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Citation statistics : Table of Contents
2012| July-August | Volume 56 | Issue 4
Online since
September 8, 2012
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CLINICAL INVESTIGATIONS
Randomized crossover comparison of the laryngeal mask airway classic with i-gel laryngeal mask airway in the management of difficult airway in post burn neck contracture patients
Jeevan Singh, Manohar Kumar Yadav, Sujan Babu Marahatta, Bikash Lal Shrestha
July-August 2012, 56(4):348-352
DOI
:10.4103/0019-5049.100815
PMID
:23087456
Purpose:
The objective of the study was to compare the performance of i-gel supraglottic airway with cLMA in difficult airway management in post burn neck contracture patients and assess the feasibility of i-gel use for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening.
Methods:
Prospective, crossover, randomized controlled trial was performed amongst forty eight post burn neck contracture patients with limited mouth opening and neck movement. i-gel and cLMA were placed in random order in each patient. Primary outcome was overall success rate. Other measurements were time to successful ventilation, airway leak pressure, fiberoptic glottic view, visualization of square wave pattern.
Results:
Success rate for the i-gel was 91.7% versus 79.2% for the cLMA. i-gel required shorter insertion time (19.3 seconds vs. 23.5 seconds,
P
=0.000). Airway leak pressure difference was statistically significant (i-gel 21.2 cm H20; cLMA 16.9 cm H
2
0;
P
=0.00). Fiberoptic view through the i-gel showed there were less epiglottic downfolding and better fiberoptic view of the glottis than cLMA. Overall agreement in insertion outcome for i-gel was 22/24 (91.7%) successes and 2/24(8.3%) failure and for cLMA, 19/24 (79.16%) successes and 5/24 (16.7%) failure in the first attempt.
Conclusion:
The i-gel is cheap, effective airway device which is easier to insert and has better clinical performance in the difficult airway management of the airway in the post burn contracture of the neck. Our study shows that i-gel is feasible for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening in post burn neck.
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SPECIAL ARTICLES
Rapid emergence of day-care anaesthesia: A review
SB Gangadhar, TM Gopal, Sathyabhama , KS Paramesh
July-August 2012, 56(4):336-341
DOI
:10.4103/0019-5049.100813
PMID
:23087454
The number of day-care surgeries is increasing every day. The boundaries of day-care surgeries are being redefined on a continual basis. Multi-dimensional benefits to the patient, hospital and national economy are the driving forces behind the changing scenario on the horizon of day surgery. The literature search included Google, medlinx, pubmed and medline. We have attempted to look at the controversies in patient selection with comorbidities, pre-operative assessment and an acceptable ASA grade of patients. An attempt is also made to look at suitable surgical procedures, a pathway of introducing procedures, which are still complex and specialist procedures in challenging environment. The techniques of general anaesthesia, central neuraxial blocks, regional nerve blocks with indwelling catheters and monitoring techniques are deliberated upon. Finally the most important post-operative issues of discharge criteria, including recovery after spinal anaesthetic, oral fluid intake, voiding and travel after day surgery, are considered.
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CLINICAL INVESTIGATIONS
The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia
Aloka Samantaray, Mangu Hanumantha Rao, Abha Chandra
July-August 2012, 56(4):359-364
DOI
:10.4103/0019-5049.100817
PMID
:23087458
Background:
Treatment of acute post-thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications.
Aim:
This study was designed to test the effect of pre-induction administration of clonidine, given as a single intravenous dose, on post-operative pain scores and fentanyl consumption in patients after thoracic surgery.
Setting and Design:
Tertiary referral centre. Prospective, randomised, double-blind, placebo-controlled trial.
Methods:
Sixty patients were randomly allocated to receive clonidine (3 mcg/kg) or saline pre-operatively before induction of anaesthesia. The primary endpoint was pain on coughing (visual analogue scale (VAS) 0-100 mm) 120 min after surgery, time to first analgesic injection in the post-anaesthesia care unit (PACU) and 24-h fentanyl consumption.
