://doi.org/10.2174/2589645801913010040","url":null,"abstract":"A synopsis of the latest research on the perioperative use of chewing gum by surgical patients is presented, focusing on the preoperative and postoperative periods. Current data now suggest that the preoperative use of chewing gum does not adversely affect gastric emptying and that the postoperative use of chewing gum may actually aid recovery from some forms of major surgery. Additionally, the use of chewing gum may increase alertness and serve to reduce stress, as well as offer important oral health benefits.","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82251466","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 : 2019-04-30DOI: 10.2174/2589645801913010031
Sherif A. Elokda, H. Farag
Impaired respiratory functions during general anesthesia are commonly caused by lung atelectasis more in morbidly obese patients. This occurs more frequently with laparoscopic surgery due to trendelenburg position and pneumoperitoneum. Preemptive recruitment maneuver + PEEP results in the prevention of these changes. To quantitate the effects of RM and PEEP on intraoperative hypoxemia and respiratory mechanics during laparoscopic gastric banding in obese patients. A randomized, double-blinded, controlled study. Fifty adults ASA I-II, BMI (40-50 kg/m2) for elective laparoscopic gastric banding were randomized into, groups C, and RM, 25 patients each. Group C patients received standard ventilation, VT 6 ml/kg, I: E ratio 1: 2 PEEP 5 cm H2O, and respiratory rate 10-12 breaths/ min. RM patients received standard ventilation with one alveolar recruitment maneuver after mechanical ventilation with PEEP of 15 cm H2O till the end of the surgery. Heart rate, mean blood pressure, respiratory mechanical parameters: peak airway pressure, plateau pressure and end-expiratory lung volume, PaO2, PaO2/FiO2 and (SpO2) were assessed. PaO2 and PaO2/FiO2 ratio increased significantly in the RM group after RM from T2 (before pneumoperitoneum) to T6 (end of surgery) compared with group C (P < 0.001). Peak and plateau airway pressures increased significantly in group C from T2 till T5 (60 min after pneumoperitoneum) compared with the RM group (P < 0.001). End-expiratory lung volume increased significantly in the RM group after RM compared with group C (P<0.001). Preemptive RM with PEEP of 15 cm H2O was effective in preventing pneumoperitoneum-induced intraoperative hypoxemia and respiratory mechanics changes.
全身麻醉时呼吸功能受损通常由肺不张引起，多见于病态肥胖患者。由于trendelenburg体位和气腹，这种情况在腹腔镜手术中更常见。先发制人的招募策略+ PEEP可以防止这些变化。定量观察RM和PEEP对肥胖患者腹腔镜胃束带术中低氧血症和呼吸力学的影响。一项随机、双盲、对照研究。50例ASA I-II, BMI (40-50 kg/m2)的成人择期腹腔镜胃束带随机分为C组和RM组，每组25例。C组患者给予标准通气，VT 6 ml/kg, I: E比1:2 PEEP 5 cm H2O，呼吸频率10-12次/ min。RM组患者在机械通气后，PEEP为15 cm H2O，给予标准通气1次肺泡复盖手法，直至手术结束。评估心率、平均血压、呼吸力学参数:气道峰值压、平台压、呼气末肺容积、PaO2、PaO2/FiO2、SpO2。RM组在术后T2(气腹前)至T6(手术结束)期间PaO2和PaO2/FiO2比值较C组显著升高(P < 0.001)。与RM组相比，C组在T2 ~ T5(气腹后60 min)的峰值和平台气道压力显著升高(P < 0.001)。RM组术后呼气末肺容量较C组显著增加(P<0.001)。15 cm H2O正压下的抢先RM可有效预防气腹引起的术中低氧血症和呼吸力学改变。
{"title":"Preemptive Alveolar Recruitment Maneuver Followed by PEEP in Obese Patients Undergoing Laparoscopic Gastric Banding. Does it make a Difference? A Randomized Controlled Clinical Study","authors":"Sherif A. Elokda, H. Farag","doi":"10.2174/2589645801913010031","DOIUrl":"https://doi.org/10.2174/2589645801913010031","url":null,"abstract":"\u0000 \u0000 Impaired respiratory functions during general anesthesia are commonly caused by lung atelectasis more in morbidly obese patients. This occurs more frequently with laparoscopic surgery due to trendelenburg position and pneumoperitoneum. Preemptive recruitment maneuver + PEEP results in the prevention of these changes.