Pub Date : 2023-10-01DOI: 10.33545/26643766.2023.v6.i4a.432
Aya Allah Hamdy Elbahy, Taysser Mahmoud Abdalraheem, R. S. A. Elrahman, Yasser Mohamed Ragheb
{"title":"Post-operative analgesia in penile surgeries in pediatrics with focus on sacral erector spinae plane block and caudal block","authors":"Aya Allah Hamdy Elbahy, Taysser Mahmoud Abdalraheem, R. S. A. Elrahman, Yasser Mohamed Ragheb","doi":"10.33545/26643766.2023.v6.i4a.432","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i4a.432","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139327637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.33545/26643766.2023.v6.i4a.428
Zinb Twfik Ragab, Shaimaa F Mostafa, Nagat Sayed El Shamaa, Hesham Mohamed Maruf, Ahmed Mohamed El-Sheikh
Background: Restrictive lung disease affects the majority of morbidly obese individuals. This study compared the effects of two different doses of dexmedetomidine (Dex) infusion on oxygenation as primary outcome and on lung mechanics, quality of recovery, and postoperative pain relief as secondary outcomes in morbidly obese patients with restrictive lung disease scheduled for laparoscopic abdominal surgery. Methods: Ninety morbidly obese patients were recruited in this prospective randomized trial. Patients were randomly divided into 3 equal groups. Fifteen minutes after intubation, Dex o.3 and Dex 0.6 groups received a bolus dose of 1μg/kg over 10 min followed by continuous infusion of 0.3 and 0.6 μg/kg/hr for one hour respectively. Control group (C): Patients received comparable volume of normal saline (0.9%).P/F ratio, lung mechanics quality of recovery and perioperative analgesic consumption were recorded. Results: Dex groups resulted in increased P/F ratios, static and dynamic compliance and QoR-15 score compared to control group. Both Dex groups had lower dead space values, lower scores on sedation agitation scale, as well as lower pain scores and perioperative analgesic consumption. However hypotension and bradycardia were more common in the Dex 0.6 groups. Conclusions: Dex infusion at a dose of 0.3µg /kg /hr and 0.6 µg /kg /hr after a loading dose of 1 µg/kg resulted in improvement of oxygenation and lung mechanics lower postoperative pain scores, decreased analgesic consumptions as well as improved quality of recovery in morbidly obese patients with restrictive lung disease undergoing laparoscopic surgery
{"title":"The Effect of Two Different Doses of Dexmedetomidine Infusion on Oxygenation, Lung Mechanics and Quality of Recovery in Morbidly Obese Patients: A Prospective Randomized Study","authors":"Zinb Twfik Ragab, Shaimaa F Mostafa, Nagat Sayed El Shamaa, Hesham Mohamed Maruf, Ahmed Mohamed El-Sheikh","doi":"10.33545/26643766.2023.v6.i4a.428","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i4a.428","url":null,"abstract":"Background: Restrictive lung disease affects the majority of morbidly obese individuals. This study compared the effects of two different doses of dexmedetomidine (Dex) infusion on oxygenation as primary outcome and on lung mechanics, quality of recovery, and postoperative pain relief as secondary outcomes in morbidly obese patients with restrictive lung disease scheduled for laparoscopic abdominal surgery. Methods: Ninety morbidly obese patients were recruited in this prospective randomized trial. Patients were randomly divided into 3 equal groups. Fifteen minutes after intubation, Dex o.3 and Dex 0.6 groups received a bolus dose of 1μg/kg over 10 min followed by continuous infusion of 0.3 and 0.6 μg/kg/hr for one hour respectively. Control group (C): Patients received comparable volume