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Anesthesia, Essays and Researches

Omar Viswanath, Andrew P White
No abstract text is available yet for this article.
April 2018: Anesthesia, Essays and Researches
Saurabh Sud, Deepak Dwivedi, Manish Paul, Sanasam Ushakiran Singh
No abstract text is available yet for this article.
April 2018: Anesthesia, Essays and Researches
Chelliah Sekar, Tuhin Mistry, Poonoly Varkey Sheela, Vipin Kumar Goel
No abstract text is available yet for this article.
April 2018: Anesthesia, Essays and Researches
Nandita Mehta, Gurleen Kaur
Glutaric aciduria Type 1 (GA-1) is an autosomal recessive metabolic disorder that results from deficiency of enzyme glutaryl-CoA dehydrogenase. This gives rise to elevated neurotoxic glutaric acid and 3-hydroxyglutaric acid as well as nontoxic glutarylcarnitine in body fluids. The enzyme defect leads to secondary damage to central nervous system due to the accumulation of glutaric acid. Approximately 90% people will develop the neurological disease during a finite period of brain development (3-36 months) following an acute encephalopathic crisis often precipitated by gastroenteritis, immunization, surgical intervention, and intercurrent febrile illness...
April 2018: Anesthesia, Essays and Researches
Shaila S Kamath, Julie C R Misquith
Myasthenia gravis (MG) is a neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. The decrease in the number of acetylcholine receptors results in decreased efficiency of neuromuscular transmission. Although acetylcholine is released normally, it produces small end-plate potentials that fail to trigger muscle action potentials. Failure of transmission at many neuromuscular junctions results in weakness of muscle contraction. This also makes them susceptible to neuromuscular blocking agents which pose a challenge to the anesthesiologist...
April 2018: Anesthesia, Essays and Researches
Parikshit Singh, Sharmishtha Pathak, Ram Murti Sharma
Context: Acute Physiology and Chronic Health Evaluation (APACHE) III and Simplified Acute Physiology Score (SAPS) II are frequently used to predict the outcome of Intensive Care Unit (ICU) patients of sepsis. Aim: The aim of the study was to compare the predictability of outcome with APACHE III and SAPS II score in ICU patients of sepsis, severe sepsis, and septic shock and the 28-day mortality. Settings and Design: This study was an observational, prospective cohort study...
April 2018: Anesthesia, Essays and Researches
Sumedha Mehta, Manojkumar Namdeorao Gajbhare, Neha Prabhakar Kamble
Introduction: Ropivacaine is preferred over racemic bupivacaine for postoperative analgesia as it is less cardiotoxic and has high selectivity for sensory fibers. We aim to compare postoperative epidural analgesia using 0.2% bupivacaine and 0.2% ropivacaine in major lower limb orthopedic surgery. Materials and Methods: In a prospective, randomized, double-blind study, 100 patients, aged 18-70 years, undergoing elective major lower limb orthopedic surgery under spinal anesthesia, were randomly allocated to receive either 7 ml ropivacaine 0...
April 2018: Anesthesia, Essays and Researches
Gayatri Mishra, Varghese Mammen Philip, Vadlamudi Reddy Hemanth Kumar, Thiyagarajan Sivashanmugam
Background: Several video laryngoscopes had demonstrated their superiority over conventional oral and nasal intubation techniques. King Vision video laryngoscope has fewer studies supporting its suitability for oral intubations. However, its suitability as a nasal intubating device has not been yet evaluated. We evaluated the suitability of King Vision video laryngoscope for nasotracheal intubation comparing with TruviewPCD . Methods: Eighty American Society of Anesthesiologists Grade I and II elective surgical patients were studied...
April 2018: Anesthesia, Essays and Researches
Arindam Sarkar, Narendra Singh Bafila, Raj Bahadur Singh, Mohd Asim Rasheed, Sanjay Choubey, Vishal Arora
Context: Different trials have shown that multimodal analgesia through different techniques is associated with superior pain relief. Opioids as epidural adjunct to local anesthetics have been in use for long and α2 agonists are being increasingly used for same. The present study aims at comparing the hemodynamic, sedative, and analgesic effects of epidurally administered fentanyl and dexmedetomidine when combined with bupivacaine. Aims: The aim of this study was to compare the efficacy of epidural dexmedetomidine with bupivacaine versus epidural fentanyl with bupivacaine for postoperative pain relief...
April 2018: Anesthesia, Essays and Researches
Neha Sharma, Nandita Mehta
Context: The hemodynamic response associated with laryngoscopy and tracheal intubation is a common concern for the anesthesiologist, especially in high-risk patients. The use of dexmedetomidine has found favor in obtunding this response, in addition to providing better intubating conditions and reducing the dose of other anesthetic drugs. Most of the current literature states a loading dose of 1 μg/kg dexmedetomidine to be superior to lower doses in this regard. However, using a lower dose may be advantageous by reducing incidence of adverse effects such as hypotension and bradycardia which are likelier with the use of higher dose, in addition to being more cost-effective...
April 2018: Anesthesia, Essays and Researches
Tripat Kaur Bindra, Parmod Kumar, Garima Jindal
Background: Nalbuphine when used as adjuvant to hyperbaric bupivacaine has improved the quality of perioperative analgesia with fewer side effects. Fentanyl is a lipophilic opioid with a rapid onset following intrathecal injection. It does not cause respiratory depression and improves duration of sensory anesthesia without producing significant side effects. Aim: This study aims to compare the postoperative analgesia of intrathecal nalbuphine and fentanyl as adjuvants to bupivacaine in cesarean section...