\u0000 \u0000 \u0000 \u0000 \u0000 To quantitate the effects of RM and PEEP on intraoperative hypoxemia and respiratory mechanics during laparoscopic gastric banding in obese patients.\u0000 \u0000 \u0000 \u0000 A randomized, double-blinded, controlled study.\u0000 \u0000 \u0000 \u0000 Fifty adults ASA I-II, BMI (40-50 kg/m2) for elective laparoscopic gastric banding were randomized into, groups C, and RM, 25 patients each. Group C patients received standard ventilation, VT 6 ml/kg, I: E ratio 1: 2 PEEP 5 cm H2O, and respiratory rate 10-12 breaths/ min. RM patients received standard ventilation with one alveolar recruitment maneuver after mechanical ventilation with PEEP of 15 cm H2O till the end of the surgery. Heart rate, mean blood pressure, respiratory mechanical parameters: peak airway pressure, plateau pressure and end-expiratory lung volume, PaO2, PaO2/FiO2 and (SpO2) were assessed.\u0000 \u0000 \u0000 \u0000 PaO2 and PaO2/FiO2 ratio increased significantly in the RM group after RM from T2 (before pneumoperitoneum) to T6 (end of surgery) compared with group C (P < 0.001). Peak and plateau airway pressures increased significantly in group C from T2 till T5 (60 min after pneumoperitoneum) compared with the RM group (P < 0.001). End-expiratory lung volume increased significantly in the RM group after RM compared with group C (P<0.001).\u0000 \u0000 \u0000 \u0000 Preemptive RM with PEEP of 15 cm H2O was effective in preventing pneumoperitoneum-induced intraoperative hypoxemia and respiratory mechanics changes.\u0000","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83433110","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 : 2019-04-30DOI: 10.2174/2589645801913010018
R. Mahrose, A. Elsayed, M. Elshorbagy
The most common cardiac arrhythmia that happens after on-pump Coronary Artery Bypass Graft (CABG) surgery is Atrial Fibrillation (AF). It is combined with several postoperative complications such as increased incidence of stroke, increased hospital stay and increased costs.The aim of this study was to look for safe, effective, reliable and well tolerated tools for the prevention of atrial fibrillation after on pump coronary artery bypass surgery.The study enclosed 176 patients (the age ranges from 40 to 79 years) and scheduled for elective on-pump CABG operations without concomitant procedures. The patients were selected randomly into two equal groups. Group (A) in which bisoprolol was used to prevent atrial fibrillation after surgery. Group (B) in which bisoprolol and hydrocortisone were used for prevention of atrial fibrillation after surgery. For each patient, the following data were collected: gender, preoperative diseases, cardiopulmonary bypass time, intraoperative cross clamp time, Left internal mammary Artery usage, incidence of postoperative atrial fibrillation, death, myocardial infarction chest infection and C-reactive protein amount in plasma.There was a statistically significant decrease in the occurrence of atrial fibrillation in group (B) when compared to corresponding values in group (A). Also, group (B) showed a statistically significant decrease in length of hospital stay in comparison to group (A). C-reactive protein concentrations on the 1stand 2ndpostoperative days were lower significantly in group (B) than in group (A). There were no statistically significant differences between both groups regarding gender, preoperative diseases, cardiorespiratory bypass time, intraoperative cross clamp time, Left internal mammary artery usage, death, myocardial infarction and chest infection.This study demonstrated that using bisoprolol and hydrocortisone combination showed greater benefit than the use of bisoprolol only for prevention of postoperative AF after on-pump coronary artery bypass graft surgery.
