Show all abstracts Show selected abstracts Add to my list |
|
EDITORIAL |
|
|
|
What is the Youngest Age Appropriate for Outpatient Surgery? |
p. 5 |
Pramila Bajaj PMID:20640071 |
[HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
REVIEW ARTICLE |
 |
|
|
 |
21st Century - Still No Standardization |
p. 12 |
Urmila Palaria, DC Punera, AK Sinha, UK Bhadani, B Chhabra PMID:20640072Standardization of anaesthetic equipment is needed for safe anaesthetic practice. Various organizations and regulatory bodies have been made throughout world to formulate and control standards for anaesthesia equipment including endotracheal tubes. All endotracheal tubes must conform to ASTM standards. This has medico-legal importance also. Regulatory bodies should look after the whole process right from the manufacturers to the actual users. The Indian Society of Anaesthesiologists promotes safe anaesthetic practice, by establishing purchase guidelines for equipments and drugs. It is working in collaboration with World Federation of Societies of Anaesthesiologists. Standards have made anaesthesia and critical care equipment much safer over the years. There is need to form standards for various equipment in India. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
SPECIAL ARTICLE |
 |
|
|
|
Anticancer Chemotherapy and it's Anaesthetic Implications (Current Concepts) |
p. 18 |
RP Gehdoo PMID:20640073Many a times, cancer patients undergo chemotherapy before being subjected for surgery. Such patients pose some serious interactions and complications during the anaesthetic management. So, it is very important to know such interactions, and problems in advance for a smoother and uncomplicated management of anaesthesia. Herewith, a detailed review of this problem is discussed along with the current concepts and solutions. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
CLINICAL INVESTIGATIONS |
 |
|
|
|
Intrathecal Catheterization by Epidural Catheter: Management of Accidental Dural Puncture and Prophylaxis of PDPH |
p. 30 |
Ashok Jadon, Swastika Chakraborty, Neelam Sinha, Rajiv Agrawal PMID:20640074Accidental or inadvertent dural puncture during epidural anaesthesia results in high incidence of post dural puncture headache (PDPH). Spinal or intrathecal catheter in such a situation, provides aconduit for administration of appropriate local anaesthetic for rapid onset of intraoperative surgical anaesthesia and postoperative pain relief. This procedure prevents PDPH if catheter left in situ for > 24 hrs and also avoids the associated risks with a repeat attempts at epidural analgesia.
Primary aim of this study was to observe the effect of spinal catheter on incidence of PDPH, and to assess early and delayed complications of spinal catheterization by epidural catheter.
In prospective clinical study 34 patients who had accidental dural puncture during epidural anaesthesia were included. The catheter meant for epidural use was inserted in spinal space and used for spinal anaesthesia and postoperative analgesia. Catheter was removed between 24-36hrs after surgery.
The incidence of accidental dural puncture was 4% (34/ 846). Two patients 5.88% (2/34) had transient paresthesia duringspinal catheter insertion. Postdural puncture headache occurred in 11.76% (4/34) patients. Two patients required epidural blood patch and two patients were managed with conservative treatment. No patient had any serious intraoperative or postoperative side effects.
Epidural catheter can be used as spinal catheter to manage accidental dural puncture without serious complications, and it also prevents PDPH. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Reasons for Cancellation of Cases on the Day of Surgery-A Prospective Study |
p. 35 |
Rakesh Garg, Anju R Bhalotra, Poonam Bhadoria, Nishkarsh Gupta, Raktima Anand PMID:20640075Late cancellation of scheduled operations is a major cause of inefficient use of operating-room time and a waste of resources. We studied elective operating theatre bookings in general surgical discipline. On the day of surgery the intended list was noted and a list of cancellations with the reason was noted by the attending anaesthesiologist.
1590 patients were scheduled for elective surgical procedures in 458 operation rooms. 30.3 % patients were cancelled on the day of surgery. Of these, 59.7% were cancelled due to lack of availability of theatre time, 10.8% were cancelled because of medical reasons and 16.2% did not turned up on the day of surgery. In 5.4% patients, surgery was cancelled by surgeons due to a change in the surgical plan, 3.7% were cancelled because of administrative reasons, and 4.2% patients were postponed because of miscellaneous reasons.