Statistical Analysis:
For between-group comparisons,
t
-test and
U
-test were used as appropriate after checking normality of distribution. The incidence of complications between the groups was compared by Fisher's exact test.
Results:
The post-operative VAS for the first 120 min and the fentanyl consumption at 24 h was significantly greater in the placebo group compared with the clonidine group (
P
<0.05). The sedation score was increased in the clonidine group during study drug infusion, but did not differ significantly on admission to the PACU.
Conclusions:
A single intravenous dose of clonidine (3 mcg/kg) given before induction of anaesthesia significantly reduced the post-operative VAS score in the initial period and fentanyl consumption during 24 h after thoracic surgery.
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Randomized double-blind comparison of prophylactic ketamine, clonidine and tramadol for the control of shivering under neuraxial anaesthesia
Rama Wason, Nikhil Jain, Poonam Gupta, Anoop R Gogia
July-August 2012, 56(4):370-375
DOI
:10.4103/0019-5049.100821
PMID
:23087460
Background:
Shivering is a common problem during neuraxial anaesthesia. Neuraxial anaesthesia impairs thermoregulatory control and up to a 56.7% incidence of shivering has been reported.
Aim:
To evaluate the effectiveness of prophylactic use of intravenous ketamine, clonidine and tramadol in control of shivering and to note any side-effects of the drugs used.
Setting and Design:
Randomised double-blind study.
Methods:
This study was conducted in 200 ASA grade I and II patients. Neuraxial block was performed with 2.8 mL (14 mg) of 0.5% bupivacaine heavy in all patients. The patients were randomly allocated into four groups of 50 each to receive saline as placebo (group P), ketamine 0.5 mg/kg (group K), Clonidine 75 mcg (group C) and Tramadol 0.5 mg/kg (group T). Temperature and hemodynamic parameters were recorded at every 5-min interval. Shivering was graded from 0 to 4 grades and, if grade 3 shivering occurred, the study drug was considered as ineffective and intravenous pethidine 25 mg was given as rescue drug.
Statistical Analysis:
Data among groups was compared using one-way ANOVA. The incidence of shivering and side-effects were compared using the chi-square test.
Results:
The incidence of grade 3 shivering showed a statistically significant difference (
P=
0.001) in group P (27/50) as compared with the other groups (group K=5/50, group C=2/50, group T=4/50). No drug showed any statistically significant advantage over the other. No major hemodynamic changes were seen with prophylactic use of test drugs; however, sedation score was significantly higher in group K (
P
<0.05) as compared with the other groups.
Conclusion:
The prophylactic use of ketamine, clonidine and tramadol were effective in preventing shivering during neuraxial anaesthesia without causing any major untoward side-effects.
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Echo-guided estimation of formula for paravertebral block in neonates, infants and children till 5 years
Vrushali C Ponde, Ankit P Desai
July-August 2012, 56(4):382-386
DOI
:10.4103/0019-5049.100825
PMID
:23087462
Aims:
The aim of the study was to derive a clinically useful formula for paravertebral block for thoracic, lumbar (L1) and cervical level (C6) as per the ultrasound-guided measurements in neonates, infants and children up to 5 years of age.
Settings and Design:
Observational study.
Methods:
Seventy-five patients from 2 days to 60 months were included. Paravertebral transverse ultrasound scans at cervical (C6), thoracic (T1-12) and lumbar (L1) regions were viewed to determine the optimal insertion point and depth for performing paravertebral blocks. The lateral distance from the spinous process to the insertion point and the depth from the insertion point to the paravertebral space or reference point (point just anterior to the transverse process) were measured.
Statistical Analysis:
Data was analyzed using the SPSS (V 10.0) package. Preliminary data was collected with the actual values of paravertebral parameters and weight and age. Initially, Pearson Bivariate Correlation Coefficients were calculated between parameters and age and weight so as to predict paravertebral parameters with the help of weight and age. As there were statistically significant associations between parameters and age and weight, an attempt was made to predict parameters with the help of age and weight. Multiple regression method (forward) was applied by taking parameters as dependent variables and age and weight as independent variables.