{"title":"Bisoprolol Versus Corticosteroid and Bisoprolol Combination for Prevention of Atrial Fibrillation After On-Pump Coronary Artery Bypass Graft Surgery","authors":"R. Mahrose, A. Elsayed, M. Elshorbagy","doi":"10.2174/2589645801913010018","DOIUrl":"https://doi.org/10.2174/2589645801913010018","url":null,"abstract":"The most common cardiac arrhythmia that happens after on-pump Coronary Artery Bypass Graft (CABG) surgery is Atrial Fibrillation (AF). It is combined with several postoperative complications such as increased incidence of stroke, increased hospital stay and increased costs.The aim of this study was to look for safe, effective, reliable and well tolerated tools for the prevention of atrial fibrillation after on pump coronary artery bypass surgery.The study enclosed 176 patients (the age ranges from 40 to 79 years) and scheduled for elective on-pump CABG operations without concomitant procedures. The patients were selected randomly into two equal groups. Group (A) in which bisoprolol was used to prevent atrial fibrillation after surgery. Group (B) in which bisoprolol and hydrocortisone were used for prevention of atrial fibrillation after surgery. For each patient, the following data were collected: gender, preoperative diseases, cardiopulmonary bypass time, intraoperative cross clamp time, Left internal mammary Artery usage, incidence of postoperative atrial fibrillation, death, myocardial infarction chest infection and C-reactive protein amount in plasma.There was a statistically significant decrease in the occurrence of atrial fibrillation in group (B) when compared to corresponding values in group (A). Also, group (B) showed a statistically significant decrease in length of hospital stay in comparison to group (A). C-reactive protein concentrations on the 1stand 2ndpostoperative days were lower significantly in group (B) than in group (A). There were no statistically significant differences between both groups regarding gender, preoperative diseases, cardiorespiratory bypass time, intraoperative cross clamp time, Left internal mammary artery usage, death, myocardial infarction and chest infection.This study demonstrated that using bisoprolol and hydrocortisone combination showed greater benefit than the use of bisoprolol only for prevention of postoperative AF after on-pump coronary artery bypass graft surgery.","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"166 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72877511","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 : 2019-04-30DOI: 10.2174/2589645801913010012
A. Sobhy, D. M. K. Eldin, H. Zaki
In our study, we investigated the effectiveness of intravenous milrinone in life-threatening bronchial asthma as compared to conventional treatment. Fifty patients aged 18-50 years, presenting with life-threatening asthma were enrolled in a Randomised Controlled Trial (RCT). They were randomly allocated into Group C (25 patients): who received the standard pharmacotherapy and placebo, and Group M (25 patients): who in addition to the standard therapy, received 25 μg milrinone as an initial slow IV bolus diluted in 10 ml of normal saline. The following data were recorded: PEFR (Peak Expiratory Flow Rate) expressed as a percentage of the patient’s previous value, Respiratory Rate (RR), MABP (Mean Arterial Blood Pressure), arterial blood gases, and the number of patients requiring mechanical ventilation. Differences between groups were tested using Analysis of Variance (ANOVA) for quantitative variables with post hoc using the Least Significant Difference (LSD) test, and Chi square test for categorical variables. Group M showed marked improvement in PEFR that was highly significant (P < 0.001) 10 min after injection and significant after one hour from the start of treatment in comparison to Group C. There was also an improvement in RR and PO2 that was significant in group M. Milrinone was associated with a reduction in MABP only after 10 min from injection, and showed a statistically significant decrease in the number of patients requiring mechanical ventilator support (P ˂ 0.05). Milronine is a promising agent as a rescue drug in the treatment of life-threatening bronchial asthma.
