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Article
The Role of Dexamethasone in Reducing the Severity of Postoperative Sore Throat

Authors: Hassan Sarhaan Haider --- Bashar Taha Al-Ali*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 3 Pages: 454-459
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ACKGROUND: Effect of intravenously administered dexamethasone in reducing the incidence and severity of postoperative sore throat in patients receiving general anesthesia with endotracheal intubation. OBJECTIVE: To investigate the effect of dexamthasone administered intravenously preoperative in reducing post opretive sore throat METHODS: 80 patients receiving general anesthesia with endotracheal intubation in randomized double blindedplacebo controlled were randomly assigned to two groups: group1(control) patients receivingnormal saline 2 mLiv and group 2 (D) patients received dexamethasone 8 mg iv. After surgery,visual analogue scale(VAS) scores at rest and with effort (swallowing movment) for post operativesore throat were recorded. RESULTS: This study revealed that post operative sore throat during the first 24 hr following surgery waslower in dexamethasone group(D) compared to the control group(C).Nine (22.4%) patients in thedexamethasone group had postoperative sore throat, compared to 23(57.5%)patients in the controlgroup (p<0.01). Postoperatively at one hour,threehours, six hours, 12 hours and 24 hours, the VASscores for postoperative sore throat at rest and during effort were lower in dexamethasone group(D) compared to the control group(p<0.01) at corresponding time intervals. CONCLUSION: Preoperative administration of dexamethasone 8mh iv reduces the incidence and severity ofpostoperative sore throat in patients receiving general anesthesia with endtacheal intubation


Article
COMBINATION OF ROCURONIUM WITH PROPOFOL TO AID ENDOTRACHEAL INTUBATION IN EMERGNCY CESAREAN SECTION

Authors: Edwar Z Khosho --- Mohammad Radhi Al-Rekaby
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 2 Pages: 55-60
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract This study aimed to verify that rocuronium can be used as an alternative to succinylcholine for rapid sequence intubation in emergency cesarean section. A study conducted on 300 ladies in Al-Basrah Maternity and Childbirth Hospital between February 2013 to November 2014. Assessment of the effectiveness of rocuronium 0.6 mg/kg with propofol as an intubating dose for emergency caesarean section. The intubation conditions of rocuronium was compared with succinylcholine 1mg/kg as standard muscle relaxant of choice. Rocuronium 0.6 mg/kg with propofol resulted in 94% clinically acceptable (good to excellent) intubation conditions but for succinylcholine it was 95-97%. In conclusion, although succinylcholine creates excellent intubation conditions in emergency caesarean section, rocuronium proved its efficacy as a good alternative choice for succinylcholine.


Article
Comparative Effects of Fentanyl, Medazolam, Lignocaine and Propranolol on Controlling the Hemodynamic Pressor Response during Laryngoscopy and Intubation

Author: May S. Al-Sabbagh مي صديق طه الصباغ
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2010 Volume: 19 Issue: 2 Pages: 24-30
Publisher: Baghdad University جامعة بغداد

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Abstract

Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in each group), assigned as F, M, L and P groups. Each patient in the four groups received 1 µg/kg i.v fentanyl. Patients in groups M, L and P are treated with 0.2 mg/kg i.v medazolam, 1.5mg/kg i.v lignocaine and 0.01mg/kg i.v propranolol respectively. Induction of anesthesia was then accomplished with 2mg/kg thiopental sodium followed by1.5mg/kg succinylcholine. Tracheal intubation was performed 2 minutes after induction of anesthesia. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were measured before induction, after induction and at 2, 4, 6 and 8 minutes after intubation. The results indicated no significant variation in the hemodynamic pressor response in all four groups with tracheal intubation. In conclusion, a minimum effective dose of i.v pre-medications (fentanyl, medazolom, lignocaine and propranolol) were found to be individually successful in attenuating and providing a reliable control of all hemodynamic response changes accompanied the process of laryngoscopy and intubation. Therefore, all are proved effective premedication and no one being superior.