Results:
Age and weight correlated very well (statistically significant) with paravertebral parameters; hence, prediction (regression) equations were calculated as: Prediction (regression) equation: C6A=0.005 × wt + 0.005 × age + 1.31 C6B=0.009 × wt + 0.002 × age + 1.78 T1-12 A=0.02 × wt + 0.003 × age + 0.93 T1 to 12 B=0.03 × wt + 0.03 × age + 1.02 L1A=0.03 × wt + 0.02 × age + 0.91 L1B=0.05 × wt + 0.02 × age + 0.94
Conclusions:
We could derive equations to predict the values for paravertebral blocks in centimetres at different levels in the study population.
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SPECIAL ARTICLES
Factors influencing career choice in anaesthesiology
Asha Tyagi, Surendra Kumar, Ashok Kumar Sethi, Upreet Dhaliwal
July-August 2012, 56(4):342-347
DOI
:10.4103/0019-5049.100814
PMID
:23087455
Background:
There is a shortage of anaesthesiologists in India. The factors that prompt medical students to opt for anaesthesiology as their career are not known; neither do we have any mechanism to know a student's stress-bearing ability before he/she opts for a stressful career like anaesthesiology. We conducted an anonymous, questionnaire-based, cross-sectional survey among 200 post-graduate anaesthesiology students to know various factors that they considered while opting for this speciality, and also evaluated their stress-bearing ability using Antonovsky's 13-point sense of coherence scale.
Methods:
Two-hundred anaesthesiology students were asked to complete a questionnaire regarding the factors they considered important while opting for anaesthesiology, also enumerated in order of importance the three most important factors that led to opting this career. Students also answered the questions in Antonovsky's sense of coherence (SOC) scale.
Results:
Economic security was considered by maximum number of students (67.7%), while intellectual stimulation/challenge offered by anaesthesiology was rated first in order of importance. Influence of doctor−patient relationship was not considered by large number of students. The weak SOC score (55) (25
th
percentile) was not greatly different than the mean SOC score (60) in the survey.
Conclusion:
Increasing the exposure of students to anaesthesiology at undergraduate level and building public awareness about the speciality will prompt more students to opt for the speciality, while career counselling with regard to specific needs of a speciality and ability of a student will help in opting the speciality that best suits the student's personality.
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1,149
BRIEF COMMUNICATIONS
Trade names that have become generic names in anaesthesia
AA Abraham
July-August 2012, 56(4):411-413
DOI
:10.4103/0019-5049.100852
PMID
:23087471
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Use of dexmedetomidine infusion in anaesthesia for awake craniotomy
Basavaraj G Kallapur, Raghavendra Bhosale
July-August 2012, 56(4):413-415
DOI
:10.4103/0019-5049.100854
PMID
:23087472
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CLINICAL INVESTIGATIONS
Comparision of efficacy of sufentanil and fentanyl with low-concentration bupivacaine for combined spinal epidural labour analgesia
P Akkamahadevi, HT Srinivas, Anjali Siddesh, Naveen Kadli
July-August 2012, 56(4):365-369
DOI
:10.4103/0019-5049.100819
PMID
:23087459
Objectives:
The highly lipid-soluble opioids, sufentanil and fentanyl, are used in combination with low-concentration bupivacaine to provide combined spinal epidural (CSE) analgesia during labour. We designed a prospective, randomized, single-blind study to compare the efficacy of these two opioids with bupivacaine in terms of the quality of analgesia, side-effects and maternal and foetal outcome.
Methods:
Sixty parturients requesting labour analgesia were divided into two groups randomly. Group S (n=30) received bupivacaine heavy (2.5 mg) and sufentanil (5 mcg) intrathecally and 10 mL intermittent bolus of sufentanil 0.30 mcg/mL in bupivacaine 0.125% as epidural top-ups. Group F (n=30) received bupivacaine heavy (2.5 mg) and fentanyl (25 mcg) intrathecally and 10 mL intermittent bolus of fentanyl 2.5 mcg/mL in bupivacaine 0.125% as epidural top-ups. Duration of intrathecal and epidural analgesia, mean duration between epidural top-ups and total analgesic requirements were noted. Pain and overall satisfaction scores were assessed with a 10-point visual scale. Mode of delivery and neonatal Apgar scores were recorded.