April 2018: Anesthesia, Essays and Researches
Tufail Ahmad Sheikh, Bashir Ahmad Dar, Nihida Akhter, Nadeem Ahmad
Background: The use of intravenous sedation during cardiac surgery to reduce awareness has been practised routinely during past few years and the two most commonly used drugs include propofol and dexmedetomidine, but their effects on hemodynamics and postoperative outcomes in cardiac surgery is continually being evaluated. Aims: The aim of this study was to compare the effects of anesthesia by dexmedetomidine and propofol on the hemodynamic variables and postoperative outcomes in patients who were planned for elective cardiac surgery...
April 2018: Anesthesia, Essays and Researches
Abhijit S Nair, Vibhavari Naik, Mohammed Salman Saifuddin, Poornachand Anne, Kodisharapu Praveen Kumar, Basanth Kumar Rayani
Background: Peri-operative incentive spirometry (IS) helps in improving pulmonary function, facilitates sputum clearance and prevents unwanted postoperative pulmonary complications after major abdominal and thoracic surgery. In our hospital, all patients are instructed to practice IS before abdominal and thoracic surgeries so that they can perform it in the postoperative period effectively. However, many patients do not follow our advice. A few unfortunate patients land up with pulmonary complications as it becomes difficult to train them after surgery...
April 2018: Anesthesia, Essays and Researches
Bindu K Vasu, Kruthika P Ramamurthi, Sunil Rajan, Mathew George
Background: Hip fracture is a devastating health-care problem in a geriatric patient, leading to high mortality and morbidity. Preoperative risk assessment in the geriatric patient is often inexact because of the difficulty in measuring their poor physiologic reserves. Aims: The primary objective was to find the association of modified frailty index (MFI) with 90-day mortality in geriatric patients who received anesthesia for fractured hip. Secondary objectives were to assess the association of preoperative waiting time with the 90-day mortality and the correlation of preexisting medical conditions with poor functional outcome among the survivors...
April 2018: Anesthesia, Essays and Researches
Mallika Ganesh, Dinesh Krishnamurthy
Context: Spinal block is the first choice for lower abdominal surgeries. Bupivacaine is the most common local anesthetic used but has a shorter duration of action. Many adjuvants have been used to improve the quality of analgesia till postoperative period. In this study, we used α2 -agonists. Aims: The aim of this study is to compare the effects of intrathecal dexmedetomidine and clonidine as adjuvants to hyperbaric bupivacaine with respect to onset and duration of sensory and motor blockade duration of analgesia and incidence of side effects...
April 2018: Anesthesia, Essays and Researches
Bhavana B Gurunath, Ravi Madhusudhana
Context: Subarachnoid block or spinal anesthesia is a commonly used technique for lower abdominal and lower limb surgeries. Bupivacaine is the commonly used cost-effective drug which gives satisfactory analgesia for 90-120 min. Additives such as opioids and α2 agonists extend the analgesia in the postoperative period. In this study, we compared the effects of nalbuphine with fentanyl. Aims: The aim of this study is to compare the effects of intrathecal nalbuphine and fentanyl as adjuvants to hyperbaric bupivacaine in regard to time of onset of sensory blockade, duration of sensory blockade, two-segment sensory regression time, duration of effective postoperative analgesia, and incidence of side effects...
April 2018: Anesthesia, Essays and Researches
Nikila Devarayasamudram Gopal, Dinesh Krishnamurthy
Context: Positioning fracture femur cases for sub arachnoid block (SAB) is challenging. Fascia iliaca compartment block (FICB) is low skilled, helps positioning, and provides analgesia. Dexmedetomidine as an adjuvant prolongs analgesia. Aims: The aims were to study and compare FICB with bupivacaine and bupivacaine with dexmedetomidine in fracture femur cases with regard to positioning during SAB, duration of analgesia in terms of Visual Analog Scale (VAS), Numerical Rating Scale (NRS), and Patient Satisfaction Score, and assess side effects...
April 2018: Anesthesia, Essays and Researches
Gerard Gonsalvez, Deepa Baskaran, Vasudeva Upadhyaya
Background: Emergence delirium (ED) is a distressing side effect of sevoflurane anesthesia in children. Midazolam is a widely studied drug for the prevention of ED with conflicting results. Aim Settings and Design: We designed this prospective randomized double-blind study to compare the effect of 0.03 mg/kg midazolam administered at induction and the same dose administered 10 min before the end of surgery in the prevention of ED in children undergoing sevoflurane anesthesia and also the effect on the time to recovery in both groups...
April 2018: Anesthesia, Essays and Researches
Mohamed Ahmed Hamed, Abeer Shaban Goda, Reham Mohmmed Salah Eldein
Background: It is a challenge for anesthesiologists to balance between administering intravenous fluid, vasoactive agents, and inotropic drugs to maintain appropriate cardiac output. Aim: The aim of this study was to evaluate the effect of treatment algorithm guided either by pulmonary artery catheter (PAC) or by the fourth generation FloTrac/Vigileo system combined with monitoring of oxygen transport on hemodynamic management and outcome after coronary artery bypass graft surgery (CABG)...
April 2018: Anesthesia, Essays and Researches
Jeetinder Kaur Makkar, Deepak Dwivedi, Aswini Kuberan, Balbir Kumar, Indu Bala
Context: Neuraxial techniques have sedative properties secondary to decreased inputs from sensory and motor afferents. We hypothesized that caudal analgesia decreases the requirement of desflurane as measured by bispectral index (BIS). Aims: This study aims to determine the minimum alveolar concentration (MAC) of desflurane for maintaining BIS below 50 (MACBIS50 ) in children undergoing infraumbilical surgeries with laryngeal mask airway (LMA) and study the effect of caudal analgesia on the same...
April 2018: Anesthesia, Essays and Researches
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