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Anesthesia, Essays and Researches

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[This retracts the article on p. 921 in vol. 11, PMID: 29284850.].
July 2018: Anesthesia, Essays and Researches
Vijay Kumar Mishra, Souvik Chaudhuri, Rajesh Kumar Singh, Ajay Kumar Singh
Unilateral pulmonary artery agenesis (UPAA) is a rare condition where the patient may remain asymptomatic for a long period till adulthood. Presentation may be in the form of dyspnea, cough, hemoptysis, decreased exercise tolerance, and recurrent respiratory tract infections. Ventilation-perfusion mismatch and excessive blood flow to the normal lung may eventually lead to unilateral acute respiratory distress syndrome (ARDS). We present a case of a 40-year-old gentleman with nonresolving pneumonia who was diagnosed to have unilateral ARDS due to UPAA...
July 2018: Anesthesia, Essays and Researches
Aastha Srivastava, Ankit Arora, Divya Gupta, Veena Asthana
Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine which leads to ossification and formation of a classical bamboo spine. This poses a challenge to the anesthetist both in terms of administering general and regional anesthesia due to the limited mobility of the spine. With the advent of ultrasound as an aid in regional anesthesia, it has been relatively easy to perform a central neuraxial blockade in such patients though the skill requires some degree of expertise. Here, we have described the use of ultrasound as a guide for administering regional anesthesia to a patient with AS after initially attempting a blind approach which had failed due to difficult anatomy...
July 2018: Anesthesia, Essays and Researches
Ebru Tarıkçı Kılıç, Mehmet Erdem Akçay, Mehmet Salim Akdemir, Egemen Atağ, Onur Gürsu
Corpus callosum agenesis develops when the band which connects the two hemispheres of the brain does not occur in utero. It is associated with prenatal infections, genetic factors, toxic exposures, metabolic disorders, and chromosome errors. Mostly seen clinical features are macrocephaly, microcephaly, seizures, motor retardation, hypotonia, eye anomalies, and facial dysmorphisms. Here, we report a case of corpus callosum agenesis syndrome undergoing upper endoscopy under deep sedation with dexmedetomidine...
July 2018: Anesthesia, Essays and Researches
Rajesh Kesavan, Sindhu Balakrishnan, Sunil Rajan, Shyam S Purushothaman, Rekha Varghese, Lakshmi Kumar
Background: Apneic mass movement of oxygen by applying continuous positive airway pressure (CPAP) is possible only when the airway is kept patent which helps to reduce the rate of desaturation. Aims: The aim of this study was to check the efficiency of preoxygenation and apneic oxygenation by assessing the drop in partial pressure of arterial oxygen (PaO2 ) during apnea with and without keeping an oropharyngeal airway to maintain the patency of airway. Settings and Design: This prospective observational study was conducted at a tertiary care center...
July 2018: Anesthesia, Essays and Researches
Veena Chatrath, Rajan Kumar, Upasna Sachdeva, Milind Thakur
Background: Surgery is a very stressful experience for patients. Children are the most susceptible to fear, anxiety, and stress due to their limited cognitive capabilities and dependency. In children, pharmacologic agents are frequently used as premedication to relieve the fear of surgery, to make child-parental separation easy, and to carry out a smooth induction of anesthesia. We conducted this study to compare the efficacy of intranasal fentanyl, midazolam, and dexmedetomidine as premedication in pediatric patients...
July 2018: Anesthesia, Essays and Researches
Naglaa Khalil Yousef
Background: Abdominal hysterectomy is associated with sever postoperative pain. Quadratus lumborum (QL) block is a regional analgesic technique which has an evolving role in postoperative analgesia. Aims: we aimed to compare ultrasound guided bilateral transverse abdominis plane (TAP) block versus bilateral QL block in patients undergoing total abdominal hysterectomy. Settings and Design: This is a prospective randomized controlled double blinded study...