of normal saline (0.9%).P/F ratio, lung mechanics quality of recovery and perioperative analgesic consumption were recorded. Results: Dex groups resulted in increased P/F ratios, static and dynamic compliance and QoR-15 score compared to control group. Both Dex groups had lower dead space values, lower scores on sedation agitation scale, as well as lower pain scores and perioperative analgesic consumption. However hypotension and bradycardia were more common in the Dex 0.6 groups. Conclusions: Dex infusion at a dose of 0.3µg /kg /hr and 0.6 µg /kg /hr after a loading dose of 1 µg/kg resulted in improvement of oxygenation and lung mechanics lower postoperative pain scores, decreased analgesic consumptions as well as improved quality of recovery in morbidly obese patients with restrictive lung disease undergoing laparoscopic surgery","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136161511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.33545/26643766.2023.v6.i4b.440
Mohamed Ahmed El Malah, Motaz Amr Abusaba, Naglaa Khalil Yousef, Ahmed Said El-gebaly, Ghada Fouad El baradey
{"title":"Prognostic value of platelet to lymphocyte ratio in sepsis outcome prediction","authors":"Mohamed Ahmed El Malah, Motaz Amr Abusaba, Naglaa Khalil Yousef, Ahmed Said El-gebaly, Ghada Fouad El baradey","doi":"10.33545/26643766.2023.v6.i4b.440","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i4b.440","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139328160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.33545/26643766.2023.v6.i4a.434
Dina Hamdy Alhassanin, Amr Arafa Mohamed Elbadry, Naglaa Khalil Mohamed, H. Ezz
{"title":"The efficacy of ultrasound-guided rhomboid intercostal block versus serratus plane block in patients undergoing modified radical mastectomy","authors":"Dina Hamdy Alhassanin, Amr Arafa Mohamed Elbadry, Naglaa Khalil Mohamed, H. Ezz","doi":"10.33545/26643766.2023.v6.i4a.434","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i4a.434","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139328840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.412
Dr. Rebecca Shalini Lionel, D. Sm
Total knee arthroplasty is a major surgical procedure that can result in significant pain during recovery. Adequate analgesia is, therefore, the cornerstone in enabling good functional outcomes for the patient. Our study assessed retrospectively, the post-operative pain scores with continuous proximal adductor canal nerve block catheter with and without posterior capsular infiltration. Materials and Methods: All patients undergoing unilateral robotic total knee arthroplasty were randomized into two groups. One group received only a continuous adductor canal nerve block catheter. The other group was provided with a continuous adductor canal nerve block catheter with posterior capsular infiltration. The post-operative VAS (Visual Analogue Scale) score and the time of the first rescue analgesic were noted. Results: The group which received continuous adductor canal nerve block catheter with posterior capsular infiltration had better post-operative analgesia with delayed time of first rescue analgesia. Hence local anaesthetic infiltration in the posterior capsule provided superior recovery rates in terms of pain management. Conclusion: Our study concluded that patients receiving continuous adductor canal catheters and posterior capsular infiltration had better post-operative analgesia than those receiving only continuous adductor canal catheters. This aided in faster recovery and mobilization in robotic knee arthroplasty, contributing to fast-tracking.
