BACKGROUND Head fixation can induce hemodynamic instability. Remifentanil is commonly used with propofol for total intravenous anesthesia (TIVA) during neurosurgery. This study investigated the 90% effective concentration (EC90) of remifentanil for blunting of cardiovascular responses to head fixation during neurosurgery via bispectral index (BIS) monitoring. METHODS Fifty patients undergoing...

conclusions although propofol remains a standard agent for such types of surgeries, lidocaine proved equally effective and coupled with its low cost, minimal side effects and omission of other hypnotic agents was a plausible induction agent and a maintenance drug in the selected cases. case presentation lidocaine was applied as the sole anaesthetic for induction and maintenance during aneurysm ...

Background Data is suggesting that non-balanced conventional crystalloids (0.9% saline) are not only associated with the occurrence of hyperchloremic, metabolic acidosis but increased incidence of acute kidney injury and even morbidity and mortality. Experimental data suggested infusion of hyperchloremic crystalloids to be associated with hypotension in experimental sepsis. We aimed to investig...

Limited evidence-based protocols exist regarding the management of venous pseudoaneurysms. Cases reports have documented surgical treatments including endovascular coil embolization or suture ligation in the setting of hemodynamic stability. Depending on the location of the venous injury, a more conservative approach to a stable pseudoaneurysm may be advantageous. This report describes a case o...

course, significant and warrants careful clinical consideration because this technique could exacerbate hypoxemia in the child with transposition; but the potential advantage of this technique is the ability to eliminate the afterload rapidly. Further experimental work is necessary to determine the minimal afterload requirements to induce sufficient myocardial hypertrophy to sustain the increas...

The management of polytrauma patients is clinically challenging and requires a multi-disciplinary team approach. The immediate and definitive operative care of fractures represents the optimal treatment for polytrauma patients with orthopedic injuries. Early orthopedic intervention in long bone fractures and pelvic ring injuries has been shown to decrease pulmonary complications, improve hemody...

At intravenous dosages of ≥8 mcg/kg, sufentanil produces hypnosis and anesthesia without the use of additional anesthetic agents. A deep level of anesthesia is maintained at these dosages, as demonstrated by EEG patterns. Dosages of up to 25 mcg/kg attenuate the sympathetic response to surgical stress. The catecholamine response, particularly norepinephrine, is further attenuated at doses of su...

We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after int...

A 67-year-old man was admitted to the emergency department with a recent history of melena and progressive fatigue. He had a past medical history of hypertension, dyslipidemia, ischemic heart disease, chronic renal failure and was on antiaggregation therapy. Physical examination showed pallor and hemodynamic stability. Laboratory workup revealed normocytic anemia (hemoglobin 9 g/dL; normal: 13-...