S. Kinthala, M. Fakoory, Allan I Smith, Tamara T Semei, K. T. Johnny
Diaphragmatic injuries are relatively rare and result from either blunt or penetrating trauma. Intrapericardial diaphragmatic hernia (IPDH) hernia is a rare complication of diaphragmatic rupture, occurring in less than 1% of cases of diaphragmatic hernias (DH). IPDH presentation can range from being asymptomatic to having potentially fatal cardiac tamponade. This is a case of delayed traumatic hernia of diaphrgam and pericardium that resulted in deterioration during weaning from the mechanical ventilation. The patient underwent surgical repair for diaphragmatic hernia and reduction of pericardial contents through thoracic approach following which the patient was weaned successfully from the mechanical ventilation.
{"title":"Delayed Traumatic Hernia Of Diaphragm And Pericardium Causing Deterioration During Weaning From The Mechanical Ventilation.","authors":"S. Kinthala, M. Fakoory, Allan I Smith, Tamara T Semei, K. T. Johnny","doi":"10.5580/2c76","DOIUrl":"https://doi.org/10.5580/2c76","url":null,"abstract":"Diaphragmatic injuries are relatively rare and result from either blunt or penetrating trauma. Intrapericardial diaphragmatic hernia (IPDH) hernia is a rare complication of diaphragmatic rupture, occurring in less than 1% of cases of diaphragmatic hernias (DH). IPDH presentation can range from being asymptomatic to having potentially fatal cardiac tamponade. This is a case of delayed traumatic hernia of diaphrgam and pericardium that resulted in deterioration during weaning from the mechanical ventilation. The patient underwent surgical repair for diaphragmatic hernia and reduction of pericardial contents through thoracic approach following which the patient was weaned successfully from the mechanical ventilation.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"2012 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121749684","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}
Pierre Levan, Michael J O'Rourke, M. Presta, S. Byram
Mobile technologies are increasingly utilized by today’s healthcare providers both in their personal and professional lives. In modern healthcare, mobile technologies have numerous applications that may revolutionize how doctors practice medicine. We report the use of a commercially available personal consumer electronics device (Apple’s IPhone 4 generation (Cupertino, CA)) which aided in the positioning and monitoring of a patient undergoing spine surgery in the prone position.
{"title":"The Use of Mobile Smartphone Technology to Enhance Positioning of a Prone Patient for Thoracic Spine Surgery.","authors":"Pierre Levan, Michael J O'Rourke, M. Presta, S. Byram","doi":"10.5580/2b9b","DOIUrl":"https://doi.org/10.5580/2b9b","url":null,"abstract":"Mobile technologies are increasingly utilized by today’s healthcare providers both in their personal and professional lives. In modern healthcare, mobile technologies have numerous applications that may revolutionize how doctors practice medicine. We report the use of a commercially available personal consumer electronics device (Apple’s IPhone 4 generation (Cupertino, CA)) which aided in the positioning and monitoring of a patient undergoing spine surgery in the prone position.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117087580","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}
Adenoidectomy and tonsillectomy are common ear, nose and throat operations in children and are often accompanied by complications. This study assessed the perianaesthetic complications encountered among patients who had adenotonsillectomy in a tertiary hospital through May 2009 to April 2010.The study comprised of 49 subjects made up of 26 (53%) males and 23 (47%) females with a median age 36 (range=8 � 64) months and a median weight of 14kg (range = 5 �76kg). All the patients had general anaesthesia with endotracheal intubation. The procedures included tonsillectomy in 8 (16%) subjects, adenoidectomy in 18 (37%) and adenotonsillectomy in 23 (47%). Of the 49 patients, 24 (49%) had associated OSA, 2 (4%) had
{"title":"Perianaesthetic Complications Associated With Adenotonsillectomy At The University College Hospital, Ibadan, Nigeria.","authors":"A. Sanusi, M. Akinwale, O. Uchendu, A. Lasisi","doi":"10.5580/2c39","DOIUrl":"https://doi.org/10.5580/2c39","url":null,"abstract":"Adenoidectomy and tonsillectomy are common ear, nose and throat operations in children and are often accompanied by complications. This study assessed the perianaesthetic complications encountered among patients who had adenotonsillectomy in a tertiary hospital through May 2009 to April 2010.The study comprised of 49 subjects made up of 26 (53%) males and 23 (47%) females with a median age 36 (range=8 � 64) months and a median weight of 14kg (range = 5 �76kg). All the patients had general anaesthesia with endotracheal intubation. The procedures included tonsillectomy in 8 (16%) subjects, adenoidectomy in 18 (37%) and adenotonsillectomy in 23 (47%). Of the 49 patients, 24 (49%) had associated OSA, 2 (4%) had","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123962956","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}
Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is one of the most common autosomal recessive hereditary diseases. The impairment of cortisol synthesis leads to excessive stimulation of adrenal gland by adrenocorticotropic hormone(ACTH), adrenal hyperplasia and excessive androgen synthesis. More than 90% of congenital adrenal hyperplasia is caused by 21-hydroxylase deficiency which is found in 1:10,000 to 1:15,000 live births. Children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency presenting for surgeries is very unusual. Here we are presenting a fifteen year old male child with classical 21-hydroxylase deficiency, who was successfully managed as a day case for elective orchidopexy under general anaesthesia. The consent for publication for the case was obtained by mother of child after surgery.
