LETTER FROM THE EDITORS
KETOFOL (KETAMINE/PROPOFOL) AS A SUPERIOR SEDATIVE AGENT TO MITIGATE CARDIORESPIRATORY EFFECTS AND ALLEVIATE PAIN WHEN USED FOR PROCEDURAL SEDATION AND ANALGESIA: A REVIEW.
POSTDURAL PUNCTURE HEADACHE: AN UPDATE ON TREATMENT IN OBSTETRIC PATIENTS.
ΕΠΙΔΡΑΣΗ ΣΥΣΤΗΜΑΤΙΚΩΝ ΠΑΡΑΓΟΝΤΩΝ ΣΕ ΑΣΘΕΝΕΙΣ ΜΕ ΟΞΕΙΑ ΕΓΚΕΦΑΛΙΚΗ ΒΛΑΒΗ.
THE WORK OF BREATHING DURING MECHANICAL VENTILATION IN A PORCINE MODEL OF ABDOMINAL HYPERTENSION:THE IMPACT OF SEPSIS.
ANESTHETIC MANAGEMENT OF RENAL TRANSPLANTATION IN A PATIENT WITH ALPORT SYNDROME: A CASE REPORT. Continue reading

Dear colleagues,

The first issue of the Greek e-journal of Perioperative Medicine for 2023 presents a systematic review article of Papageorgiou L et al, in which the authors reviewed the existing evidence regarding superiority of ketofol (ketamine/propofol) in mitigating cardiorespiratory effects when administered as a main agent for procedural sedation and analgesia (PSA) in comparison to other drugs administered for such purposes underlying the safety and efficacy profile of this cocktail medication. They found limited evidence to support superiority of ketofol compared to other agents, specifically to propofol. They noted that the addition of ketamine to propofol in sub-dissociative doses is associated with less respiratory and haemodynamic complications during PSA, while achieving adequate analgesia and deeper sedation, possibly more amnesia and consequently high satisfaction in both patients and health-care professionals.

The next article of Varvarousi G et al was aimed to present the current knowledge on the treatment of postdural puncture headache (PDPH) in obstetric anesthesia practice, given to the fact that the incidence of accidental dural puncture complicating epidural cathether placement, in obstetric patients, varies between 0,13-0,91%.

The review article of Schizodimos Th et al described several systemic factors (arterial hypotension, low cardiac output, hypercapnia, hypocapnia, systemic hypoxia, anemia,… Continue reading

Procedural sedation and analgesia (PSA) is often necessary in order to deal with anxiety, pain and stress that may accompany patients at the hospital during invasive, unpleasant and/or painful procedures. The literature has not presented firm conclusions regarding ideal sedative agents in terms of efficacy and safety in PSA or even present firm data regarding superiority of specific drugs over others which are considered the “gold-standard” in sedation (i.e. propofol). Continue reading
Neuraxial analgesia and anaesthesia in an obstetric patient is associated with the risk of accidental dural puncture and subsequent development of a post dural puncture headache (PDPH). The management of accidental dural puncture requires consists of prevention of PDPH, patient’s information, early diagnosis, treatment, and monitoring until remission of PDPH. Continue reading
Η οξεία εγκεφαλική βλάβη (acute brain injury, ABI) αποτελεί συχνό κλινικό πρόβλημα, που απαιτεί άμεση και επείγουσα αντιμετώπιση. Περιλαμβάνει οποιαδήποτε πάθηση επηρεάζει οξέως το κεντρικό νευρικό σύστημα (ΚΝΣ), [π.χ. τραυματική εγκεφαλική βλάβη (traumatic brain injury, TBI)] και έχει δύο συστατικά, την πρωτογενή (primary brain injury, PBI) και τη δευτερογενή εγκεφαλική βλάβη (secondary brain injury, SBI)1. Continue reading
The work of breathing (WOB) is the amount of energy, which is consumed by the respiratory muscles, in order to perform one complete respiratory cycle. In several medical conditions, WOB might rise to a critical level which could necessitate initiation of mechanical ventilation (MV) or complicate weaning of the patient from MV. Continue reading
Alport syndrome (AS) is a rare hereditary disease, in which there is a defect in type IV collagen, an essential constituent of basal membrane in kidney, ear and eye. This can cause progressive renal damage and eventually renal failure, as well as hearing loss and visual impairment. Definitive treatment, when end stage renal disease (ESRD) has ensued, is renal transplantation. Continue reading
LETTER FROM THE EDITORS
ANAESTHETIC MANAGEMENT IN A PEDIATRIC PATIENT WITH MALIGNANT TRANSFORMATION OF HEPATIC ADENOMA IN GLYCOGEN STORAGE DISEASE TYPE 1 (VON-GIERKE) FOR LIVER TRANSPLANTATION: A CASE REPORT.
NON-OPERATING ROOM ANESTHESIA (NORA) MANAGEMENT AND VACTERL SYNDROME: A CASE REPORT.
ANESTHETIC MANAGEMENT OF A GLYCOGEN STORAGE DISEASE TYPE 1A WITH AIR EMBOLISM DURING LIVER TRANSPLANTATION.
INTRAOPERATIVE DIAGNOSIS OF AN ASCENDING AORTA DISSECTION IN A PATIENT WITH GRADUALLY COLLAPSING CARDIOVASCULAR SYSTEM: AN EXAMPLE OF HOW THE ROLE OF PERIOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) BECOMES CRUCIAL.
ANESTHESIA MANAGEMENT OF A PATIENT WITH HEREDITARY ANGIOEDEMA UNDER DEXMEDETOMIDINE: A CASE REPORT
ANESTHETIC MANAGEMENT IN A PATIENT WITH CRIGLER-NAJJAR SYNDROME UNDERGOING A DENTAL PROCEDURE: A CASE REPORT Continue reading

Dear colleagues

The fourth issue of the Greek e-journal of Perioperative Medicine for 2022 presents various case reports concerning perioperative medicine.

The case of Sivrioğlu D et al. presents the perioperative management of an 8-year-old patient with Glycogen storage disease type Ia (GSD type-Ia), with malignant transformation of hepatic adenoma, that underwent liver transplantation. The authors note that the anesthetic management of these patients has important implications for anesthesiologists due to different system involvements.

The case report of Uslu A et al. presents the preparation and management of non-operating room anesthesia (NORA) in an 8-year-old patient diagnosed with VACTERL syndrome (multiple congenital malformations: vertebral, cardiac, tracheo-esophageal, renal and extremity anomalies, cardiac anomaly-large secundum ASD-, right renal agenesis, operated tracheoesophageal fistula and esophageal atresia).

The article of Kandemir E et al. evaluates the anesthetic management and considerations of a glycogen storage disease type 1a pediatric patient with air embolism during liver transplantation. The authors conclude a multidisciplinary approach and care should be taken in terms of limiting the presence of perioperative complications.

Next, the article of Papagiannopoulou O et al. shows that the intraoperative use of transesophageal echocardiogram (TEE) establishes the diagnosis (aneurysm dissection of the ascending aorta, a large thrombus… Continue reading

Glycogen storage disease type Ia (GSD-Ia; Von Gierke disease) is an inherited disease caused by glucose-6-phosphatase deficiency. Perioperative management of patients with GSD has important implications for anaesthesiologists due to different system involvements. Continue reading
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