{"title":"The Use of Milrinone Versus Conventional Treatment for the Management of Life-Threatening Bronchial Asthma","authors":"A. Sobhy, D. M. K. Eldin, H. Zaki","doi":"10.2174/2589645801913010012","DOIUrl":"https://doi.org/10.2174/2589645801913010012","url":null,"abstract":"\u0000 \u0000 In our study, we investigated the effectiveness of intravenous milrinone in life-threatening bronchial asthma as compared to conventional treatment.\u0000 \u0000 \u0000 \u0000 Fifty patients aged 18-50 years, presenting with life-threatening asthma were enrolled in a Randomised Controlled Trial (RCT). They were randomly allocated into Group C (25 patients): who received the standard pharmacotherapy and placebo, and Group M (25 patients): who in addition to the standard therapy, received 25 μg milrinone as an initial slow IV bolus diluted in 10 ml of normal saline. The following data were recorded: PEFR (Peak Expiratory Flow Rate) expressed as a percentage of the patient’s previous value, Respiratory Rate (RR), MABP (Mean Arterial Blood Pressure), arterial blood gases, and the number of patients requiring mechanical ventilation. Differences between groups were tested using Analysis of Variance (ANOVA) for quantitative variables with post hoc using the Least Significant Difference (LSD) test, and Chi square test for categorical variables.\u0000 \u0000 \u0000 \u0000 Group M showed marked improvement in PEFR that was highly significant (P < 0.001) 10 min after injection and significant after one hour from the start of treatment in comparison to Group C. There was also an improvement in RR and PO2 that was significant in group M. Milrinone was associated with a reduction in MABP only after 10 min from injection, and showed a statistically significant decrease in the number of patients requiring mechanical ventilator support (P ˂ 0.05).\u0000 \u0000 \u0000 \u0000 Milronine is a promising agent as a rescue drug in the treatment of life-threatening bronchial asthma.\u0000","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74755450","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 : 2019-04-30DOI: 10.2174/2589645801913010006
R. Mahrose, M. Kamal
Epidural block is today the most common method of pain relief during labor. Nowadays, facing a multiparus parturient requiring epidural for the second or third time is common due to increased frequency of using epidural analgesia during labor. Examination of the performance and outcome of women receiving their first versus repeated epidural block. The study included 140 American Society of Anesthesiologists (ASA) Physical Status II parturients (age range 20 to 40 years) and scheduled for normal vaginal delivery. The parturients were divided randomly into two equal groups. Group (A) in which 70 women primipara subjected to their first epidural block, while group (B) in which 70 women multipara subjected to their repeated epidural block. Our primary outcome of the study is the incidence of a unilateral block and secondary outcomes include Visual Analogue Scale (VAS) before the epidural and 30 minutes after injection of local anesthetic and details of labor as gestation and cervical dilatation. The results showed that there was a statistically significant decrease in the incidence of a unilateral block in the group (A) when compared to the corresponding values in the group (B) (P-value < 0.05). Moreover, group (A) showed a statistically significant decrease in Visual Analogue Scale (VAS) values 30 minutes after the injection of local anesthetic (P-value < 0.05). The conclusion of our study is that there is a higher incidence of unilateral block amongst women receiving their repeated epidurals for labour than those receiving their first epidural block.