July 2018: Anesthesia, Essays and Researches
Manish Khandelwal, Varun Kumar Saini, Sandeep Kothari, Gaurav Sharma
Context: Airway management is a crucial skill and area of concern for the anesthesiologist. Awake fiber-optic intubation (AFOI) remains the gold standard in managing difficult airway. Anaesthetizing the airway along with psychological assurance is the mainstay for Preparation of AFOI. Different topical and regional techniques have been developed to subdue reflexes and facilitate AFOI. Aim: This randomized controlled study was performed to evaluate the effectiveness of using lignocaine nebulization in addition to specific airway blocks for AFOI...
July 2018: Anesthesia, Essays and Researches
Palanisamy Nagalakshmi, Sundararajan Leo, S Uthirapathi
Background: Management of airway is of great importance in the practice of anesthesia. Supraglottic airway devices, such as laryngeal mask airway (LMA), have greatly revolutionized the management of airway both in terms of ease and degree of invasiveness. Propofol, by its inherent property of decreasing airway reflexes, is used to aid in LMA insertion. In this study, we have evaluated the LMA insertion conditions and hemodynamic stability, comparing butorphanol, fentanyl, and ketamine as co-induction agents with propofol...
July 2018: Anesthesia, Essays and Researches
Mohamed Ahmed Hamed, Mohammed Awad Al-Saeed
Background: One of the most common complications of tonsillectomy is pain, which leading to delayed recovery and later hospital discharge. Aims: We intended to compare the efficacy of magnesium sulfate versus paracetamol on the posttonsillectomy pain and analgesic requirement. Settings and Design: This study design was a prospective randomized controlled double-blinded clinical study. Patients and Methods: A total of 60 children with the American Society of Anesthesiologists physical status classes I and II, aged 3-12 years, scheduled for tonsillectomy were randomly divided into two groups each group contains 30 patients: (Group M): received an initial loading dose of magnesium sulfate 30 mg/kg over 15 min started with induction followed by continuous infusion of 10 mg/kg/h for 1 h regardless of the operation time and (Group P): received paracetamol infusion 10 mg/kg started with induction and continued for 1 h...
July 2018: Anesthesia, Essays and Researches
Sindhu Balakrishnan, Manjulatha Kannan, Sunil Rajan, Shyam Sundar Purushothaman, Rajesh Kesavan, Lakshmi Kumar
Background: Stress-induced neuroendocrine and metabolic changes lead to intraoperative hyperglycemia which is related to surgery and the type of intravenous fluids used. Aims: The primary objective was to assess the incidence of hyperglycemia with use of lactate versus acetate-based intravenous fluids in nondiabetics undergoing major surgeries. Incidence of lactatemia and metabolic acidosis were also assessed. Settings and Design: Prospective parallel group observational study conducted in a tertiary care institute...
July 2018: Anesthesia, Essays and Researches
Mohamed Ahmed Hamed
Background: Intraoperative bleeding impairs surgical field visibility during functional endoscopic sinus surgery (FESS); several methods have been used to decrease blood loss and improve surgical field, one of them is usage of hypotensive anesthetic agents. Aim: We intended to compare magnesium sulfate with lidocaine, regarding their efficiency in inducing controlled hypotension and providing a better surgical field exposure during FESS and the influence of their usage on extubation time...
July 2018: Anesthesia, Essays and Researches
Mohammad Asif, Aman Sai Guntreddy
Background: Tracheal intubation is usually facilitated by using a muscle relaxant to supplement drugs given for the induction of general anesthesia. Nondepolarizing muscle relaxants are also associated with the few disadvantages. Endotracheal intubation under volatile anesthetics without the use of muscle relaxants is possible, but it has disadvantages. Time available for intubation is much less when compared to the use of muscle relaxants. Considering the disadvantages of muscle relaxants and volatile agents in mind, there is a need for endotracheal intubation without muscle relaxants...
July 2018: Anesthesia, Essays and Researches
Fikret Salik, Ebru Tarikçi Kiliç, Hakan Akelma, Abdülmenap Güzel
Aim: Spinal anesthesia is a widely used procedure in modern anesthesia. Although it is a reliable and frequently used anesthetic procedure, it involves complications, including postdural puncture headache caused by arachnoid punctured, which significantly affects postoperative well-being. In this study, we aimed to observe headache frequency with 26-G Quincke spinal needle in either transverse or sagittal planes. Materials and Methods: One hundred patients with American Society of Anesthesiologists status classes I and II who were scheduled for elective cesarean delivery with no contraindications for performing spinal anesthesia were randomly divided into two groups: Group I (transverse n = 50) and Group II (sagittal n = 50)...
