... of this study was to compare the effectiveness of spinal anesthesia with subdiaphragmatic lidocaine at the beginning of surgery versus spinal anesthesia in pain reduction for gynecological laparoscopic surgery.This was a clinical trial conducted in Arash ... significant difference in patients' postoperative VAS scores compared to spinal anesthesia and GA during and after gynecological surgical procedures.
... of vital signs monitors and working ventilators in PACUs and the CCU. In 2015, there were 10,319 anesthetics administered, with obstetric and gynecologic, general, and orthopedic procedures comprising 62% of surgeries. From 2011 to 2015, all-cause perioperative mortality rate in ORs and PACUs was 0.65% or 1 death per 154 anesthetics, with 99% of deaths occurring in PACUs.
Only English language literature was included. Papers concerning aortic stenosis and obstetricalanaesthesia were excluded.There are no randomised clinical trials on the subject, and existing literature is extremely sparse. Four retrospective studies and eight case reports counting a total of ten patients were found. All report successful use of neuroaxial blockade in patients with aortic stenosis, without severe haemodynamic ...
To determine the necessary mean infusion rate of propofol during combined nitrous oxide (N2O) and propofol spinal anesthesia by using the processed electroencephalogram (pEEG).Twelve elective gynecological patients were monitored by a Dräger pEEG monitor under N2O and propofol spinal anesthesia. To make it easier to detect an inadequate depth of anesthesia, muscle relaxants were not given and the patients ...
Background: Anaesthetists use dexamethasone principally for its anti-emetic effect. The purpose of this study was to characterize the effects of a single intraoperative dose of dexamethasone on cellular and metabolic components of the immune system in patients undergoing laparoscopic surgical procedures.
Methods: In this prospective double-blind trial, female patients undergoing elective major laparoscopic surgery were randomized to receive saline (Control group, n =16) or dexamethasone 4 mg (Dexamethasone group, n =16) i.v. after the induction of anaesthesia. Inflammatory markers and immune cell counts were examined at 24 and 48 h and 6 weeks after surgery. The changes from baseline preoperative values were compared between groups using a Mann-Whitney U -test, and linear mixed models were used to validate the findings.
Results: No differences in concentrations of serum glucose and interleukin-6 were observed between groups after surgery. The increase in C-reactive protein concentration at 24 h after surgery was greater in the control group [median (interquartile range), 33 (25-65) vs 17 (7-26) mg dl -1 ; P =0.018]. Extensive changes in the counts of white cells, including most lymphocyte subsets, were observed 24 h after surgery, and dexamethasone appeared to attenuate most of these changes. Changes at 48 h and 6 weeks did not differ between groups.
Conclusions: In female patients undergoing elective laparoscopic gynaecological surgery, dexamethasone administration appears to attenuate inflammation and to alter immune cell counts at 24 h, with no effects identified after this time. The importance of these changes for postoperative immune function is unknown.
Trial registration: Australia and New Zealand Clinical Trials Registry (ACTRN12608000340336).
Following epidural lidocaine anesthesia with or without light general anesthesia for major gynecological surgeries, 59 patients received epidural morphine (EPM) 2 mg (group M), 21 patients received morphine 2 mg plus 0.25% plain bupivacaine 6-10 ml epidurally (group B), and 28 patients received morphine 2 mg plus fentanyl 100 ...
We have studied the effect of glucose concentration on the spread of tetracaine spinal anesthesia in 40 parturient patients. Forty women undergoing cesarean section received a subarachnoid injection of tetracaine 8 mg dissolved in either 5% or 10% glucose solution. The maximum cephalad spread of analgesia [median (range)] was higher with 10% glucose [T3 (T4-C8)] than with 5% glucose [T4 (T5.5-T2)]. The time from the spinal injection to the maximum spread of analgesia (mean ± SD) was significantly shorter with 10% glucose (15 ± min) than with 5% glucose (28 ± 16 min). The cumulative dose of ephedrine was higher with 10% glucose (19 ± 10 mg) than with the 5% glucose (13± 8 mg). In tetracaine spinal anesthesia, the rate of onset of analgesia was faster and the maximum level of analgesia was higher in the 10% glucose solution than in the 5% glucose solution.