{"title":"Repeated Epidural Anesthesia and Incidence of Unilateral Epidural Block","authors":"R. Mahrose, M. Kamal","doi":"10.2174/2589645801913010006","DOIUrl":"https://doi.org/10.2174/2589645801913010006","url":null,"abstract":"\u0000 \u0000 Epidural block is today the most common method of pain relief during labor. Nowadays, facing a multiparus parturient requiring epidural for the second or third time is common due to increased frequency of using epidural analgesia during labor.\u0000 \u0000 \u0000 \u0000 Examination of the performance and outcome of women receiving their first versus repeated epidural block.\u0000 \u0000 \u0000 \u0000 The study included 140 American Society of Anesthesiologists (ASA) Physical Status II parturients (age range 20 to 40 years) and scheduled for normal vaginal delivery. The parturients were divided randomly into two equal groups. Group (A) in which 70 women primipara subjected to their first epidural block, while group (B) in which 70 women multipara subjected to their repeated epidural block. Our primary outcome of the study is the incidence of a unilateral block and secondary outcomes include Visual Analogue Scale (VAS) before the epidural and 30 minutes after injection of local anesthetic and details of labor as gestation and cervical dilatation.\u0000 \u0000 \u0000 \u0000 The results showed that there was a statistically significant decrease in the incidence of a unilateral block in the group (A) when compared to the corresponding values in the group (B) (P-value < 0.05). Moreover, group (A) showed a statistically significant decrease in Visual Analogue Scale (VAS) values 30 minutes after the injection of local anesthetic (P-value < 0.05).\u0000 \u0000 \u0000 \u0000 The conclusion of our study is that there is a higher incidence of unilateral block amongst women receiving their repeated epidurals for labour than those receiving their first epidural block.\u0000","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84480547","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 : 2019-04-30DOI: 10.2174/2589645801913010025
W. Salem, Khaled A Alsamahy, Wael Ibrahim, Abear S Alsaed, M. Salaheldin
Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; therefore, good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal. The study aimed to assess the analgesic potency of adding dexmedetomidine to bupivacaine in ultrasound-guided BRSB in cancer patients with a midline laparotomy incision. Sixty adult cancer patients planned for laparotomies with extended midline incision were included. Ultrasound-guided BRSB was performed immediately after the induction of anesthesia. Patients were classified randomly into two groups; B group, where only bupivacaine was used for BRSB and BD group in whom a mixture of bupivacaine and dexmedetomidine was used. A significant decrease in visual analogue scale scores, total morphine consumption, postoperative nausea and vomiting and postoperative cortisol levels was observed in group BD. Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision.
{"title":"Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study","authors":"W. Salem, Khaled A Alsamahy, Wael Ibrahim, Abear S Alsaed, M. Salaheldin","doi":"10.2174/2589645801913010025","DOIUrl":"https://doi.org/10.2174/2589645801913010025","url":null,"abstract":"\u0000 \u0000 Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; therefore, good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal.\u0000 \u0000 \u0000 \u0000 The study aimed to assess the analgesic potency of adding dexmedetomidine to bupivacaine in ultrasound-guided BRSB in cancer patients with a midline laparotomy incision.\u0000 \u0000 \u0000 \u0000 Sixty adult cancer patients planned for laparotomies with extended midline incision were included. Ultrasound-guided BRSB was performed immediately after the induction of anesthesia.\u0000 Patients were classified randomly into two groups; B group, where only bupivacaine was used for BRSB and BD group in whom a mixture of bupivacaine and dexmedetomidine was used.\u0000 \u0000 \u0000 \u0000 A significant decrease in visual analogue scale scores, total morphine consumption, postoperative nausea and vomiting and postoperative cortisol levels was observed in group BD.\u0000 \u0000 \u0000 \u0000 Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision.\u0000","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75097757","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 : 2019-03-28DOI: 10.2174/2589645801913010001
Aniello Alfieri, M. Passavanti, Sveva Di Franco, P. Sansone, Paola Vosa, F. Coppolino, M. Fiore, C. Aurilio, M. Pace, V. Pota
Awake Fibreoptic Intubation (AFOI) is, nowadays, the gold standard in predicted difficult airway management. Numerous practice guidelines have been developed to assist clinicians facing with a difficult airway. If conducted without sedation, it is common that this procedure may lead to high patient discomfort and severe hemodynamic responses. Sedation is frequently used to make the process more tolerable to patients even if it is not always easy to strike a balance between patient comfort, safety, co-operation, and good intubating conditions. In the last years, many drugs and drug combinations have been described. This minireview aims to discuss the evidence supporting the use of Dexmedetomidine (DEX) in the AFOI management.
