Background: Propofol is the preferred drug for induction of anesthesia in many centers. However, its ubiquitous use hampered by adverse effects. The rationale behind our study to prove that whether administration an opioid before propofol induction, lowers amount requirement balanced anesthesia, and enhances hemodynamic stability. Aim: present intends know consequence differing time intervals between fentanyl on dosage required achieve general anesthesia. Methods: In this observational...

Context: Patient handovers without any structured checklist may omit essential information that might have undesirable consequences for patients. Aim: We sought to determine the effectiveness of a postanesthesia care handover (PACH) in unit (PACU) reduce adverse clinical outcomes. Setting and Design: A single-center, prospective, pre–postimplementation study was conducted. Materials Methods: Moreover, post-PACH implementation data were collected from 130 participants ( n = 65 each group) by...

Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment poor recovery after surgery.To determine whether amnesia, anxiety, sedation cardio respiratory symptoms affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg).Two forty posted for head neck surgeries were involved this double...

Bupivacaine is available in isobaric and hyperbaric forms for intrathecal use opioids are used as additives to modify their effects. The aim of this study was compare the efficacy haemodynamic effect bupivacaine-fentanyl mixture common urological procedures.One hundred American Society Anesthesiologists physical status 1 2 patients undergoing procedures were randomized into two groups. Group received 3 ml 0.5% bupivacaine with 25 μg fentanyl while fentanyl. parameters measured include heart...

Background: Hyperbaric bupivacaine along with either fentanyl or sufentanil as additive, has been widely used in spinal anesthesia. In the present study, we compared analgesic effects of intrathecal versus combined for surgical procedures over abdomen and lower limbs. Settings Design: This was randomized controlled study conducted a tertiary care hospital attached to medical school. Methods: Sixty American Society Anesthesiologists I II patients were into three groups by sealed envelope...

Cranial Meningocoele is a term which represents herniation of meninges and cerebrospinal fluid through the congenital defect in cranium. Anaesthetic challenges management neonates with occipital meningocoele include airway proper positioning neonate without pressure on sac so as to preventthe rupture membranes. Associated anomalies also can cause anaesthesia procedure related complications. Other difficulties performing difficult case an unfamiliar environment outside operation theatre. We...

Arteriovenous (AV) malformations of the face are rare presentations. Endovascular coiling is one treatment modalities. We report a case 65-year-old lady who presented with large AV malformation located around nasal bride and alae nasae posted for under general anesthesia. Anesthetic management was challenge as it an anticipated difficult airway situation. Furthermore, any pressure on swelling can lead to rupture hemorrhage skin above unhealthy. There difficulty in mask ventilation both...

Background: Spinal anesthesia with 0.5% hyperbaric bupivacaine is an approved technique for lower segment cesarean sections. This study compared two different doses spinal in the section. We hypothesized that low-dose had similar outcomes as conventional of bupivacaine. Methods: was a comparative observational involving seventy healthy parturients who were posted elective Patients supposed to receive and divided into groups, low dose (LB-1.8 ml) conventional-dose (HB-2.2 group. The extent...

Case RepoRtA 14-year-old female child, weighing 16 kilograms, known case of Down's syndrome posted for Heller's cardiomyotomy.A thorough pre-anaesthetic evaluation was done.Child irritable and poorly built.Airway examination revealed receding mandible, high arched palate, Mallampatti grade 3. Auscultation lung fields occasional crepitations.A pan systolic murmur heard in the mitral area.A 2D echo valve prolapse with regurgitation normal LV function no pulmonary hypertension.Chest X-ray...

Congenital pulmonary airway malformations (CPAM) are rare bronchopulmonary developmental disorders with cystic lesions1. It is because of embryonic insult before 50th week gestation. 2 These lesions do not take part in gas exchange. Anaesthetic management quite challenging due to the risk rupture these cysts, pneumothorax, cardiovascular collapse. Prognosis depends on size lesion, hypoplasia remaining lung. We present a case 4-day old neonate CPAM diagnosed antenatally who underwent...

