The Effect of Gabapentin on Postoperative Pain, Morphine Sparing Effect and Preoperative Anxiety in Patients Going for Sleeve Gastrectomy Surgical Procedure.

OBJECTIVE: To determine the effectiveness of preoperative administration of gabapentin in reduction of acute postoperative pain, morphine consumption and preoperative anxiety and sedation in obese patients undergoing laparoscopic sleeve gastrectomy. STUDY DESIGN: Double-blinded randomised control trial. PLACE AND DURATION OF STUDY: King Khalid University Hospital, King Saud University Riyadh, Saudi Arabia, from July 2014 to January 2017. METHODOLOGY: Fifty patients undergoing sleeve gastrectomy were enrolled in the study. The subjects received either 1200 mg gabapentin or placebo 2 hours before surgery. The amount of morphine consumption and postoperative pain at 4, 8,12,16, 20 and 24 hours of surgery were measured. Preoperative anxiety and sedation were recorded at 2 hours interval after the drug administration. RESULTS: There was no significant difference in patient characteristics in both groups. 24 hours PCA morphine consumption was significantly lower in gabapentin group than in the placebo group, 15.08±4.55 vs. 27.80±2.51 (p=0.001). Preoperative VAS anxiety, pre- verses post-drug, was significantly lower in gabapentin group 5.80±1.11 vs. 3.52±1.00 (p=0.001) than in placebo group 6.08 1.28 vs. 6.28 1.24 (p=0.635). Preoperative sedation score was not different in both groups. CONCLUSION: Preoperative oral gabapentin was effective in reducing the postoperative pain, morphine consumption and preoperative anxiety in morbid obese patients undergone laparoscopic sleeve gastrectomy.

Correction to: Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope.

We are thankful to Dr. Deepak Gupta (Clinical Assistant Professor Anesthesiology, Wayne State University/Detroit Medical Center) for bringing to our attention a typographical error in our manuscript [1].

Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope.

BACKGROUND: Postoperative sore throat (POST) is a common problem following endotracheal (ET) intubation during general anesthesia. The objective was to compare the incidence and severity of POST during routine intubation with Glidescope (GL) and Macintosh laryngoscope (MCL). METHODS: One hundred forty adult patients ASA I and II with normal airway, scheduled to undergo elective surgery under GA requiring ET intubation were enrolled in this prospective randomized study and were randomly divided in two groups, GL and MCL. Incidence and severity of POST was evaluated at 0, 6, 12 and 24 h after surgery. RESULTS: At 0 h, the incidence of POST was more in MCL than GL (n = 41 v.s n = 22, P = 0.001), and also at 6 h after surgery (n = 37 v.s n = 23, P = 0.017). Severity of POST was more at 0, 6 and 12 h after surgery in MCL (P < 0.001, P = 0.001, P = 0.004 respectively). CONCLUSIONS: Routine use of GL for ET tube placement results in reduction in the incidence and severity of POST compared to MCL. TRIAL REGISRATION: ClinicalTrials.gov NCT02848365 . Retrospectively Registered (Date of registration: July, 2016).

Difficulty in the removal of epidural catheter for labor analgesia.

For labor pain management epidural analgesia is a popular and an effective method. Difficult removal of epidural catheters occasionally occurs, and several maneuvers have been recommended. The purpose of this article is to raise awareness of the problem of retained epidural catheter fragments and identify the potential impact of complications.

Anesthetic management of patient with hemophilia a undergoing emergency ventriculoperitoneal shunting: A case report and review of literature.

Hemophilia A is a hemorrhagic trend almost exclusively affecting males (X-related recessive disease). In 85% of cases, it is caused by factor VIII deficiency, called hemophilia A or classic hemophilia. Successful anesthetic management depends on the special care and a multidisciplinary team of health professionals informed about the disease, including qualified hematologist, surgeon, and anesthesiologist.

Routine Use of Glidescope and Macintosh Laryngoscope by Trainee Anesthetists.

OBJECTIVE: To compare intubating conditions, success rate, and ease of intubation by anesthesia trainees using Glidescope Videolaryngoscope (GVL) compared to Macintosh laryngoscope (MCL). STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: King Khalid University Hospital, Riyadh, Saudi Arabia, from January 2012 to February 2015. METHODOLOGY: Eighty adult patients ASAI and II with normal airway, scheduled to undergo elective surgery requiring endotracheal (ET) intubation were enrolled. Patients were randomly divided into 2 groups: GVL and MCL. All intubations were performed by trainee residents having experience of more than 1 year and who had successfully performed more than 50 tracheal intubations with each device. Glottic view based on Cormack and Lehane&#039;s (C&amp;L&#039;s) score and percentage of glottis opening (POGO) score, time to successful intubation, need of external pressure, and overall difficulty scores were compared using either GVL or MCL. RESULTS: View of glottis based on C&amp;L&#039;s classification was better (p &lt; 0.001) and POGO score was higher (88.25 &plusmn;22.06 vs. 57.25 &plusmn;29.26, p &lt; 0.001) with GVL compared to MCL. Time to intubate in seconds was (32.90 &plusmn;8.69 vs. 41.33 &plusmn;15.29, p = 0.004) and overall difficulty score was less 2.78 &plusmn;1.39 vs. 4.85 &plusmn;1.75 (p &lt; 0.001) using GVL compared to MCL. CONCLUSION: Residents found ET intubation to be faster and easier with superior glottic view using GVL compared to MCL in patients with normal airway.

Pressure-induced alopecia in pediatric patients following prolonged urological surgeries: The case reports and a review of literature.

Postoperative alopecia has been reported as a rare complication after prolonged immobilization during general anesthesia. The constant pressure on the scalp is causative and may be exacerbated by hypoxemia or hypotension. There is a correlation between the length surgery duration under anesthesia and the development of permanent alopecia. Regular head turning schedules and vigilance for the condition should be used as prophylaxis to prevent permanent alopecia.

Novel management of methylene blue extravasation: A case report and review of literature.

Methylene blue is a highly irritant drug and has been used intraoperatively. Its accidental extravasation can lead to tissue necrosis. In this report, a unique management is described, and the patient recovered without any morbidity.

Anesthetic management of patient with systemic lupus erythematosus and antiphospholipid antibodies syndrome for laparoscopic nephrectomy and cholecystectomy.

We report a case of a female having systemic lupus erythematosus and antiphospholipid antibodies syndrome, who was on immunosuppressant therapy. We discussed the preoperative evaluation and perioperative management who underwent nephrectomy and cholecystectomy.