{"title":"Dexmedetomidine in the Management of Awake Fiberoptic Intubation","authors":"Aniello Alfieri, M. Passavanti, Sveva Di Franco, P. Sansone, Paola Vosa, F. Coppolino, M. Fiore, C. Aurilio, M. Pace, V. Pota","doi":"10.2174/2589645801913010001","DOIUrl":"https://doi.org/10.2174/2589645801913010001","url":null,"abstract":"Awake Fibreoptic Intubation (AFOI) is, nowadays, the gold standard in predicted difficult airway management. Numerous practice guidelines have been developed to assist clinicians facing with a difficult airway. If conducted without sedation, it is common that this procedure may lead to high patient discomfort and severe hemodynamic responses. Sedation is frequently used to make the process more tolerable to patients even if it is not always easy to strike a balance between patient comfort, safety, co-operation, and good intubating conditions. In the last years, many drugs and drug combinations have been described. This minireview aims to discuss the evidence supporting the use of Dexmedetomidine (DEX) in the AFOI management.","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81794698","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 : 2018-12-31DOI: 10.2174/2589645801812010094
A. Shoukry, Amr Sobhy Abd el Kawy
Peribulbar block for vitreoretinal surgery is rather associated with delayed onset of globe anesthesia, akinesia and short duration of analgesia. To compare the effect of addition of Magnesium sulphate vs dexmedetomidine to standard local anesthetics mixtures on the time of onset of Globe Anesthesia, Akinesia & analgesia duration. Ninety patients of both sexes, aged 25- 75 years, ASA I-III scheduled for vitreoretinal surgery. They were randomly allocated into 3 equal groups each received peribulbar block a mixture of Levo- bupivacaine 0.5% (3 ml) + lidocaine 2% (3 ml) +120 IU hyaluronidase + Control group (C): 0.5 ml of Normal saline. Group (M): 50 mg of Magnesium sulphate in 0.5 ml normal saline. Group (D): 50 μic of dexmedetomidine in 0.5 ml normal saline. The duration of sensory, motor block, Sedation level, Intra-ocular Pressure (IOP) and surgeon satisfaction were assessed. The onset of globe anesthesia and akinesia was significantly shorter in M group in comparison with D and C Groups, with a significant increase in the duration of globe analgesia and akinesia in the D Group when compared to both M & C groups. Groups D and M showed a statistically significant decrease in the IOP at 5 min and 10 min when compared to the baseline measurement of the same groups & to C Group, no complications or adverse effects related to the drug or technique were recorded. Magnesium sulphate as a local anesthetic adjuvant in peribulbar block is safe and comparable to dexmedetomidine regarding the sensory and motor block duration with better cost-effectiveness and availability.
{"title":"Efficacy and Safety of Magnesium versus Dexmedetomidine as Additives to Local Anesthetic Mixture Using Single Injection Percutaneous Peribulbar Anesthesia in Vitreoretinal Surgeries","authors":"A. Shoukry, Amr Sobhy Abd el Kawy","doi":"10.2174/2589645801812010094","DOIUrl":"https://doi.org/10.2174/2589645801812010094","url":null,"abstract":"\u0000 \u0000 Peribulbar block for vitreoretinal surgery is rather associated with delayed onset of globe anesthesia, akinesia and short duration of analgesia.\u0000 \u0000 \u0000 \u0000 \u0000 To compare the effect of addition of Magnesium sulphate vs dexmedetomidine to standard local anesthetics mixtures on the time of onset of Globe Anesthesia, Akinesia & analgesia duration.\u0000 \u0000 \u0000 \u0000 Ninety patients of both sexes, aged 25- 75 years, ASA I-III scheduled for vitreoretinal surgery. They were randomly allocated into 3 equal groups each received peribulbar block a mixture of Levo- bupivacaine 0.5% (3 ml) + lidocaine 2% (3 ml) +120 IU hyaluronidase + Control group (C): 0.5 ml of Normal saline. Group (M): 50 mg of Magnesium sulphate in 0.5 ml normal saline. Group (D): 50 μic of dexmedetomidine in 0.5 ml normal saline. The duration of sensory, motor block, Sedation level, Intra-ocular Pressure (IOP) and surgeon satisfaction were assessed.\u0000 \u0000 \u0000 \u0000 The onset of globe anesthesia and akinesia was significantly shorter in M group in comparison with D and C Groups, with a significant increase in the duration of globe analgesia and akinesia in the D Group when compared to both M & C groups. Groups D and M showed a statistically significant decrease in the IOP at 5 min and 10 min when compared to the baseline measurement of the same groups & to C Group, no complications or adverse effects related to the drug or technique were recorded.\u0000 \u0000 \u0000 \u0000 Magnesium sulphate as a local anesthetic adjuvant in peribulbar block is safe and comparable to dexmedetomidine regarding the sensory and motor block duration with better cost-effectiveness and availability.\u0000","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89744363","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 : 2018-12-24DOI: 10.2174/2589645801812010069