{"title":"Anaesthetic Concerns In A Child With 21-Hydroxylase Deficiency For A Day Care Surgery.","authors":"Rajashekar R. Mudaraddi, Yashodanand Kumar Areti","doi":"10.5580/2c3a","DOIUrl":"https://doi.org/10.5580/2c3a","url":null,"abstract":"Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is one of the most common autosomal recessive hereditary diseases. The impairment of cortisol synthesis leads to excessive stimulation of adrenal gland by adrenocorticotropic hormone(ACTH), adrenal hyperplasia and excessive androgen synthesis. More than 90% of congenital adrenal hyperplasia is caused by 21-hydroxylase deficiency which is found in 1:10,000 to 1:15,000 live births. Children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency presenting for surgeries is very unusual. Here we are presenting a fifteen year old male child with classical 21-hydroxylase deficiency, who was successfully managed as a day case for elective orchidopexy under general anaesthesia. The consent for publication for the case was obtained by mother of child after surgery.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134640672","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: There have been many controversies with regard to the validity of different clinical parameters in the prediction of Orthotopic Liver Transplant (OLTx) outcome. Aim: The aim was to test the validity of different clinical parameters in the prediction of the outcome of Orthotopic Liver Transplant (OLTx) at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: A retrospective study of the different clinical parameters of 25 cases of End Stage Liver Disease (18 males and 7 females) ages from 11 to 70 years was done. These parameters were: operative duration (incision to skin closure time), highest and lowest Heart rate and Mean arterial pressure during the procedure, estimated blood lost, lowest Oxygen saturation. Biophysical outcomes were collected: lowest Platelets and Fibrinogen, highest Lactic acid, INR and Creatinine, Age of the patient and Warm ischemia time. The outcome in terms of major complications and / or death was correlated with these parameters. Receiver operating characteristic curve was applied to identify the validity of each parameter. Results: Highest INR was only parameter significantly associated with outcome of OLTx within 30 days (p = 0.044, c-index = 0.78). The value of 3.4 was the optimum cut off point giving the best validity for prediction of outcome" with 67% of sensitivity and 88% specificity " Conclusion: INR is the only predictor associated with major complication or death within 30 days post OLTx at cut of level of > 3.4
{"title":"Validity Of Clinical Parameters In Prediction Of Outcome For Orthotopic Liver Transplant","authors":"Ivo Zemek, K. Sofi, M. Abolfotouh","doi":"10.5580/2b9c","DOIUrl":"https://doi.org/10.5580/2b9c","url":null,"abstract":"Background: There have been many controversies with regard to the validity of different clinical parameters in the prediction of Orthotopic Liver Transplant (OLTx) outcome. Aim: The aim was to test the validity of different clinical parameters in the prediction of the outcome of Orthotopic Liver Transplant (OLTx) at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: A retrospective study of the different clinical parameters of 25 cases of End Stage Liver Disease (18 males and 7 females) ages from 11 to 70 years was done. These parameters were: operative duration (incision to skin closure time), highest and lowest Heart rate and Mean arterial pressure during the procedure, estimated blood lost, lowest Oxygen saturation. Biophysical outcomes were collected: lowest Platelets and Fibrinogen, highest Lactic acid, INR and Creatinine, Age of the patient and Warm ischemia time. The outcome in terms of major complications and / or death was correlated with these parameters. Receiver operating characteristic curve was applied to identify the validity of each parameter. Results: Highest INR was only parameter significantly associated with outcome of OLTx within 30 days (p = 0.044, c-index = 0.78). The value of 3.4 was the optimum cut off point giving the best validity for prediction of outcome\" with 67% of sensitivity and 88% specificity \" Conclusion: INR is the only predictor associated with major complication or death within 30 days post OLTx at cut of level of > 3.4","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125057670","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}
B. Bolaji, F. Omosofe, I. Kolawole, A. B. Makanjuola