We believe that many of the on-the-day surgery cancellations of elective surgery were potentially avoidable. We observed that cancellations due to lack of theatre time were not only a scheduling problem but were mainly caused by surgeons underestimating the timeneeded for the operation. The requirement of the instruments necessary for scheduled surgical listshould be discussed a day prior to planned OR list and arranged. The non-availability of the surgeon should be informed in time so that another case is substituted in that slot. All patients who have met PACU discharge criteria must be discharged promptly to prevent delay in shifting out of the operated patient. Day care patients should be counseled adequately to report on time. Computerized scheduling should be utilized to create a realistic elective schedule. Audit should be carried out at regular intervals to find out the effective functioning of the operation theatre. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Gargling with Ketamine Attenuates the Postoperative Sore Throat |
p. 40 |
A Rudra, Suchanda Ray, S Chatterjee, A Ahmed, S Ghosh PMID:20640076Postoperative sore throat (POST) is a common complication of anaesthesia with endotracheal tube that affects patient satisfaction after surgery. Therefore, this complication remains to be resolved in patients undergoing endotracheal intubation. The aim of the study was to compare the effectiveness of ketamine gargles with placebo in preventing POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anaesthesia were randomized into: Group C, water 30 ml; Group K, ketamine 50 mg in water 29 ml. Patients were asked to gargle this mixture for 40 seconds, 5 minutes before induction of anaesthesia. POST was graded at 4, 8 and 24 hours after operation on a four-point scale (0-3). In the Control group POST occurred more frequently, when compared with patients belonging to Ketamine group, at 4, 8, and 24 hours and significantly more patients suffered severe POST in Control group at 8 and 24 hours compared with Ketamine group (P<0.05). We demonstrated that gargling with ketamine significantly attenuated POST, with no drug-related side effects were observed. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Subdural Pressure and Brain Condition During Propofol Vs Isoflurane - Nitrous Oxide Anaesthesia in Patients Undergoing Elective Supratentorial Tumour Surgery |
p. 44 |
Sankari Santra, Bibhukalyani Das PMID:20640077Total intravenous anaesthesia has received much importance than inhalational anaesthesia in neuroanaesthetic practice. In an effort to determine whether any important clinical differences occur, studies concerning intracranial pressure (ICP), degree of dural tension and degree of brain swelling during intravenous and inhalational based anaesthesia are warranted like the present one.
A total of 68 patients were assigned randomly to one of two groups. In Group-I(n=34), anaesthesia was induced with propofol (1-3mg.kg -1 ) and maintained with propofol (6-10mg.kg -1 .hr -1 ) and fentanyl (2-3mcg.kg -1 .hr -1 ). In Group II (n=34), anaesthesia was induced with propofol (1-3mg.kg -1 ) but maintained with isoflurane, nitrous oxide and fentanyl (2-3mcg.kg -1 .hr -1 ). Moderate hypocapnia was applied to maintain arterial carbon dioxide around 30mmHg. Mean arterial blood pressure was stabilized with phenylephrine whenever necessary. Subdural intracranial pressure, mean arterial pressure, cerebral perfusion pressure were monitored before and after 10min period of hyperventilation. Furthermore, the tension of dura before and after of hyperventilation and the degree of brain swelling after opening of dura were also estimated by the neurosurgeon.
No differences were found between the groups with regards to demographics, neuroradiologic diagnosis, position of head and time of ICP measurement. Before hyperventilation, both ICP and dural tension were significantly lower in Group I compared with Group-II (P<0.05). But after hyperventilation there was no significant difference of ICP and dural tension in between groups. The degree of brain swelling after opening of dura was similar in both groups. There was a positive correlation between measured ICP and brain swelling score. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
A Preliminary Study of I-Gel: A New Supraglottic Airway Device |
p. 52 |
Ashish Kannaujia, Uma Srivastava, Namita Saraswat, Abhijeet Mishra, Aditya Kumar, Surekha Saxena PMID:20640078This preliminary study on I-gel TM (Intersurgical Ltd, Wokingham,U K) was conducted on 50 consecutive patients of ASA physical status I-III, to determine the ease of insertion, time to achieve effective airway, oropharyngeal seal pressure and airway stability on head and neck movement.