يعتبر تنظير الحنجرة والقصبة الهوائية وكذلك التنبيت محفز غزوي أثناء التخدير , كلاهما يثير ردود أفعال القلب والأوعية الدموية التي تشمل ارتفاع ضغط الدم وعدم انتظام ضربات القلب وخلل النظم , وقد استخدمت أساليب مختلفة من شانها أن تحد أو تخفف ردود الفعل من هذا القبيل . لقد تم تصميم هذه الدراسة لتقييم تأثير كل من الميدازولام , اليكنوكين والبروبرانولول باعتبارها مواد مساعدة ذات قيمة للفنتانيل في الدورة الدموية لتخفيف ردود الفعل غير المرغوب فيها خلال عملية التنبيت الرغامي للمرضى ذو الضغط الطبيعي . تم التوزيع العشوائي لاثنين وثلاثين حالة صنفت اعتماداً على نظم الجمعية الامريكية لأطباء التخدير , حال الأول أو الثاني من المرضى , من الذين تقرر إجراء عملية جراحية لهم تحت التخدير العام بالانتخاب القياسي . تم تقسيمهم إلى أربع مجاميع ( 8 مرضى في كل مجموعة ) ، ورمز لهم بالأحرف فاء ، ميم ، لام وياء . تلقى كل مريض في الأربع مجموعات 1 ميكروغرام / كغم من الفنتانيل وريديا . وتعالج المرضى في مجموعات ميم ، لام ، ياء بمقدار 0.2 ملغم / كغم ميدازولام وريديا 1.5 ملغم /كغم لكنوكين وريديا 0.01 ملغم / كغم بروبرانولول وريديا على التوالي . تم بعدها استقراء التخدير مع 2 ملغم /كغم من الصوديوم ثايوبنتون يتبعه 1.5ملغم /كغم من السكسنيل كولين .نفذ التنبيت الرغامي بعد 2 دقيقة من تحريض التخدير ، وتم قياس معدل نبضات القلب وضغط الدم الانقباضي ، ضغط الدم الانبساطي ، الضغط الشرياني ومعدل ضغط المنتج قبل الاستقراء ، وذلك عند الحث ثم بعد 2 ،4،6،8 دقائق بعد التنبيت ، أوضحت النتائج عدم وجود اختلاف كبير في استجابة إثارة ردود القلب أو الدورة الدموية في جميع الفئات الأربعة أثناء تنبيت القصبة الهوائية . في الختام تبين إن جرعة الحد الأدنى الفعالة من قبل الأدوية الأربعة ( الفنتانيل ، الميدازولام ، الكنوكين والبروبرانولول) ناجحة في تخفيف حدة جميع التغيرات التي تصاحب عملية تنظير الحنجرة والتنبيت وتوفير مراقبة موثوق بها لذا فكل من هذه المواد المساعد تعتبر مفضلة وليس هنالك من هو أفضل من الآخر بينهما .


Article
The effect of atropine on heart rate with rapid sequence induction in neonates

Author: Ahmed Haki Ismael Al-Rawee
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 2 Pages: 53-57
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: neonates experience physiological responses toendotracheal intubation, including bradycardia and oxygen desaturation.The bradycardia may be associated with severe hemodynamicdisturbances like significant hypotension which may threaten patient'ssafety.Aims: To determine the effectiveness of single dose IV atropine, 5minutes before induction of anesthesia on reflex bradycardia tolaryngoscopy in sick neonate baby.Patients and Methods: In a randomized double blinded, placebocontrolled clinical trial, thirty neonates aged 1-10 days, term, 2.5-3.5kgand from both sexes, were enrolled to receive 0.02mg/kg IV atropine(n=15), as study group and placebo group had received equivalentvolume of normal saline five minutes before induction of anaesthesia(n=15), as control group. The induction technique was the same in allpatients. The incidence of bradycardia just after intubation wasrecorded.Results: data analyses showed that the overall incidence of bradycardiajust after intubation in the study group was significantly lower than thecontrol group.Conclusions: A single dose IV atropine five minutes before induction ofanaesthesia in neonate baby significantly decreases the incidence ofbradycardia after intubation.


Article
eamodynamic Changes During Airway Managment in Hypertensive Patients Undergoing Abdominoplasty Surgery

Authors: Ali Abdulhamed Mohamed --- Abbas Mohamed Suhan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 509-514
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND:Avoidance of heamodynamic changes in hypertensive patients receiving general anesthesia is a goal including patients undergoing abdominoplasty surgery.OBJECTIVE: To compare haemodynamic responses to use of a classic laryngealmask airway (LMA) versus endotracheal tube (ETT) in hypertensive females undergoing abdominoplasty surgery.PATIENT AND METHODS:Place and Duration of study: Al-Amaal private hospital from march. 2012 to march 2014. Fifty hypertensive female patient undergoing abdominoplasty surgery were randomly distrusted into two equal groups using alternate patient technique endotracheal tube( ETT ) and laryngeal mask airway (LMA) ( n=25 each). Patients in both groups were received general anaesthesia using standard anesthetic technique.Patients in ETT group underwent laryngoscopy and ETT intubation, whereas patients in LMA group received LMA without laryngoscopy for their airway maintenance. Haemodynamic variables, (pulse, systolic, diastolic and mean arterial pressures) were measured using non-invasive monitoring technique at various intervals before and after intubation or LMA placement , before and after extubation or LMA removal.CONCLUSION: Laryngeal mask airway provide more stable heamodynaics parameter than endotracheal tube during incertion and removal in hypertensive patients receving general anesthesia for abdominoplasty surgery.

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