Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow stat...Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods： Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. In stage I, the cuff was inflated with the maximum volume of air as rec- ommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. The leak pressure, intracuff pressure and the leak volume were measured in both stages. Results： The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes. The airway leakage pressure was significantly lower in stage fl in comparison to stage I. Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage I1. Conclusion： Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.展开更多
Objective:After the pregabalin has been approved for the treatment of neuropathic pain,preliminary clinical studies suggested a possible role in the perioperative period.To our knowledge,It has never been studied the ...Objective:After the pregabalin has been approved for the treatment of neuropathic pain,preliminary clinical studies suggested a possible role in the perioperative period.To our knowledge,It has never been studied the perioperative analgesic effect of pregabalin in patients with cancer bladder.In this study,we hypothesized that cancer bladder patients undergoing radical cystectomy and received oral pregabalin 75 mg twice daily for ten days preoperatively would get their postoperative pain reduced.Methods:Sixty patients scheduled for elective radical cystectomy were randomly assigned to one of 2 groups(control group or pregabalin group).Patients in the pregabalin group received 75 mg pregabalin twice daily for ten days before surgery.Standard anesthesia protocol was applied to all patients.Pain intensity,opioid consumption,level of sedation and other side effects were regularly assessed for 48h postoperative.Results:Mean time for the first request of analgesia was statistically longer in pregabalin group.Meanwhile,mean morphine consumption,VAS scores at rest(in the first 32h postoperatively),VAS scores during movement(in the first 20h postoperatively) were statistically significant lower in the pregabalin group than those in the control group.Patients in the pregabalin group were statistically more sedated in the first four hours postoperative than the control group.Conclusion:Preoperative pregabalin 75 mg twice daily for ten days resulted in 60% reduction in 24h postoperative morphine requirements in patients undergoing radical cystectomy.展开更多
Objective:Caudal epidural analgesia has become very common analgesic technique in paediatric surgery.Adding tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects.The aim...Objective:Caudal epidural analgesia has become very common analgesic technique in paediatric surgery.Adding tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects.The aim of the study was to investigate the different effects of caudal bupivacaine versus bupivacaine with thamadol for postoperative analgesia in paediatric cancer patients.Methods:A prospective randomized controlled trial was conducted over 40 paediatric cancer patients who were recruited from Children Cancer Hospital of Egypt(57357 Hospital).Patients were randomized into 2 groups:bupivacaine group(group B,20 patients) to receive single shot caudal block of 1 mL/kg 0.1875% bupivacaine;tramadol group(group T,20 patients) prepared as group B with the addition of 1 mg/kg caudal tramadol.Results:The mean duration of analgesia was significantly longer among group T than group B [(24 ± 13.7) hours versus(7 ± 3.7) hours respectively with P = 0.001].Group T showed a significantly lower mean FLACC score than group B(2.2 ± 0.9 versus 3.6 ± 0.6 with P = 0.002).The difference in FLACC score was comparable on arrival,and after 2 and 4 hours.At 8 and 12 hours the group B recorded significantly higher scores(P = 0.002 and 0.0001 respectively).There were no significant differences between the groups as regards sedation score [the median in both groups was 1(0-1) with P value = o.8].No one developed facial flush or pruritis.Conclusion:Caudal injection of low dose tramadol 1 mg/kg with bupivacaine 0.1875% is proved to be effective,long standing technique for postoperative analgesia in major paediatric cancer surgery and almost devoid of side effect.展开更多
文摘Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods： Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. In stage I, the cuff was inflated with the maximum volume of air as rec- ommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. The leak pressure, intracuff pressure and the leak volume were measured in both stages. Results： The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes. The airway leakage pressure was significantly lower in stage fl in comparison to stage I. Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage I1. Conclusion： Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.
文摘Objective:After the pregabalin has been approved for the treatment of neuropathic pain,preliminary clinical studies suggested a possible role in the perioperative period.To our knowledge,It has never been studied the perioperative analgesic effect of pregabalin in patients with cancer bladder.In this study,we hypothesized that cancer bladder patients undergoing radical cystectomy and received oral pregabalin 75 mg twice daily for ten days preoperatively would get their postoperative pain reduced.Methods:Sixty patients scheduled for elective radical cystectomy were randomly assigned to one of 2 groups(control group or pregabalin group).Patients in the pregabalin group received 75 mg pregabalin twice daily for ten days before surgery.Standard anesthesia protocol was applied to all patients.Pain intensity,opioid consumption,level of sedation and other side effects were regularly assessed for 48h postoperative.Results:Mean time for the first request of analgesia was statistically longer in pregabalin group.Meanwhile,mean morphine consumption,VAS scores at rest(in the first 32h postoperatively),VAS scores during movement(in the first 20h postoperatively) were statistically significant lower in the pregabalin group than those in the control group.Patients in the pregabalin group were statistically more sedated in the first four hours postoperative than the control group.Conclusion:Preoperative pregabalin 75 mg twice daily for ten days resulted in 60% reduction in 24h postoperative morphine requirements in patients undergoing radical cystectomy.
文摘Objective:Caudal epidural analgesia has become very common analgesic technique in paediatric surgery.Adding tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects.The aim of the study was to investigate the different effects of caudal bupivacaine versus bupivacaine with thamadol for postoperative analgesia in paediatric cancer patients.Methods:A prospective randomized controlled trial was conducted over 40 paediatric cancer patients who were recruited from Children Cancer Hospital of Egypt(57357 Hospital).Patients were randomized into 2 groups:bupivacaine group(group B,20 patients) to receive single shot caudal block of 1 mL/kg 0.1875% bupivacaine;tramadol group(group T,20 patients) prepared as group B with the addition of 1 mg/kg caudal tramadol.Results:The mean duration of analgesia was significantly longer among group T than group B [(24 ± 13.7) hours versus(7 ± 3.7) hours respectively with P = 0.001].Group T showed a significantly lower mean FLACC score than group B(2.2 ± 0.9 versus 3.6 ± 0.6 with P = 0.002).The difference in FLACC score was comparable on arrival,and after 2 and 4 hours.At 8 and 12 hours the group B recorded significantly higher scores(P = 0.002 and 0.0001 respectively).There were no significant differences between the groups as regards sedation score [the median in both groups was 1(0-1) with P value = o.8].No one developed facial flush or pruritis.Conclusion:Caudal injection of low dose tramadol 1 mg/kg with bupivacaine 0.1875% is proved to be effective,long standing technique for postoperative analgesia in major paediatric cancer surgery and almost devoid of side effect.