After premedication with midazolam and fentanyl, induction was done with propofol and I-gel was inserted according to manufacturer's instruction. An effective airway was confirmed by bilateral chest movement, square wave on capnograph and SpO 2 >95%.
The success rate at first attempt was 90% with a median insertion time of 11 sec (range 8-45sec). Five patients (10%) needed second attempt while none needed 3 rd attempt. The manipulation needed to achieve effective airway were increasing the depth of insertion of I-gel in 4 (8%) cases , jaw thrust or chin lift in2(4%) cases. Oropharyngeal seal pressure was 20 cm of H 2 O (16-40 cm of H 2 O). Gastric tube placement was done in 50% of the cases; it was easy and successful in all the cases. No significant adverse event was noted in any of the patient in perioperative period.
Our initial experience showed that I-gel is a simple, easy to use supraglottic airway device with a high success rate at first time insertion. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Effect of Fentanyl Addition to Local Anaesthetic in Peribulbar Block |
p. 57 |
Mostafa Abdel Hamid Abo El Enin, Ismail Ewis Amin, Ahmed Sayed Abd El Aziz, Mostafa Mohamed Mahdy, Mohamed Abdel Hamid Abo El Enin, Mostafa Mahmoud Mostafa PMID:20640079Forty patients ASAI, II undergoing vitrectomy due to vitreous hemorrhage not associated with retinal detachment were divided into two groups randomly, each of them with 20 patients. In Control group patients received local anaesthetic only, while Fentanyl group receive 20 mcg fentanyl added to local anaesthetic, the onset and duration of lid and globe akinesia were assessed at 1,3,5 and 10 min. Postoperative VAS was recorded each hour up to 6 th hour.
The results show statistically significant difference between the two groups in the onset of lid akinesia. Fentanyl group had faster onset of lid akinesia and had significantly longer duration of akinesia (196.5 ± 14.24 min). There is statistically significant difference between the two groups in the onset of globe akinesia at 3, 5 min. Fentanyl group had faster onset than Control group and had longer duration of globe akinesia (294 ± 17.89 min).
Fentanyl group had prolonged duration of analgesia 3.25+ 0.67 hr as compared to 1.85+ 0.67 in Control group, P=0.00 postoperatively. There were statistically significant differences between the two groups as regard the mean VAS in 1,2,3,4 hours, Fentanyl group had lower median pain score than Control group. Addition of fentanyl to local anaesthetic mixtures fasters the onset and prolong the duration of akinesia and improve quality of postoperative pain in peribulbar block. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
CASE REPORTS |
 |
|
|
 |
Anaesthetic Management of A Patient with Sturge-Weber Syndrome Undergoing Oophorectomy |
p. 64 |
Manju Gandhi, Hemlata Iyer, Herman Sehmbi, Kavita Datir PMID:20640080The Sturge-Weber Syndrome (SWS) is a neurocutaneous disorder characterized by leptomeningeal and facial angiomas, neurologic and ocular manifestations. We report a case of oophorectomy for ovarian dermoid in a 14 year old girl who was a diagnosed case of Sturge-Weber Syndrome. General anaesthesia was given for the procedure. The perioperative anaesthestic management is discussed in the present report. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Anaesthetic Management of A Case of Osteogenesis Imperfecta with Urinary Bladder Stone-A Case Report |
p. 68 |
Munish Garg, Manish Jain, Amit Gupta PMID:20640081Sometimes in practice of anaesthesia, anaesthesiologist encounters patients with rare congenital diseases. To anaesthesiologist, these patients are a challenge due to inherent complications associated with the disease. Here, we are reporting a case of osteogenesis imperfecta who was posted for the surgery for vesical calculus. All investigations were done to rule out any cardio-respiratory abnormalities, bleeding disorders, which are commonly associated with these patients. Caudal epidural was chosen as anaesthesia technique of choice as spinal anaesthesia was anticipated to be difficult due to associated kyphoscoliosis. GA was avoided due to anticipated difficult airway, restrictive lung disease and susceptibility to malignant hyperthermia. We emphasize the importance of proper preanaesthetic evaluation, intellectual, mental and logistical preparation which should be done before anaesthetising these types of patients. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Total Anomalous Pulmonary Venous Connection: Post Operative Problems and Management |