Results:
Maternal demographic characteristics were comparable between the groups. Although CSE provided satisfactory analgesia in both the groups, parturients of group S had a significant prolongation of analgesia through the intrathecal route compared with parturients of group F. Incidence of caesarean, instrumental delivery did not differ between the groups. No difference in the incidence of motor blockade or cephalad extent of sensory analgesia was observed. Neonatal outcome and incidence of side-effects were similar in both the groups.
Conclusion:
We conclude that combined spinal epidural using sufentanil and fentanyl achieved high patient satisfaction and excellent labour analgesia without serious maternal or neonatal side-effects. Sufentanil provided a significantly longer duration of labour analgesia compared with fentanyl.
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BRIEF COMMUNICATIONS
Central venous catheter rotation malposition: An unusual presentation
Gaurav S Tomar, Akhilesh K Tiwari, Darshan G Jain, Sonali Chawla, Rohan Sinha
July-August 2012, 56(4):415-417
DOI
:10.4103/0019-5049.100856
PMID
:23087473
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CASE REPORTS
Anaesthetic consideration in patients with Gorham's syndrome: A case report and review of the literature
Rajendra Kumar Sahoo, Balavenkatasubramanian Jagannathan, Gurumoorthi Palanichamy, Vivekanand Natarajan
July-August 2012, 56(4):391-393
DOI
:10.4103/0019-5049.100831
PMID
:23087464
Gorham's syndrome (GS) is a rare disorder characterized by proliferation of vascular channels resulting in destruction and resorption of osseous matrix leading to bone loss. Bone loss leads to joint instability and problems during airway management and positioning for surgery. Respiratory involvement further complicates anaesthesia management. We report the anaesthetic care of a 21-year-old male patient of known GS for spine decompression and fusion in prone position. Airway management, induction technique, pathophysiology of the disease, drug selection and other concerns of anaesthesia for major spine surgery has been discussed reviewing the sparse literature available.
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LETTERS TO EDITOR
Rhabdomyolysis complicating non-invasive blood pressure measurement
Chitra Srinivasan, Balaji Kuppuswamy
July-August 2012, 56(4):428-430
DOI
:10.4103/0019-5049.100847
PMID
:23087481
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2,185
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CASE REPORTS
Anaesthetic management in Gorlin-Goltz syndrome
Kundan S Gosavi, Surbhi D Mundada
July-August 2012, 56(4):394-396
DOI
:10.4103/0019-5049.100833
PMID
:23087465
Gorlin-Goltz syndrome is a rare autosomal-dominant syndrome related to mutation in "
Patched
" tumour suppressor gene on chromosome 9. Basocellular carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri are its major features, along with more than 100 minor features. Odontogenic cysts, notorious for recurrence, can make endotracheal intubation difficult, requiring modification of the standard intubation technique. We report such a case managed successfully by awake fibreoptic intubation. Direct laryngoscopy under anaesthesia later confirmed that it was a good decision.
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2,406
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Acute methaemoglobinaemia initially treated as organophosphate poisoning leading to atropine toxicity
Srinivas Kakhandki, Mohammed Yahya, Mudalgi Praveen
July-August 2012, 56(4):397-400
DOI
:10.4103/0019-5049.100836
PMID
:23087466
A case of unknown compound poisoning is presented. It was initially treated as organophosphate poisoning with lack of response. A timely diagnosis of acute methaemoglobinaemia and iatrogenic atropine toxicity was made based on clinical evaluation. Treatment of methaemoglobinaemia using oral methylene blue and of atropine toxicity with supportive measures could save the patient.
