CONTEXT: In patients eligible for coronary artery bypass surgery, anesthesia should provide a
number of conditions that exceed the limits of cardiovascular stability, myocardial
protection and other organs. Moreover, the combination of general anesthesia and spinal
anesthesia lessens the homeostatic, metabolic, hormonal and immunosuppressive changes. The
goal of this research was to evaluate the consumption of fentanyl citrate in intra-operative
in Coronary Artery Bypass Grafting (CABG) surgery with cardiopulmonary bypass under spinal
anesthesia associated with general anesthesia.
METHODS: Clinical, prospective, randomized and double covered study, approved by the Research
Ethics Committee. Fifty-six patients candidates for CABG with CPB, after signing the Terms of
consent, were randomized and divided into two groups: GI – General and GII – General +
subarachnoid. General anesthesia was induced according to the weight of each patient and
maintenance with isoflurane and fentanyl. Spinal anesthesia was induced with 20 mg of 0.5%
hyperbaric bupivacaine and 200 mcg of morphine, the patient is placed in cephalo-position
slope of 45 degrees for 10 minutes in Group II. In the statistical study was performed using
the Mann-Whitney test; the level of statistical significance was set at 5%.
Considering fast-track principles, an ideal spinal anesthetic should have minimal
complications and above all fast recovery so reducing in-hospital stay.
Between 1/8/2015 and 1/1/2016, a total of 101 patients attending the surgeon’s practice with
an umbilical or unilateral inguinal hernia and no contra-indications for surgery were
included in this study. Patients were given 10.5mg bupivacaine (B-group), 40mg hyperbaric
2-chloroprocaïne (C-group) or 60mg prilocaïne (P-group), each with added sufentanil (2µg).
Motor block was assessed using the Bromage scale. Sensory block was measured by determining
the peak level dermatome. Intraoperative hemodynamic parameters were listed. Resolution of
sensory and motor block, time to void and home readiness were defined as clinical endpoints.
This is an observational, longitudinal real world registry of diabetic foot ulcers created
from electronic health record data obtained in the course of clinical care. Data from
certified electronic health records transmit data as part of the requirement to share data
with a specialty registry under Objective 10 of Meaningful Use of an EHR.
Background: Common adverse side effects related to the use of neuraxial opioids in the
obstetric population include nausea, vomiting, and pruritus. Serotonin (5-HT3) receptor
antagonists, in particular ondansetron, have been identified as possible antipruritic agents.
It was reported that dexamethasone plus ondansetron is more effective than ondansetron for
prevention of postoperative nausea and vomiting but no additional effect on treating
pruritus.
Objectives: The purpose of this study is to compare the effect of prophylactic ondansetron
versus ondansetron plus dexamethasone after cesarean section on pruritus and postoperative
nausea and vomiting (PONV).
Methods: A prospective randomized double blind study that will be conducted between June 2016
and June 2017. Patients will be randomly allocated into two groups. The first group will
receive 4 mg intravenous (IV) ondansetron while the other group will receive 4 mg IV
ondansetron plus 8 mg dexamethasone.
In the United States the incidence of cesarean deliveries have increased over the last
several decades and is currently approximately 30% nationwide. The anesthesia and analgesia
for elective c-sections vary between institutions.
Parturients present a unique challenge for the anesthesiologist as the mother has to care not
only for herself, but also for the newborn postpartum. While intrathecal opioids provide
adequate pain relief, they do so at the cost of bothersome side effects for patients, such as
pruritus and nausea/vomiting.
Intrathecal hydromorphone has started to be explored as a new option for intrathecal
analgesia. A study done by Beatty et al. showed in a retrospective review that 40 mcg of
intrathecal dilaudid was safe and effective as compared to intrathecal morphine for analgesia
after cesarean delivery. Additionally they showed no difference in side effect profiles of
the two medications. Mhyre et al. investigated the use of 100 mcg of intrathecal dilaudid
with hyperbaric bupivacaine in varying dosages for labor analgesia. The results were
inconclusive, but the dosage of hydromorphone was reported to be without adverse effects.
Virginia Commonwealth University Health Systems has successfully instituted the use of
intrathecal morphine with superior analgesia but with undesired side effects, most notably
pruritus. Recent drug shortages of duramorph have prompted investigators to seek alternative
options for post cesarean section analgesia. The investigators are interested in determining
the dose, efficacy, and side effect profile of intrathecal hydromorphone. Although our
institution has never utilized intrathecal hydromorphone for our patient population, it has
been studied at various other institutions where it has been found to be safe and efficacious
with an acceptable side effect profile.
The purpose of this study is to compare the frequency of hypotension between hyperbaric
anesthetics and isobaric anesthetics during cesarean section and determine whether continuous
infusion of phenylephrine is effective in mothers who received hyperbaric anesthetics.
Recent studies show preliminary evidence of HBOT therapeutic effects on angiogenesis,
increased tissue blood flow and oxygenation correlated with tissue function.
Our primary hypothesis is that HBOT will have beneficial effects on the above mentioned
organs associated with aging-related malfunctions due to restored mitochondrial function,
mobilization of stem cells and induction of angiogenesis.
The purpose of this study is to evaluate the efficacy and safety of spinal anesthesia with
isobaric ropivacaine, compared with hyperbaric bupivacaine in geriatric patients undergoing
lower limb orthopedic surgery.
Hyperbaric oxygen therapy (HBOT) is proposed as a possible in vivo angiogenic stimulator for
improving microvascular myocardial perfusion and anginal symptoms as assessed by myocardial
perfusion imaging and angina questionnaire in patients with chronic stable ischemic heart
disease, when no other means to relief symptoms and/or ischemia are available.