Extracorporeal 'work bench surgery' with subsequent autotransplantation is a challenge from both anaesthetic and surgical point of view when performed bilaterally or in solitary kidney. A 28-year-old female bilateral giant angiomyolipoma kidneys was taken up for renal autotransplantation. Patient had huge tumour, which the largest reported exophytic tumour to be excised by this technique. Both were operated at an interval 1 month, under combined general epidural anaesthesia. Anaesthetic...

Introduction: There are various methods for sedation in colonoscopies and ketamine has been found to be an effective alternative drug sedation. Aim: To compare the efficacy haemodynamic stability of lower dose fentanyl co-administered with midazolam propofol colonoscopies. Materials Methods: Sixty American Society Anaesthesiologists (ASA) I-II patients undergoing were randomised into 2 groups. Group I (n=30) (Fentanyl group) was assigned receive 20μg/kg, 2μg/kg. II (Ketamine 0.5mg/kg. The...

Lymphatic cyst in the cervical region presents a great challenge to anesthesiologist. The anesthetic difficulties are because of extension cyst, difficult airway, postoperative respiratory obstruction, and coexisting anomalies. management such patients depends on direct communication between surgeon We hereby present case 53-year-old male presenting with lymphatic cervicothoracic dysphagia dyspnea, posted for laryngoscopy biopsy under general anesthesia. Awake fiberoptic intubation was done...

Spinal anesthesia causes hypotension and in some cases bradycardia.Making the patient to sit for different period after spinal anesthesia, we can reduce these complications achieve desired level of analgesia perineal, few gynecological procedures & urological surgeries. INTRODUCTION:Subarachnoid block is a popular commonly used technique regional anaesthesia.It often preferred efficacy, rapidity, minimal effects on body physiology reduction blood loss.The most associated complication with...

A 51-year-old female underwent a laparoscopic-assisted vaginal hysterectomy for fibroid uterus. After an uneventful procedure, the patient developed symptoms of Pulmonary Thromboembolism (PTE). The PTE was managed with, systemic thrombolysis using tissue plasminogen activator (Tenecteplase), appropriate support inotropes and anticoagulants. While there is less incidence in laparoscopic procedures, particular, gynecology, definite risk even with low-risk factors, which has been highlighted....

Post-operative pain is an acute which starts with the surgical trauma and usually ends tissue healing. Our study was done to evaluate compare postoperative analgesic effect of Butorphanol, Parecoxib Tramadol in patients undergoing major procedures. Randomized double blinded study. Sixty ASA I II grades age group 20­ 50 years, surgeries were included They divided into three groups 20 each. Group P­-Parecoxib, B­-Butorphanol group, T –Tramadol group. Pain intensity score, relief sedation...

Background: Supraclavicular block is a commonly used for regional anesthesia in forearm surgeries. The rationale behind this study to prove that ultrasound (USG)-guided supraclavicular sufficient provide adequate analgesia and eliminates the need an intercostobrachial (ICB) Aim: We aimed find whether there any additional advantage performing ICB along with brachial plexus Methods: In study, 110 patients undergoing elective surgeries under USG-guided were observed. A solution of 30 ml was...

Respiratory distress associated with vocal cord palsy can be attributed to recurrent laryngeal nerve injury. Bilateral cause adduction of cords and respiratory distress. Airway, in these patients, compromised result unanticipated difficult intubation. The time frame pass tube such situations are less. This is a case series on successful airway management three patients who presented obstruction. Thus the “cannot intubate-cannot oxygenate” situation was avoided all patients.

Pneumoperitoneum for laparoscopic surgeries has anesthetic implications due to increase in the intra-abdominal pressure and end-tidal carbon dioxide. The effects are more pronounced if patient only one lung. However, advantages of laparoscopy include reduced postoperative pain early recovery. We present a case 30-year-old who had undergone pneumonectomy was posted appendicectomy. General anesthesia instituted, with some modifications ventilation, procedure uneventful we were able extubate on...