LMA is a suitable method for paediatric patients undergoing sinonasal surgery because it offers airway protection from blood contamination comparable to that of a standard uncuffed ETT with throat pack.
Objective:This study was designed to determine the efficacy of dexmedetomidine (a highly selective alpha-2 agonist) in achieving fast tracking and improved postoperative pain control in off-pump coronary artery bypass (OPCAB) patients.Methods:Thirty patients scheduled for elective OPCAB were prospectively randomized into two groups: Group I (15 patients) started dexmedetomidine at 0.5 ug/kg/hour after the induction of anesthesia; this was reduced to 0.3 ug/kg/hour on admission in the cardiac intensive care unit and continued for 12 hours post extubation. Group II (15 patients) received a similar volume and infusion rate of normal saline. Visual analog scale (VAS) of 10-100 was explained thoroughly to the patients during the preoperative visit. Postoperative pain was managed with morphine. The total dose of morphine was recorded. Extubation time and VAS was recorded every two hours for 12 hours post extubation.Results:Extubation time in group I was 72±8 minutes and 186±22 minutes in group II. Mean total use of narcotics in group II was 23.5±20.7 mg compared to 11.4±6.3 mg in group I. VAS median figures were lower at all data points in group I than in group II.Conclusion:Dexmedetomidine showed an effective and safe profile as an anesthetic adjunct in OPCAB, achieving fast tracking of patients and higher quality of pain control with a lower consumption of narcotics.
The outer diameter of the 'best-fit' ETT was less than the ITD at the cricoid level by 0.1-1.7 mm. The correlation of the outer diameter of the 'best-fit' ETT with age was stronger than with height or weight.
A new registry of adult patients with CHD managed in Cairo University Hospitals provides useful information, including the extent to which congenital heart defects are underdiagnosed and undertreated during infancy and childhood. In addition, those who were previously treated early in life require long-term follow-up in specialized centers. Establishment of a multidisciplinary team with expert physicians (cardiologists, dentists, obstetricians, and psychiatrists), cardiac surgeons, and nurses may be facilitated by development of a dedicated database system. Continuous financial support is a major challenge.
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