BACKGROUND: Identifying the epidural space is essential during epidural anesthesia (EA). Pressure of the epidural space in pregnancy is higher than that in nonpregnant woman. Loss of resistance (LOR) method is the most commonly preferred method for identifying the epidural space. Epidrum and Epi-Jet are recently innovated supporting devices that facilitate identifying process for epidural space. In this study we aimed to compare Epidrum, Epi-Jet, and LOR methods in identifying the epidural space, feasibility of technique.
METHODS: Two hundred and forty pregnant women who were scheduled for caesarian section surgery under lumbar EA or combined spinal epidural anesthesia (CSEA) were randomized into three groups (Group I Epidrum, n = 80), Group II (Epi-Jet, n = 80), and Group III (LOR, n = 80). We recorded the time required to identify the epidural space and deflation of Epidrum balloon and Epi-Jet syringe, number of attempts, additional methods used to identify epidural space, usefulness of methods, accuracy of identification of epidural space, and outcomes of epidural catheterization.
RESULTS: There were no significant differences between the groups with respect to demographic data, duration of deflation of Epidrum balloon and Epi-Jet syringe and distance between skin and epidural space. The mean time required to enter epidural space in Group I was shorter than that in Group II (P = 0.031). Feasibility of Epi-Jet was easier than that of Epidrum (P = 0.015). Number of uncertainties of epidural space identification was higher in Group I than that in Group II (P = 0.009). Also, the requirement for LOR to confirm epidural space and failure rates was higher in Group I than Group II (P < 0.001).
CONCLUSION: We suggest that Epi-Jet is superior to Epidrum in pregnant patients in terms of clarity of epidural space identification, usefulness, and success rates of EA or CSEA.
BACKGROUND AND OBJECTIVES: Programmed intermittent epidural bolus (PIEB) is a delivery mode associated with decreased local analgesia dosing, motor block, and physician-administered top-ups (PATU) during labor analgesia. We hypothesized that PIEB delivery at different settings will result in fewer PATU for labor analgesia than the same hourly volume of a continuous epidural infusion (CEI).
METHODS: 'Before and after' study design of combined-spinal epidural (CSE) for labor, with bupivacaine 0.0625%-fentanyl 2mcg/ml and patient-controlled epidural analgesia (PCEA; 5ml bolus with 10min lockout). The 'before' group (N = 120) received a CEI at 10ml/hour. PIEB groups received a programmed bolus of 10mL: every 60min (PIEB60, N = 120), every 45min (PIEB45, N = 140), or every 45min with high flow (500ml/hour) (PIEB45HF, N = 25).
MAIN OUTCOME MEASURES: Number of women requesting a PATU, time intervals from CSE to PATU and to delivery, and obstetric outcomes.
RESULTS: There was no difference in proportion of women requesting PATU between CEI and PIEB60 groups (45/120 versus 52/120, respectively; p > 0.05). PATU rate was lower in PIEB45 group compared with PIEB60 and CEI groups (23/140 versus 52/120 and 45/120, p < 0.005 and p < 0.05, respectively), and in PIEB45HF versus PIEB60 (5/25 versus 52/120, p < 0.05). No difference in other outcomes was observed.
CONCLUSIONS: The number of women requesting a PATU was lowest with PIEB45 and PIEB45HF settings. There were no differences in any other outcomes between groups. This study emphasizes the many variations in programming that need to be further tested to establish the benefits of PIEB delivery compared with traditional CEI with PCEA.
The incidence of sore throat was evaluated among 80 healthy (ASA 1 and 2) nonpremedicated adult patients undergoing general anesthesia for general, plastic, urologic, gynecologic, and orthopedic surgery. The patients were randomly allocated in two groups: group one (n=39) consisted of patients in whom the airway was maintained by a laryngeal mask, and in group 2 (n=40), orotracheal ...
Muscular and Skeletal Diseases (1) Sore Throat (5), more mentions