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Anaesthetic management of a patient with Cushing's syndrome and non-compaction cardiomyopathy for adrenal tumour resection
Akilandeswari Manickam, Aruna Parameswari, Mahesh Vakamudi
July-August 2012, 56(4):401-404
DOI
:10.4103/0019-5049.100838
PMID
:23087467
We describe the anaesthetic management of adrenalectomy in a patient with Cushing's syndrome due to adrenal mass with coexisting non-compaction cardiomyopathy. The problems due to hypersecretion of cortisol in Cushing's syndrome were compounded by the association of a rare form of genetic cardiomyopathy with very few guidelines regarding the perioperative management. The knowledge about the pathophysiological changes, clinical presentation and complications in non-compaction cardiomyopathy is essential for planning the anaesthetic care, and the aim of this presentation is to highlight the issues crucial for management of such challenging patients.
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2,924
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Pulmonary oedema in a patient undergoing vitreo-retinal surgery under peribulbar block
Anjolie Chhabra, Preet M Singh, Mritunjay Kumar
July-August 2012, 56(4):387-390
DOI
:10.4103/0019-5049.100828
PMID
:23087463
A 42
-
year-old diabetic and hypertensive male with good effort tolerance was administered peribulbar block for vitreo-retinal surgery. Ten millilitres of an equal mixture of 2% lignocaine and 0.5% bupivacaine was administered for the block after ascertaining negative aspiration for blood. Inadequate akinesia of the eye necessitated further supplementation with 4 mL of local anaesthetic (LA) mixture. Thirty minutes later, the patient complained of uneasiness, respiratory distress and desaturated despite oxygen supplementation. He was found to be in pulmonary oedema. He subsequently developed a weak thready pulse, became unresponsive, apnoeic and had generalized tonic clonic convulsions. Immediately, atropine 0.6 mg, followed by midazolam, intubation, mechanical ventilation, morphine and furosemide, were administered intravenously. Spontaneous respiration returned in 20 minutes and he started responding to verbal commands 90 minutes later. He was weaned off the ventilator the next morning. There was no evidence of an ischemic myocardial event and non-contrast computerized tomography scan of the head was normal. The reversible cardiorespiratory arrest, associated convulsions and loss of consciousness were suggestive of LA toxicity. Pulmonary oedema manifesting as respiratory distress and desaturation can be the initial manifestation of LA toxicity in patients with pre-existing cardiovascular disease undergoing eye surgery under peribulbar block.
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CLINICAL INVESTIGATIONS
Mechanical and infectious complications of central venous catheterizations in a tertiary-level intensive care unit in northern India
Randeep Kaur, Ashu Sara Mathai, John Abraham
July-August 2012, 56(4):376-381
DOI
:10.4103/0019-5049.100823
PMID
:23087461
Background:
Central venous catheters (CVC) are associated with mechanical, infectious and thrombotic complications.
Aims:
To study (a) the incidence of mechanical and infectious complications of CVC insertions and to compare, (b) the rates of these complications between the internal jugular venous (IJV) and the subclavian venous (SCV) accesses.
Settings and Design:
An adult intensive care unit of a tertiary care hospital. Prospective, observational study.
Methods:
All landmark-based CVC insertions performed between 1
st
October 2008 and 30
th
September 2009 were prospectively studied for mechanical and infectious complications.
Statistical Analysis:
SPSS software for Windows, Version SPSS 16.0, and Epi Info (3.5.1) software.
Results:
Four hundred and eighty central venous catheterizations were studied (IJV route, 241 and SCV route, 239). Mechanical complications occurred in 86 patients (17.9%, bleeding complications-48, catheter-related complications-27 and pneumothorax-11). The IJV route was associated with a significantly higher incidence of bleeding complications (
P
=0.009). Forty-seven patients had infectious complications (9.79%), like exit site infections (
n
=17), catheter tip infections (
n
=22) and catheter-related bloodstream infections (CRBSIs) (
n
=8). The risks of infectious complications increased significantly if the CVC was
in situ
for longer than 7 days (
P
=0.009), especially with IJV cannulae. The incidence density of CVC tip infections was 7.67 per 1000 catheter days and of CRBSIs was 2.79 per 1000 catheter days.
Conclusions:
Bleeding complications occurred more frequently with IJV insertions and infectious complications occurred more commonly in cannulae that were left
in situ
for longer than 7 days.