{"title":"Comparison of analgesic efficacy between continuous adductor canal nerve block catheter with and without posterior capsular infiltration in patients undergoing unilateral robotic total knee replacement: A retrospective study","authors":"Dr. Rebecca Shalini Lionel, D. Sm","doi":"10.33545/26643766.2023.v6.i3a.412","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.412","url":null,"abstract":"Total knee arthroplasty is a major surgical procedure that can result in significant pain during recovery. Adequate analgesia is, therefore, the cornerstone in enabling good functional outcomes for the patient. Our study assessed retrospectively, the post-operative pain scores with continuous proximal adductor canal nerve block catheter with and without posterior capsular infiltration. Materials and Methods: All patients undergoing unilateral robotic total knee arthroplasty were randomized into two groups. One group received only a continuous adductor canal nerve block catheter. The other group was provided with a continuous adductor canal nerve block catheter with posterior capsular infiltration. The post-operative VAS (Visual Analogue Scale) score and the time of the first rescue analgesic were noted. Results: The group which received continuous adductor canal nerve block catheter with posterior capsular infiltration had better post-operative analgesia with delayed time of first rescue analgesia. Hence local anaesthetic infiltration in the posterior capsule provided superior recovery rates in terms of pain management. Conclusion: Our study concluded that patients receiving continuous adductor canal catheters and posterior capsular infiltration had better post-operative analgesia than those receiving only continuous adductor canal catheters. This aided in faster recovery and mobilization in robotic knee arthroplasty, contributing to fast-tracking.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77821612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3a.406
Radwa Emad Eissa, W. Messbah, Mohammad Ali Abdullah, A. M. El-Sheikh, Nadia Hassan Fatouh
Background: It has been shown that placing local Anesthetics (LA) as far as 4 mm laterally from the sheath of the brachial plexus throughout US-guided ISBPB can result in beneficial analgesia for shoulder surgeries, demonstrating the significance of needle-nerve proximity in the context of ISBPB. The distance to the phrenic nerve is increased by this extrafascial injection, which may lessen the possibility that the local anesthetic spread would block it. The purpose of this work is to compare the effects of extrafascial and intrafascial (ISBPB) on the diaphragmatic excursion (phrenic nerve blockade). Methods: This work was performed on 50 adult individuals, their age ranges between 21-60 years of both sexes with American Society of Anesthesiologists (ASA) physical state classification I-II who were planned for shoulder arthroscopic surgery under general anaesthesia. Patients were allocated into two groups at random (25 patients each) according to the US-guided method of interscalene block: Group I (Intrafascial injection group): 10 ml of 0.5% bupivacaine were given to the individuals for intrafascial (conventional) ISBPB. Group E (Extrafascial injection group): 10 ml of 0.5% bupivacaine were given to the individuals for extrafascial ISBPB. Results: In group I, at PACU, the diaphragmatic excursions were significantly lower when compared to pre-block values. In group E, At PACU, the diaphragmatic excursions were comparable to pre-block values ( P value = 0.062). After 30 minutes of block, the extrafascial block (group E) had a significantly ( P value = 0.005) lower effect on diaphragmatic excursion than intrafascial block (group I). The same effect was observed at PACU. Extrafascial block had a significantly ( P value <0.001) lower effect on a diaphragmatic excursion to intrafascial block. No difference between both groups was observed regarding the analgesic properties. Conclusions: Given the increased incidence of partial hemi-diaphragmatic paralysis (HDP) with an intrafascial approach, extrafascial method to interscalene brachial plexus block is likely a more appropriate choice.
