Background: The purpose of this study was to compare the onset and duration of sensory and motor block, as well as the hemodynamic changes and level of sedation, following intrathecal bupivacaine supplemented with either dexmedetomidine or clonidine. Methods: In a prospective, double-blind study, 60 patients undergoing transurethral resection of prostate or bladder tumor under spinal anesthesia were randomly allocated to one of three groups. Group B received 12 mg of hyperbaric bupivacaine, group D received 12 mg of bupivacaine supplemented with 3 mg of dexmedetomidine and group C received 12 mg of bupivacaine supplemented with 30 mg of clonidine. The onset times to reach peak sensory and motor levels, and the sensory and motor regression times, were recorded. Hemodynamic changes and the level of sedation were also recorded. Results: Patients in groups D and C had a significantly shorter onset time of motor block and significantly longer sensory and motor regression times than patients in group B. The mean time of sensory regression to the S1 segment was 303 AE 75 min in group D, 272 AE 38 min in group C and 190 AE 48 min in group B

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SummaryDuring apnoea following induction of anaesthesia, morbidly obese patients may suffer a rapid decrease in oxygen saturation. This study compares pre-oxygenation alone with pre-oxygenation followed by nasopharyngeal oxygen insufflation on the onset of desaturation occurring during the subsequent apnoea. A randomised controlled trial was performed in 34 morbidly obese patients undergoing gastric bypass or gastric band surgery. Seventeen patients received nasopharyngeal oxygen supplementation following pre-oxygenation (Study group, body mass index = 41.8 (6.9) kg.m ). Time from the onset of apnoea until S p O 2 fell to 95% was compared between the two groups with a cut-off of 4 min. In the control group, the S p O 2 fell from 100% to 95% during the subsequent apnoea in 145 (27) s, with a significantly negative correlation (r 2 = 0.66, p < 0.05) between the time to desaturation to 95% and the body mass index. In the study group, the S p O 2 was maintained in 16 of 17 patients at 100% for 4 min when apnoea was terminated. In conclusion, nasopharyngeal oxygen insufflation following pre-oxygenation in morbidly obese patients delays the onset of oxyhaemoglobin desaturation during the subsequent apnoea.

Epidural morphine has been used for postoperative analgesia. However, many side effects such as nausea, vomiting, pruritus, urinary retention, and delayed respiratory depression have been reported. 1-6 Although rare, delayed resporatory depression is the most serious complication and may occur several hours after the administration of epidural morphine.One(m-methylphenyl)-2-(dimethylaminoethyl)-cyclohexan-l-01(tramadol; Tramal*) 7 is a new synthetic opioid CAN J ANAESTH 1993 / 40:4 / pp 308-13

In this double-blinded, placebo-controlled study, we examined the efficacy of a single dose of dexamethasone 0.5 mg/kg IV on posttonsillectomy vomiting and oral intake in children 2-12 yr old. Dexamethasone significantly decreased the incidence of postoperative vomiting during the first 24 h, shortened the time to the first oral intake and the duration of IV hydration, and improved the quality of oral intake and the satisfaction scores of the patients.

Anaesthesia and myasthenia gravis

There was no difference in the incidence of hypotension in women who received colloid administration before the initiation of spinal anesthesia compared with at the time of initiation of anesthesia. Both modalities are inefficient as single interventions to prevent hypotension.