p. 71 |
Sandeep Khanna, Minati Choudhury, Usha Kiran PMID:20640082The uncommon congenital cardiac anomaly, total anomalous pulmonary venous connection is incompatible with life unlessearly surgical intervention isdone. Most of the post operative problems and mortality in these children are also due to the changes in pulmonary vasculature. We hereby report two such cases that experienced a stormy postoperative course. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Airway Management in A Case of Tongue Flap Division Surgery: A Case Report |
p. 75 |
Tapas Kumar Sahoo, Manasi Ambardekar, RD Patel, SH Pandya PMID:20640083This article sums up successful airway management in an 18-year-old male presented for tongue flap division surgery constructed before for a palatal fistula in our hospital. After induction of general anaesthesia, we performed laryngoscopywith right molar approach using miller straight blade, intubated from rightside of flap and throat packing done using left molar approach. Tongue flap was divided without any ties and hemostasis checked. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Anaesthetic Consideration in Macroglossia Due to Lymphangioma of Tongue: A Case Report |
p. 79 |
Anurag Tewari, Munish Munjal, Kamakshi , Shuchita Garg, Dinesh Sood, Sunil Katyal PMID:20640084Successful airway management of an infant or child with macroglossia prerequisites recognition of a potential airway problem. We describe our experience with a debilitated 13-year-old girl who presented with severe macroglossia, secondary to lymphangioma of the tongue. Along with the social discomfort she had inability to speak, eat or drink properly and exposure-induced dryness. Such patients are a challenge for the anaesthesiologists due to the anticipated difficult intubation associated with the oral mucosa occupying lesion. It also becomes pertinent to rule out any of the associated congenital anomalies. The importance of a thorough preoperative evaluation and attention to difficult intubation and maintenance of airway is emphasized. We endeavor to review the available literature regarding patient's perioperative management of such patients. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Submandibular Approach for Tracheal Intubation-A Case Report |
p. 84 |
G Uma, PN Viswanathan, PS Nagaraja PMID:20640085Intubating a patient with panfacial fractures is always a challenge to the anaesthesiologist. In a 40-yr-old male patient with left Le Fort's III fracture with nasal bone and symphysis menti fracture, we successfully carried out oral endotracheal intubation which was then modified to submandibular approach to provide adequate surgical field. Initially oral endotracheal intubation was performed, then an incision was made in the submandibular region through which the endotracheal tube was brought out and maintained as submandibular approach throughout the surgery. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Ruptured Aneurysm of Right Sinus of Valsalva in Pregnancy-A Case Report |
p. 88 |
Leena Goel, Pooja Gautam, Suchith C PMID:20640086A 26 year old multigravida at 36.6 weeks of gestation with ruptured aneurysm of right sinus of Valsalva was presented for caesarean section. Diagnosis was confirmed by transthoracic echocardiography. Here we present the anaesthetic management of this case posted for caesarean section. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Anaesthetic Management for Cataract Surgery in VACTERL Syndrome Case Report |
p. 94 |
Sonal S Khatavkar, SR Jagtap PMID:20640087Eight year old girl, weighing 14 kg with VACTERL syndrome V: Vertebral anomalies, A: Anal malformation, C: Cardiovascular defect, TE: Tracheal and esophageal malformation, R:Renal agenesis, L: Limb anomalies., underwent cataract surgery under general anaesthesia. She had multiple congenital anomalies like esophageal atresia, imperforate anus (corrected), single kidney& radial aplasia. Anticipating problems of gastro-esophageal reflux& chronic renal failure, successful management was done. |
[ABSTRACT] [HTML Full text] [PDF] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
EVIDENCE BASED DATA |
 |
|
|
|
Cardiac Arrest During Regional Anaesthesia |
p. 98 |
Pramila Bajaj |
[HTML Full text] [PDF] [Sword Plugin for Repository]Beta |
|
|
|
|
|