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Article
Clinical evaluation of TIVA by romifidine as a premedication, midazolam and ketamine in donkeys
التقييم السريري لنظام التخدير العام الاحداث والادامة بالحقن الوريدي باستخدام الرومفدين والميدازولام والكيتامين في الحمير

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Abstract

The objective of this study was to determine the clinical effects of total intravenous anesthesia (TIVA) by romifidine 0.1mg/kg as a premedication and anesthesia by intravenous injection of a mixture of midazolam 0.1 mg/kg and ketamine hydrochloride 2.2 mg/kg in the ten health She donkeys. The maintenance of anesthesia was performed by intravenous infusion of a mixture of the midazolam 0.065mg/kg/hrs and ketamine 6.6mg/kg /hrs prepared in 500ml normal saline. Data were collected just before intravenous administration of premedication (control data) and after the administration of anesthetics drugs at 5, 10, 15, 20, 25, 30, 45, 60 and 90 minutes. The clinical parameters measured included: Anesthetic Parameter (induction, anesthetic time and recovery), rectal body temperature, arterial oxyheamglobin saturation in blood (SPO2), analgesia, muscles relaxation, at the above times until the donkey responds to external stimuli. The results of the induction and maintenance of general anesthesia by this regime was found to be superior and stable. Recovery from anaesthesia was smooth and similar quality in all animals. The body temperature showed significant differences between control and 5min 37.35 ± 0.054 ;37.19 ± 0.08 ◦C with 15 min and above to the 60 min, while in SPO2 (%) the result showed significant difference (P<0.05) in time 90 min 97.4 ± 0.541 with 10min ; 15min 94.6 ± 1.229 ;93.7 ± 1.075 %and 20 min 93.9 ± 1.075%. There were no adverse effects noted following this anesthetic regime.

هدفت هذه الدراسة قياس التأثيرات السريرية الناتجة عن استخدام برنامج التخدير العام في الحمير باستخدام الرومفدين بجرعة 0.1 ملغم كغم من وزن الجسم كعلاج تمهيدي ما قبل التخدير يعقبه احداث التخدير العام بحقن مزيج من الميدازولام بجرعة 0.1 ملغم كغم من وزن الجسم مع عقار الكيتامين بجرعة 2.2 ملغم كغم من وزن الجسم. تم ادامة التخدير العام بالحقن الوريدي لمزيج الميدازولام 0.065 ملغم كغم ساعة وعقار الكيتامين بجرعة 6.6 ملغم كغم ساعة ممزوجة ب 500 مل من محلول الملح الوريدي. استعملت عشرة من الحمير المحلية وتم قياس قيم المعايير السريرية قبل الحقن واعتبرت كقيم سيطرة وكذلك تم قياسها بالأوقات 5و10و 15و 20و 25و30و 45و 60 و 90 دقيقة بعد الحقن للأدوية المخدرة. شملت المعاير درجة حرارة الجسم وتشبع الدم بالاوكسي هيموكلوبين ودرجة تسكين الالم وارتخاء العضلات الهيكلية كما و تم قياس وقت احداث التخدير العام ووقت الافاقة. اظهرت نتائج التجربة ان احداث وادامة التخدير بهذا البرنامج كان فائق الجودة ومستقرة كما وان الافاقة من التخدير بهذا البرنامج كانت سلسة وبدون تعقيدات. سجل وجود فرق معنوي في درجة حرارة الجسم ونسبة تشبع الدم بالاوكسي هيموكلوبين كما لم تسجل اي تأثيرات سلبية مؤثرة في هذا البرنامج.

Keywords

TIVA --- romifidine --- midazolam --- ketamine.


Article
Comparison between Total Intravenous Anesthesia (TIVA) and Conventional General Anesthesia in Day Case Surgical Procedures

Authors: Iyad Abbas Salman --- Ali Yousif Mohammad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 700-705
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Day case surgery should be of short duration, rapid recovery, and with low incidence of postoperative complications. For long time was done with conventional inhalational based anesthesia, in last year's, TIVA began to be used in these surgeries.OBJECTIVE:To evaluate total intravenous anesthesia (TIVA), as an aesthetic technique for day case procedures and to compare it with conventional inhalational based technique in terms of intra and postoperative hemodynamic and respiratory changes, postoperative recovery and postoperative vomiting.PATIENTS AND METHODS: This is a prospective randomized study has been done on 100 patient who underwent general anesthesia for short duration surgical procedure in AL- Jumhory teaching hospital in Al-Mosul city in Iraq, during the period between Nov 1st, 2011 and March 1st, 2012 , All patients were allocated into either TIVA or inhalational (INH) groups, of 50 patient each. In TIVA group: induction and maintenance of anesthesia done by propofol. While in INH group: maintenance of anesthesia done by halothane. Blood pressure, pulse rate, respiratory rate were monitored at a specific time. Recovery time was recorded according to Aldrete score. Any episode of vomiting was recorded.RESULTS: Aldrete score of ≥ 9 was achieved earlier in the TIVA group than in the INH group. It was also observed that there was initial fall in HR, MAP and respiratory rate in the both group, and post operative vomiting was less in the TIVA group.CONCLUSION: The time needed for recovery and episodes of postoperative vomiting in TIVA is less than in inhalational anesthesia.KEYWORDS: TIVA, propofol, day case surgery.


Article
A Comparison of Using Ketamine Versus Combination of Ketamine and Thiopentone in Short Painful Procedures in Pediatrics

Authors: Iyad Abbas Salman --- Saba J. AL-Wardi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 1 Pages: 103-109
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Short painful procedures in pediatric age group like bone marrow aspiration (BMA) and biopsy taking are day case operations which demand rapid recovery and minimal incidence of postoperative complications.OBJECTIVE: To compare between intra & postoperative complications & the time of stay in the recovery room for pediatrics undergoing short painful procedures under general anesthesia with either "ketamine and thiopental" or "ketamine alone".PATIENTS AND METHOD: THIS IS A PROSPECTIVE RANDOMIZED clinical trial done in Children Welfare Hospital in Medical City, Baghdad, Iraq, from August - November 2010 on 89 children patients who were scheduled for short painful procedures. All patients were allocated randomly into 2 groups: the 1st group (KT) received I.V ketamine 1% (1mg/kg) plus I.V thiopental 1% 3-5 mg/kg (anesthetizing dose) on induction and maintained on intermittent I.V doses of thiopental 1% in case of need. While the 2nd group(K) received I.V ketamine 1% (1.5mg/kg) alone on induction and maintained on intermittent I.V doses of ketamine 1%(0.5mg/kg) in case of need. Any intra or postoperative complications & the duration of recovery for all patients were recorded. RESULTS:It was found that the intraoperative complications (temporary & mild decrease in arterial O2 saturation and its associated breath holding, & cough) occurred more in the KT group, while the occurrence of (mild involuntary movements and verbal responses) occurred more frequently in the K group. The postoperative complications (nausea, vomiting, verbal hallucinations and dizziness) occurred only in the K group. The duration of recovery is more prolonged in the (KT) group.CONCLUSION: The use of combination of thiopentone and ketamine is associated with more mild and temporary intraoperative decreased arterial oxygen saturation, breath holding, and postoperative cough than using ketamine alone, while the use of ketamine alone is associated with more mild involuntary movements and verbal responses, postoperative nausea &/or vomiting, hallucinations, and dizziness. The duration of recovery is prolonged by the use of thiopental.KEY WORDS: ketamine, thiopental, TIVA, pediatrics, day case.

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