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Comparison of haemodynamic responses to intubation: Flexible fibreoptic bronchoscope versus bonfils rigid intubation endoscope
Kapil Gupta, Kiran Kumar Girdhar, Raktima Anand, Sumanth Mallikarjuna Majgi, Surinder Pal Gupta, Payal Bansal Gupta
July-August 2012, 56(4):353-358
DOI
:10.4103/0019-5049.100816
PMID
:23087457
Background
: The flexible fibreoptic bronchoscope and bonfils rigid intubation endoscope are being widely used for difficult intubations.
Methods:
The haemodynamic response to intubation under general anaesthesia was studied in 60 adult female patients who were intubated using either flexible fibreoptic bronchoscope or bonfils rigid intubation endoscope (30 in each group). Non-invasive blood pressure and heart rate (HR) was recorded before induction of anaesthesia, immediately after induction, at the time of intubation and, thereafter, every minute for the next 5 min. The product of HR and systolic blood pressure (rate pressure product) at every point of time was also calculated.
Statistical Analyses:
Graph pad prism, 5.0 statistical software, independent t test and repeated measure ANOVA test were used.
Results:
Both bonfils rigid intubation endoscope and flexible fibreoptic bronchoscope required a similar time (less than 1 min) for orotracheal intubation. After intubation, there was a significant increase in HR, blood pressure and rate pressure product (P<0.001) in both the groups compared with the baseline and post-induction values. There was no significant difference in HR, blood pressure and rate pressure product at any of the measuring points or in their maximum values during observation between the two groups. The time required for recovery of systolic blood pressure and HR to post-induction value (±10%) was not significantly different between the two groups (more than 2 min).
Conclusion:
In female adults under general anaesthesia, bonfils rigid intubation endoscope and flexible fibreoptic bronchoscope require a similar time for successful orotracheal intubation and cause a similar magnitude of haemodynamic response.
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EDITORIAL
Perioperative fluid therapy: How much is not too much?
CL Gurudatt
July-August 2012, 56(4):323-325
DOI
:10.4103/0019-5049.100810
PMID
:23087452
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1
5,066
2,464
LETTERS TO EDITOR
A rare potentially hazardous malposition of the nasotracheal tube
Kalavala Lakshminarayana Subramanyam, Mellacheruvu Sree Rama Chandra Murthy
July-August 2012, 56(4):433-433
DOI
:10.4103/0019-5049.100853
PMID
:23087484
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1
1,574
325
Catheter malposition in infants: A preventable complication
Ira Balakrishnan, Manpreet Kaur, Chhavi Sawhney, Nita D'Souza
July-August 2012, 56(4):427-428
DOI
:10.4103/0019-5049.100846
PMID
:23087480
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1
2,029
319
Facilitated nasotracheal intubation in patient with restricted mouth opening aided by D-blade of C-Mac videolaryngoscope and Schroeder's directional stylet
Abdullah M Al-Jadidi, Rashid M Khan, Sujit V Nair, Naresh Kaul
July-August 2012, 56(4):422-423
DOI
:10.4103/0019-5049.100840
PMID
:23087477
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1
1,895
439
REVIEW ARTICLE
Liver transplantation: Advances and perioperative care
Amar Nandhakumar, Stuart A McCluskey, Coimbatore Srinivas, Tony T Chandy
July-August 2012, 56(4):326-335
DOI
:10.4103/0019-5049.100812
PMID
:23087453
Liver transplantation is one of the treatments for many-life threatening liver diseases. Numerous advances in liver transplant surgery, anaesthesia and perioperative care have allowed for an increasing number of these procedures. The purpose of this review is to consider some of the important advances in perioperative care of liver transplant patients such as pre-operative evaluation, intraoperative monitoring and management and early extubation. A PubMed and EMBASE search of terms "Anaesthesia" and "Liver Transplantation" were performed with filters of articles in "English", "Adult" and relevant recent publications of randomised control trial, editorial, systemic review and non-systemic review were selected and synthesized according to the author's personal and professional perspective in the field of liver transplantation and anaesthesia. The article outlines strategies in organ preservation, training and transplant database for further research.
