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Article
The Role of Gabapentin in Prevention of Remifentanil-Induced Hyperalgesia

Author: Iyad Abbas Salman*, Bashar Zuhair Talib**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 1 Pages: 1-5
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Remifentanil is widely used as intraoperative analgesic. Post infusion hyperalgesia has been documented experimentally in both animal and human volunteers. Gabapentin has anti-hyperalgesic effect.OBJECTIVE: To evaluate the effect of single preoperative oral dose of 300 mg gabapentin in attenuation of postoperative hyperalgesia induced by remifentanil and the decrease in post-operative analgesic requirement.PATIENT AND METHOD: A prospective randomized clinical trial conducted in Tikrit teaching hospital/ Iraq, at 2013. It involves 60 patients who underwent appendectomy. All patients were randomly allocated into two equql groups (each of 30 patients): First controlled group (CG) didn’t pre-medicated with gabapentine and 2nd gabapentine group (GG) pre-medicated with gabapentin. Intraoperative infusion of remifentanil was used & postoperative pain was assessed in all cases. RESULTS: The numerical analog scale NAS score and analgesia requirement post operatively was significantly higher in most times in the (CG) as compared with those of the (GG).CONCLUSION: Premedication with 300mg gabapentin orally decreased hyperalgesic effect induced by remifentanil and so decreased the pain score and the analgesic requirement postoperatively.


Article
Time From Giving Reversal to Train of Four 90 %: A Comparison Between Inhalational Anaesthesia and Propofol

Author: Iyad Abbas Salman*, Reem Abbas Naem**, Ali Mohammed Kareem Naji
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 2 Pages: 114-120
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: The train-of-four (TOF) ratio should return to at least 90% to exclude potentially clinically significant postoperative residual block. The time gap between clinical recovery (subjective) until objective recovery (i.e. TOF ratio has returned to _0.90) can be considered “the potentially unsafe period of recoveryOBJECTIVE:To determine the time difference (from giving the reversal drugs till reach TOF90% readings by acceleromyography) between patients maintained on propofol and those maintained on halothane.PATIENTS AND METHOD: A prospective clinical trial study100 females underwent caesarian section divided into inhalational anaesthesia group (maintained on inhalational anaesthesia-halothane) and propofol group (maintained on propofol infusion after delivery of the baby till the end of operation) then recovery is monitored using acceleromyography.RESULT: Times from giving reversal of the muscle relaxant till extubation and time from giving reversal till reading of TOF90% were significantly lower in propofol group than in inhalational group. CONCLUSION: Patients maintained on propofol was extubated earlier than those maintained on inhalational anaesthesia also needed less time to reach TOF90% i.e. inhalational anaesthesia augment muscle relaxation more than propofol..


Article
Evaluation of Endotracheal Intubation with and without Neuromuscular Blocking in Pediatric Anesthesia

Author: Iyad Abbas Salman*, Reem Abbas Naem**, Aras As.Sediq
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 3 Pages: 220-224
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Endotracheal intubation is an important step in airway control in pediatric age group, the drugs used for this purpose are ultra-short acting hypnotic agents plus neuromuscular blocking agents (NMBA). NMBA have many serious side effects.OBJECTIVE :To evaluate endotracheal intubation without using NMBA, and assess the intubation conditions and hemodynamic response to this method of intubation in pediatric age groupPATIENTS AND METHOD: This is a prospective randomized double blind study done in Rizgary teaching general hospital from 1/ October to 1/ December 2012 included 60 patients age 4-8 years,American society of anesthesiologist (ASA) I or II.Patients were allotted to one of these two groups randomly 30 patients per each group. Group (F): those patients that receive Fentanyl 4 μg/kg I.V +Propofol 3 mg/kg I.V. Group (S): those patients that receivePropofol 3 mg/kg +suxamethonium 1 mg/kg I.V. Intubation conditions and hemodynamic changes have been measured and compared between both groups.RESULTS:In group F acceptable intubation conditions were obtained in 27 (89%) patients.whileFair intubation conditions occurred in only 3 (11%) patients. In group S acceptable intubation conditionsoccurred in 30 (100%) of patients.In S group there was a significant rise in systolic arterial pressure(SAP) and heart rate (HR) in 0, 1, 3 minute after intubation (P<0.001).In F group there was significant decrease in SAP (P<0.001) in post induction reading. In F group there was non-significant decrease in HR in post intubation time 1, 3 minutes (P>0.05).CONCLUSION:Endotracheal intubation can be accomplished in pediatric age group using Fentanyl and Propofol without the need to use muscle relaxant with acceptable hemodynamic response.KEY WORDS: endotracheal intubation, fentanyl, Propofol, suxamethonium.

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