{"title":"Perioperative respiratory and analgesic effects of ultrasound-guided extrafascial versus interfacial interscalene brachial plexus block in patients undergoing shoulder arthroscopy","authors":"Radwa Emad Eissa, W. Messbah, Mohammad Ali Abdullah, A. M. El-Sheikh, Nadia Hassan Fatouh","doi":"10.33545/26643766.2023.v6.i3a.406","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3a.406","url":null,"abstract":"Background: It has been shown that placing local Anesthetics (LA) as far as 4 mm laterally from the sheath of the brachial plexus throughout US-guided ISBPB can result in beneficial analgesia for shoulder surgeries, demonstrating the significance of needle-nerve proximity in the context of ISBPB. The distance to the phrenic nerve is increased by this extrafascial injection, which may lessen the possibility that the local anesthetic spread would block it. The purpose of this work is to compare the effects of extrafascial and intrafascial (ISBPB) on the diaphragmatic excursion (phrenic nerve blockade). Methods: This work was performed on 50 adult individuals, their age ranges between 21-60 years of both sexes with American Society of Anesthesiologists (ASA) physical state classification I-II who were planned for shoulder arthroscopic surgery under general anaesthesia. Patients were allocated into two groups at random (25 patients each) according to the US-guided method of interscalene block: Group I (Intrafascial injection group): 10 ml of 0.5% bupivacaine were given to the individuals for intrafascial (conventional) ISBPB. Group E (Extrafascial injection group): 10 ml of 0.5% bupivacaine were given to the individuals for extrafascial ISBPB. Results: In group I, at PACU, the diaphragmatic excursions were significantly lower when compared to pre-block values. In group E, At PACU, the diaphragmatic excursions were comparable to pre-block values ( P value = 0.062). After 30 minutes of block, the extrafascial block (group E) had a significantly ( P value = 0.005) lower effect on diaphragmatic excursion than intrafascial block (group I). The same effect was observed at PACU. Extrafascial block had a significantly ( P value <0.001) lower effect on a diaphragmatic excursion to intrafascial block. No difference between both groups was observed regarding the analgesic properties. Conclusions: Given the increased incidence of partial hemi-diaphragmatic paralysis (HDP) with an intrafascial approach, extrafascial method to interscalene brachial plexus block is likely a more appropriate choice.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80808200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.417
Dr. Zareen Fatima, Dr. Ruchira Sarkar, D. Neeraj, Dr. Jignesh Singh
{"title":"A comparative study between nalbuphine with Bupivacaine versus bupivacaine alone in USG guided axillary Brachial plexus block","authors":"Dr. Zareen Fatima, Dr. Ruchira Sarkar, D. Neeraj, Dr. Jignesh Singh","doi":"10.33545/26643766.2023.v6.i3b.417","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.417","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82751782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The use of controlled hypotension has been shown to enhance the operational field visibility and reduce many surgical factors such as total blood loss, surgery duration and the occurrence of ecchymosis and postoperative edema. The objective of this research was to assess and evaluate the effectiveness of propofol, magnesium sulfate, and Dexmedetomidine in inducing controlled hypotensive anesthesia for Functional Endoscopic Sinus Surgery (FESS).Methods: The use of controlled the current research had a prospective randomized double-blind design and included a sample of sixty individuals aged between twenty-one and fifty years, including both genders. The participants were having FESS. The participants were classified into three distinct groups. In the first group, participants were administered Dexmedetomidine intravenously at a loading dosage of 0.5 micrograms per kilogram, followed by a maintenance dose ranging from 0.2 to 0.4 mcg/kg/hour. The second group got an intravenous dose of forty mcgkg of magnesium sulfate, with a maintenance dose ranging from ten to fifteen mcg/kg/hour. Lastly, the third group received an intravenous dose of two hundred mg per twenty ml of propofol, with a maintenance dose ranging from two to four mcg/kg/hour. These administrations were carried out continuously during the surgical procedure.Results: The research observed a substantial decline in the visibility and bleeding score within group one compared to group two. However, there was no important variance in the visibility and bleeding score between group one and group three. Additionally, the research found a significant elevate in the visibility and bleeding score within group two compared to group three. The bradycardia incidence and the need for atropine were higher in patients receiving propofol and Dexmedetomidine. There was no bradycardia or atropine needed with group two. Side effects as nausea, shivering, and vomiting were less with propofol and Dexmedetomidine than with group two.Conclusions: The efficacy of Dexmedetomidine is better than MgSO4 and propofol and for controlled hypotension during FESS.
