Dexmedetomedine versus standard sedatives in weaning from mechanical ventilation

Background: Sedation in the intensive care unit Patients is assumed to reduce discomfort from care interventions, increase tolerance of mechanical ventilation, prevent accidental removal of instrumentation, and reduce metabolic demands during cardiovascular and respiratory instability

Aim of the Work: The aim of the work was to evaluate the use of dexmedetomedine as a sedative to facilitate weaning from mechanical ventilation and extubation, so decrease the incidence of reintubation, ventilator complications and decrease the ICU cost and stay

Patients and Methods: This was a controlled randomized prospective clinical trial carried out at Ain-Shams University Hospitals. After approval of institutional ethical committee, the study included 90 adult postoperative patients and requiring postoperative mechanical ventilation in the surgical ICU for maximum duration of 48 hours postoperatively

Results: As regard to time to extubation, results of the current study showed a highly statistically significant difference between three groups regarding time to extubation [hr] when p-value was < 0.001

Conclusion: dexmedetomidine has clinically relevant benefits compared to midazolam and propofol in facilitating extubation because of its shorter time to extubation, more hemodynamic stability, easy arousability and lack of respiratory depression; hence, it can be used as an effective, and safe sedative agent to facilitate extubation in ICUs and decreasing ICU length of stay

Prophylactic use of parenteral ketamine versus ondansetron for prevention of shivering during spinal anesthesia in hernia surgeries

Background: Perioperative shivering is a common complication in modern anesthesia. It's usually defined as readily detectable fasciculation or tremors of the face, jaw, head, trunk or extremities lasting longer than 15 seconds

Aim of the work: Compare the anti-shivering effect of parentral low dose ketamine and ondansetron after spinal anesthesia during hernia surgery, as well as the anticipated side effects and complications

Patients and Methods: This study presents a prospective randomized single blinded study. After obtaining approval from the medical ethical committee of Ain Shams University, this study was conducted in Ain Shams University hospitals operating rooms. Study period was from January 2018 to May 2018

Results: Our results indicated that low dose ketamine and ondansetron were effective, with more extent to ketamine, in prevention of post spinal shivering in patients undergoing hernia surgery and these results agreed with other results of studies done before

Conclusion: Our results indicated that Prophylactic low dose ketamine [0.25mg/kg] and Ondansetron [4mg] significantly decreased shivering in patients undergoing spinal anesthesia without significant side effects. Ketamine found to be more effective in controlling post spinal shivering