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13,618
4,420
BRIEF COMMUNICATIONS
The whistling adapter: A device mimicking complication
Kapil Chaudhary, Bharti Taneja, Kirti N Saxena, Raktima Anand
July-August 2012, 56(4):408-409
DOI
:10.4103/0019-5049.100844
PMID
:23087469
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Perioperative management of term pregnant patient with Guillian Barre syndrome
B Jyothi, Himanshu Verma, Vaidyanathan , Safiya S Shaikh
July-August 2012, 56(4):409-411
DOI
:10.4103/0019-5049.100848
PMID
:23087470
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2,263
510
CASE REPORTS
Cardiac arrest following ventilator fire: A rare cause
K Nazeer Ahmed, Babu P Kattimani, Ramakanth Baloorkar
July-August 2012, 56(4):405-407
DOI
:10.4103/0019-5049.100841
PMID
:23087468
Operating room fires are rare events, but when occur they result in serious and sometimes fatal consequences. Anaesthesia ventilator fire leading to cardiac arrest is a rare incident and has not been reported. We report a near catastrophic ventilator fire leading to cardiac arrest in a patient undergoing subtotal thyroidectomy. In the present case sparks due to friction or electrical short circuit within the ventilator might have acted as source of ignition leading to fire and explosion in the oxygen rich environment. The patient was successfully resuscitated and revived with uneventful recovery and no adverse sequelae. The cardiac arrest was possibly due to severe hypoxia resulting from inhalation of smoke containing high concentrations of carbon monoxide and other noxious gases.
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LETTERS TO EDITOR
Anaesthetic management of an infant with vallecular cyst: A challenging situation
Upma Bhatia Batra, Suniti Kale, Amita Malik
July-August 2012, 56(4):423-425
DOI
:10.4103/0019-5049.100842
PMID
:23087478
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1,702
406
Should ultrasonography check be routinely done following removal of femoral vascular catheter in patients with end-stage renal disease?
Tanmoy Ghatak, Afzal Azim, Arvind K Baronia, Banani Poddar, Mohan Gurjar
July-August 2012, 56(4):425-427
DOI
:10.4103/0019-5049.100845
PMID
:23087479
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1,692
268
Unusual injury sustained by an escort in a radiology suite: Correlation with anaesthesiologists' plight
Mohan Chandra Mandal, Susanta Sarkar, Deepanwita Das, Sekhar Ranjan Basu
July-August 2012, 56(4):418-419
DOI
:10.4103/0019-5049.100827
PMID
:23087474
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1,626
313
An innovative use of the flexible fibreoptic scope to identify the tracheo-bronchial tree intraoperatively for closure of a bronchopleural fistula
PI Lohita, PS Sathyanarayan, LN Seshadri, Arun K Haridas
July-August 2012, 56(4):419-420
DOI
:10.4103/0019-5049.100830
PMID
:23087475
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1,864
353
Psoas compartment block for intramedullary supracondylar nailing for fracture shaft femur in an 80-year-old patient with severe ischaemic heart disease, hypertension, COPD and anaemia
Shruti Sangani, Kavita Lalchandani, VN Swadia
July-August 2012, 56(4):420-422
DOI
:10.4103/0019-5049.100834
PMID
:23087476
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1,891
451
A rare, potentially hazardous malposition of the nasotracheal tube
Jitin N Trivedi
July-August 2012, 56(4):434-435
DOI
:10.4103/0019-5049.100855
PMID
:23087485
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1,485
316
Management of heparin resistance in an emergency cardiac surgical patient
Canan Tulay Isil, Pinar Yazici, Ufuk Topuz, Ersin Erek, Ihsan Bakir
July-August 2012, 56(4):430-431
DOI
:10.4103/0019-5049.100849
PMID
:23087482
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2,418
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A simple, feedback-based simulation model for ultrasound-guided regional anaesthesia
Alper Kilicaslan, Ahmet Topal, Aybars Tavlan, Atilla Erol
July-August 2012, 56(4):431-433
DOI
:10.4103/0019-5049.100851
PMID
:23087483
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1,876
404
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th
March, 2010