Hemoperitoneum following rupture of ectopic varix along splenorenal ligament in extrahepatic portal vein obstruction.

A 29-year-old man with extrahepatic portal vein obstruction who underwent variceal eradication by sclerotherapy six years ago, was admitted with hypotension and abdominal pain. Abdominal paracentesis yielded frank blood. Laparotomy showed bleeding from a large ectopic vessel along the splenorenal ligament. The vessel was ligated and the patient recovered.

Propofol [diprivan] versus midazolam - flumazenil anaesthesia for direct laryngoscopy

The study.was carried out on 40 patients of both sexes aged from 15-55 years old and with body weight between 55-85 kg scheduled for direct laryngoscopic procedures. Patients were divided randomly into 2 groups, 20 patients each.In the first group, propofol 2 mg/kg was used for induction of anaesthesia and maintained by continuous infusion of 200 micro g/kg/min for 10 minutes, followed by 150 micro g/kg/min for the next 10 minutes and 100 micro g /kg/min Thereafter .In the second group, midazolam 0.3 mg /kg was used for induction and maintained by infusion of 1 micro g/kg/min if the procedure lasted more than 20 minutes. At the recovery placebo was used to reverse the effect of propofol and fIumazeniI was used to reverse the effect of midazolam. Perianaesthetic care was the same for both groups. In both groups we evaluated the operative condition [adequate, inadequate and poor] and the quality of recovery [recovery time, degree of sedation, cooperation and orientation to time and space]. We found that both propofol and midazolam offered an adequate operative anaesthetic condition needed for the procedure but the quality of recovery of propofol was better than that of midazolam even after fIumazenil administration reaching to a conclusion to leave the midazolam - fIumazenil technique to be used in the poor cardiovascular risk patients or in a situation where propofol is not available or contraindicated

Nitroglycerine transdermal patch, is it effective in blocking the pressor response to tracheal intubation and noxious stimulation in hypertensive patients?

Fourty hypertensive patients ASA II scheduled for elective surgical procedures requiring endotracheal intubation, were randomly allocated into two groups 20 patients each. Nitroglycerine transdermal patch was applied to the patients of the first group [Nitroglycerine group] and was not applied to the patients of the other group [control group]. The anaesthetic technique was standerised for patients of both groups.A significant rise in blood pressure occured after tracheal intubation and following skin incision in the control group, while no rise in blood pressure recorded in the other group in which patients pretreated with nitroglycerine transdermal patch. In both groups, either serum cortisol concentration and serum glucose level increased significantly after tracheal intubation and skin incision. We conclude that nitroglycerine transdermal patch is effective in blocking the pressor response to tracheal intubation and noxious stimulation in hypertensive patients but not effective in minimizing the rise of stress hormones released with these situations

Nitroglycerine transdermal patch, is it effective in blocking the pressor response to tracheal intubation and noxious stimulation in hypertensive patients?

Fourty hypertensive patients ASA II scheduled for elective surgical procedures requiring endotracheal intubation were randomly allocated into two groups 20 patients each. Nitroglycerine transdermal patch was applied to the patients of the first group [Nitroglycerine group] and was not applied to the patients of the other group [control group]. The anaesthetic technique was standerised for patients of both groups. A significant rise in blood pressure occured after tracheal intubation and following skin incision in the control group, while no rise in blood pressure recorded in the other group in which patients pretreated with nitroglycerine transdermal patch.In both groups, either serum cortisol concentration and serum glucose level increased significantly after tracheal intubation and skin incision. We conclude that nitroglycerine transdermal patch is effective in blocking the pressor response to tracheal intubation and noxious stimulation in hypertensive patients but not effective in minimizing the rise of stress hormones released with these situations