Background: Electroconvulsive therapy (ECT) provokes abrupt changes in systemic haemodynamics. We compared the effects of modified (propofol and thiopentone) versus unmodified ECT on haemodynamic responses of patients scheduled for ECT in two Nigerian tertiary hospitals between September 2008 and March 2009.Methods: In a prospective, randomized study, sixty patients slated for ECT were allocated to unmodified (UG), thiopentone (TG) and propofol (PG) groups with twenty in each group. Anaesthesia was induced with either 1mg/kg propofol (PG) or 5mg/kg thiopentone (TG) and 0.5mg/kg suxamethonium. Anaesthesia was not administered to UG. Blood pressure, systolic (SBP), diastolic (DBP) and heart rate (HR) were recorded before ECT and at 1 and 5 minutes after seizure had ended. The means of the post and pre ictal haemodynamic parameters and increases in means were compared. Results: Mean HR and SBP decreased significantly at 1 min in the modified group and increased significantly at 5 min. The mean HR increased significantly in both modified groups at 1 and 5 min. Mean SBP and DBP increased significantly at 5 min in the modified group and insignificantly in both modified groups. Increase in MAP was significant in TG (p = 0.028). Though the increase in SBP was not significant in modified groups, it was significantly greater in the TG than PG (p = 0.012) Conclusion: Modified ECT may not be commonly practiced in our environment because of dearth of qualified anaesthetists. This study has shown that modified ECT minimizes increases in haemodynamic response when compared with unmodified ECT. Propofol at 1 mg/kg minimized increases in DPB and MAP more than thiopentone 5 mg/kg. Propofol with rapid recovery profile is suitable for modified ECT in Nigerian patients.
{"title":"Comparative Effects Of The Haemodynamic Responses Of Modified Versus Unmodified Electroconvulsive Therapy In Nigerians.","authors":"B. Bolaji, F. Omosofe, I. Kolawole, A. B. Makanjuola","doi":"10.5580/2bb2","DOIUrl":"https://doi.org/10.5580/2bb2","url":null,"abstract":"Background: Electroconvulsive therapy (ECT) provokes abrupt changes in systemic haemodynamics. We compared the effects of modified (propofol and thiopentone) versus unmodified ECT on haemodynamic responses of patients scheduled for ECT in two Nigerian tertiary hospitals between September 2008 and March 2009.Methods: In a prospective, randomized study, sixty patients slated for ECT were allocated to unmodified (UG), thiopentone (TG) and propofol (PG) groups with twenty in each group. Anaesthesia was induced with either 1mg/kg propofol (PG) or 5mg/kg thiopentone (TG) and 0.5mg/kg suxamethonium. Anaesthesia was not administered to UG. Blood pressure, systolic (SBP), diastolic (DBP) and heart rate (HR) were recorded before ECT and at 1 and 5 minutes after seizure had ended. The means of the post and pre ictal haemodynamic parameters and increases in means were compared. Results: Mean HR and SBP decreased significantly at 1 min in the modified group and increased significantly at 5 min. The mean HR increased significantly in both modified groups at 1 and 5 min. Mean SBP and DBP increased significantly at 5 min in the modified group and insignificantly in both modified groups. Increase in MAP was significant in TG (p = 0.028). Though the increase in SBP was not significant in modified groups, it was significantly greater in the TG than PG (p = 0.012) Conclusion: Modified ECT may not be commonly practiced in our environment because of dearth of qualified anaesthetists. This study has shown that modified ECT minimizes increases in haemodynamic response when compared with unmodified ECT. Propofol at 1 mg/kg minimized increases in DPB and MAP more than thiopentone 5 mg/kg. Propofol with rapid recovery profile is suitable for modified ECT in Nigerian patients.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116641273","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}
Inflammatory hepatitis following desflurane anesthesia was once thought to be a rare occurrence. However, case reports documenting complications related to the use of this anesthetic continue to accumulate (1-5) . Risk factors for desflurane-induced hepatitis likely exist. Female gender, prior anesthetic experience with halothane, occupational exposure to halogenated anesthetics, atopy, and autoimmune disease may predispose an individual to immunemediated hepatitis following desflurane anesthesia (6,7)