July 2018: Anesthesia, Essays and Researches
Ritika Deshwal, Nidhi Kumar, Jagdish Prasad Sharma, Ranjit Kumar
Context: With modern lifestyle, there has been a steep increase in the number of low back pain patients in clinical practice. Lumbar microdiscectomy is one of the most common surgeries performed for this problem. Postoperative pain management is extremely important aspect of such advanced surgical technique among which wound infiltration is an efficient method. Aims: The aim of the study was to compare the efficacy of dexmedetomidine added to ropivacaine verses plain ropivacaine following wound infiltration in terms of pain scores, requirement of rescue analgesia, and related adverse effects...
July 2018: Anesthesia, Essays and Researches
Jyoti Gupta, Vijay Kumar Nagpal, Mohandeep Kaur, Jyoti Sharma, Ajay K Goila, Neha Kathor
Background: The diagnosis of ventilator-associated pneumonia (VAP) is a challenge because the clinical signs and symptoms lack both sensitivity and specificity. Further confirmation of the diagnosis of VAP can be done by other diagnostic procedures such as bronchoscopic and blind endotracheal aspiration, but the selection of either diagnostic procedure is debatable. Aims: The aim is to study and compare the role of bronchoscopic protected specimen brush biopsy (PSBB) and blind endotracheal aspiration for diagnosis of VAP...
July 2018: Anesthesia, Essays and Researches
Unnikrishnan Prathapadas, Maya Gomathiamma, Appavoo Arulvelan, Karen Ruby Lionel, Ajay Prasad Hrishi
Background: Propofol has emerged as an induction agent of choice over the past two decades due to its quick, smooth induction and rapid recovery. The main concern for an anesthesiologist is the hemodynamic instability caused by the standard induction dose of propofol (2-3 mg/kg). Aim: We aim to study the efficacy of propofol auto-coinduction technique in comparison to the standard propofol induction technique in terms of the total induction dose requirement of propofol, the incidence of hemodynamic side effects and pain on injection, and the incidence of fentanyl-induced cough (FIC) in the absence of a synergistic agent like midazolam...
July 2018: Anesthesia, Essays and Researches
Dimpal Saini, Urvashi Yadav
Background: Instillation of local anaesthetics over incision site is a simple technique done as a part of multimodal analgesia targetting incisional pain for post-operative pain relief following lumbar laminectomy. Aim: To determine postoperative analgesic effect of ropivacaine in wound instillation for lumbar laminectomy. Study Design: Prospective, randomised, double blind study. Methodology: Forty patients scheduled for elective lumbar laminectomy under general anaesthesia were enrolled and randomly allocated into two groups namely Group R (n=20 receiving 20ml of 0...
July 2018: Anesthesia, Essays and Researches
Erhan Gokcek, Ayhan Kaydu
Background: Vitamin D is associated with musculoskeletal function in our body, and its deficiency is a common health problem all over the world. Low back pain (LBP) is an important health problem in terms of low quality of life, loss of work power, and cost of diagnosis and treatment approaches. Aims: The purpose of this study is to investigate the relationship between pain severity and Vitamin D deficiency in patients who applied to pain polyclinic with LBP. Settings and Design: This was a retrospective, observational study...
July 2018: Anesthesia, Essays and Researches
Vandana Talwar, Veena Ganeriwal, Shipra Aggarwal, Akhilesh Gupta
Background: Laryngoscopy and tracheal intubation (LTI) are known to release catecholamines resulting in rise in heart rate (HR) and blood pressure. Various drugs have been studied till date to attenuate the sympathomimetic effects of laryngoscopy and intubation. Aims: The aim is to study the effect and safety of esmolol, diltiazem, and their combination on pressor response of laryngoscopy and intubation. Setting and Design: This prospective, randomized double-blind study was designed to assess the efficacy of the combination of esmolol and diltiazem and compare it with esmolol and diltiazem when used alone, for attenuating the pressor response to laryngoscopy and intubation...
July 2018: Anesthesia, Essays and Researches
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