{"title":"Comparative study between Dexmedetomidine, magnesium sulfate and propofol in controlled hypotensive anesthesia during endoscopic sinus surgery","authors":"Elhasab Abdelkader Elgnaidy, Sameh Refaat Elshehdawy, Magdy Elsayed Elbably, Abdelraheem Mustafa Dowidar, Abdelaziz Hamed Elbadawy","doi":"10.33545/26643766.2023.v6.i3b.424","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.424","url":null,"abstract":"Background: The use of controlled hypotension has been shown to enhance the operational field visibility and reduce many surgical factors such as total blood loss, surgery duration and the occurrence of ecchymosis and postoperative edema. The objective of this research was to assess and evaluate the effectiveness of propofol, magnesium sulfate, and Dexmedetomidine in inducing controlled hypotensive anesthesia for Functional Endoscopic Sinus Surgery (FESS).Methods: The use of controlled the current research had a prospective randomized double-blind design and included a sample of sixty individuals aged between twenty-one and fifty years, including both genders. The participants were having FESS. The participants were classified into three distinct groups. In the first group, participants were administered Dexmedetomidine intravenously at a loading dosage of 0.5 micrograms per kilogram, followed by a maintenance dose ranging from 0.2 to 0.4 mcg/kg/hour. The second group got an intravenous dose of forty mcgkg of magnesium sulfate, with a maintenance dose ranging from ten to fifteen mcg/kg/hour. Lastly, the third group received an intravenous dose of two hundred mg per twenty ml of propofol, with a maintenance dose ranging from two to four mcg/kg/hour. These administrations were carried out continuously during the surgical procedure.Results: The research observed a substantial decline in the visibility and bleeding score within group one compared to group two. However, there was no important variance in the visibility and bleeding score between group one and group three. Additionally, the research found a significant elevate in the visibility and bleeding score within group two compared to group three. The bradycardia incidence and the need for atropine were higher in patients receiving propofol and Dexmedetomidine. There was no bradycardia or atropine needed with group two. Side effects as nausea, shivering, and vomiting were less with propofol and Dexmedetomidine than with group two.Conclusions: The efficacy of Dexmedetomidine is better than MgSO4 and propofol and for controlled hypotension during FESS.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.423
Dr. Prathibha Santosh, Amera Shweita, Marwa Mamdouh
PPH is a leading cause of maternal mortality which has several aetiologies. Effective management including resuscitation, hemostasis, and identification and treatment of the cause in these cases is important. This case reports a parturient patient G4P3L3 40 weeks and 1 day gestation who suffered from PPH after normal vaginal delivery. On exploration an uncommon right broad ligament hematoma was detected which was drained, ligating the hypogastric artery. A hysterectomy was performed. During the procedure general anesthesia with ketamine was administered. Haemostasis was maintained by transfusing 2 units of packed red blood cells and 1 unit of fresh frozen plasma (FFP). Inj Fibrinogen 2 grams and Inj. Tranexamic acid 1 gram was infused intravenously. In total, 9 units of packed RBCs, 6 units of FFP, 4 units of platelets, and 2 liters of crystalloids were transfused during the entire procedure. 10 ml of 10 % calcium gluconate was also given after every 3 units of packed RBC transfusion. The patient was weaned off the ventilator after stabilizing the vitals and discharged 5 days later.
{"title":"Anaesthetic management of atonic postpartum haemorrhage secondary to trauma during normal vaginal delivery: A case report","authors":"Dr. Prathibha Santosh, Amera Shweita, Marwa Mamdouh","doi":"10.33545/26643766.2023.v6.i3b.423","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.423","url":null,"abstract":"PPH is a leading cause of maternal mortality which has several aetiologies. Effective management including resuscitation, hemostasis, and identification and treatment of the cause in these cases is important. This case reports a parturient patient G4P3L3 40 weeks and 1 day gestation who suffered from PPH after normal vaginal delivery. On exploration an uncommon right broad ligament hematoma was detected which was drained, ligating the hypogastric artery. A hysterectomy was performed. During the procedure general anesthesia with ketamine was administered. Haemostasis was maintained by transfusing 2 units of packed red blood cells and 1 unit of fresh frozen plasma (FFP). Inj Fibrinogen 2 grams and Inj. Tranexamic acid 1 gram was infused intravenously. In total, 9 units of packed RBCs, 6 units of FFP, 4 units of platelets, and 2 liters of crystalloids were transfused during the entire procedure. 10 ml of 10 % calcium gluconate was also given after every 3 units of packed RBC transfusion. The patient was weaned off the ventilator after stabilizing the vitals and discharged 5 days later.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.33545/26643766.2023.v6.i3b.418
Dr. Babli Attri, Dr. Vikash Kumar, Dr. Vishal Kant
{"title":"Serum sodium and potassium changes during transurethral resection of prostate gland in patients under subarachnoid block","authors":"Dr. Babli Attri, Dr. Vikash Kumar, Dr. Vishal Kant","doi":"10.33545/26643766.2023.v6.i3b.418","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i3b.418","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91505293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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