V. RaoKadam, Arun Kumar
{"title":"Likely Local Anaesthetic Toxicity Following Dorsal Penile Nerve Block in an Adult. Early detection and Treatment with Lipid","authors":"V. RaoKadam, Arun Kumar","doi":"10.2174/2589645801812010069","DOIUrl":"https://doi.org/10.2174/2589645801812010069","url":null,"abstract":"","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"21 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72665881","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 : 2018-12-24DOI: 10.2174/2589645801812010085
R. Mostafa, A. Saleh, M. Hussein
The delivery of aerosolized drugs is a vital component of treatment for many respiratory disorders. We used this mode of medication delivery as a pre-emptive strategy to alleviate a Postoperative Sore Throat (POST) in children receiving general anesthesia. The primary aim of the study was to compare the effects of prophylactic ketamine, magnesium sulfate and dexamethasone nebulization, on the intensity of POST. Through a prospective, randomized, double-blind study, data were collected from children (6-16 years) undergoing surgeries from March 2018 to May 2018. The patients were allocated into 3 equivalent groups (36 patients each). Preoperative nebulization was performed for all patients. Group M received 40 mg/kg magnesium sulphate, group K received 1 mg/kg ketamine, and group D received 0.16 mg dexamethasone. The primary outcome of the study was the incidence and intensity of POST at the 4th postoperative hour. The secondary outcomes included evaluation of adverse effects specifically nausea, vomiting, postoperative cough and postoperative sedation. Patients in the K group had the lowest incidence of POST compared to patients in groups M and D, specifically, at the 4th - postoperative hour (p-value = 0.003). Preoperative nebulization with ketamine was more effective in reducing the intensity of POST in pediatric patients postoperatively without systemic adverse effects.
{"title":"A Comparative Study of Three Nebulized Medications for the Prevention of Postoperative Sore Throat in the Pediatric Population","authors":"R. Mostafa, A. Saleh, M. Hussein","doi":"10.2174/2589645801812010085","DOIUrl":"https://doi.org/10.2174/2589645801812010085","url":null,"abstract":"\u0000 \u0000 The delivery of aerosolized drugs is a vital component of treatment for many respiratory disorders. We used this mode of medication delivery as a pre-emptive strategy to alleviate a Postoperative Sore Throat (POST) in children receiving general anesthesia.\u0000 \u0000 \u0000 \u0000 The primary aim of the study was to compare the effects of prophylactic ketamine, magnesium sulfate and dexamethasone nebulization, on the intensity of POST.\u0000 \u0000 \u0000 \u0000 Through a prospective, randomized, double-blind study, data were collected from children (6-16 years) undergoing surgeries from March 2018 to May 2018. The patients were allocated into 3 equivalent groups (36 patients each). Preoperative nebulization was performed for all patients. Group M received 40 mg/kg magnesium sulphate, group K received 1 mg/kg ketamine, and group D received 0.16 mg dexamethasone. The primary outcome of the study was the incidence and intensity of POST at the 4th postoperative hour. The secondary outcomes included evaluation of adverse effects specifically nausea, vomiting, postoperative cough and postoperative sedation.\u0000 \u0000 \u0000 \u0000 Patients in the K group had the lowest incidence of POST compared to patients in groups M and D, specifically, at the 4th - postoperative hour (p-value = 0.003).\u0000 \u0000 \u0000 \u0000 Preoperative nebulization with ketamine was more effective in reducing the intensity of POST in pediatric patients postoperatively without systemic adverse effects.\u0000","PeriodicalId":22862,"journal":{"name":"The Open Anesthesia Journal","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77845941","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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