{"title":"Desflurane-Induced Hepatitis","authors":"T. Nelson","doi":"10.5580/2b99","DOIUrl":"https://doi.org/10.5580/2b99","url":null,"abstract":"Inflammatory hepatitis following desflurane anesthesia was once thought to be a rare occurrence. However, case reports documenting complications related to the use of this anesthetic continue to accumulate (1-5) . Risk factors for desflurane-induced hepatitis likely exist. Female gender, prior anesthetic experience with halothane, occupational exposure to halogenated anesthetics, atopy, and autoimmune disease may predispose an individual to immunemediated hepatitis following desflurane anesthesia (6,7)","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132021007","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}
Surgery elicits profound changes in the neuroendocrine, metabolic, and immune systems, which collectively constitutes the “stress response”. These responses have been implicated in the development of a number of postoperative complications such as postoperative delirium, cognitive dysfunction, infection, and cancer recurrence. This review describes how ‘surgical stress’ and inflammatory responses affects the immune system as well as the patient's susceptibility to these untoward events. The immune system is composed of two major subdivisions, the innate or non-specific immune system and the adaptive or specific immune system. Each subdivision has humoral and cellular elements which allow the immune system to protect the body from foreign pathogens and cancer. The ‘Stress response’ results in the systemic release of cortisol, catecholamines, acute phase reactants, and cytokines which modulate the activity of both innate and adaptive components. There is a sensitive balance between proand anti-inflammatory cytokines after injury/surgery. Deficient responses may result in infections secondary to immunosuppression. On the other hand the excessive responses may lead to systemic inflammatory response syndrome (SIRS) and multi-organ failure (MOF). Additionally, we discuss how anesthesia and variable perioperative factors, such as blood transfusions, pain, and hyperglycemia can further disrupt immune performance. Understanding these postsurgical disruptions in immune homeostasis may aid the surgeon and anesthesiologist in choosing surgical and anesthetic techniques that preserve and/or enhance immune function.
{"title":"Neuroendocrine and Immune Responses to Surgery","authors":"R. Scholl, A. Bekker, R. Babu","doi":"10.5580/2b9a","DOIUrl":"https://doi.org/10.5580/2b9a","url":null,"abstract":"Surgery elicits profound changes in the neuroendocrine, metabolic, and immune systems, which collectively constitutes the “stress response”. These responses have been implicated in the development of a number of postoperative complications such as postoperative delirium, cognitive dysfunction, infection, and cancer recurrence. This review describes how ‘surgical stress’ and inflammatory responses affects the immune system as well as the patient's susceptibility to these untoward events. The immune system is composed of two major subdivisions, the innate or non-specific immune system and the adaptive or specific immune system. Each subdivision has humoral and cellular elements which allow the immune system to protect the body from foreign pathogens and cancer. The ‘Stress response’ results in the systemic release of cortisol, catecholamines, acute phase reactants, and cytokines which modulate the activity of both innate and adaptive components. There is a sensitive balance between proand anti-inflammatory cytokines after injury/surgery. Deficient responses may result in infections secondary to immunosuppression. On the other hand the excessive responses may lead to systemic inflammatory response syndrome (SIRS) and multi-organ failure (MOF). Additionally, we discuss how anesthesia and variable perioperative factors, such as blood transfusions, pain, and hyperglycemia can further disrupt immune performance. Understanding these postsurgical disruptions in immune homeostasis may aid the surgeon and anesthesiologist in choosing surgical and anesthetic techniques that preserve and/or enhance immune function.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"2 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134035010","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: This survey was conducted to assess surgical patient’s perception about the role of the anesthetist in patient care and to determine any change in this perception after a visit to the preoperative clinic. Methods: Four hundred and eighty one patients filled a questionnaire prior to attending the preoperative anaesthesia clinic and again after the clinic visit over a four month period. Results: Seventy one percent of the patient knew that anaesthetists were medically qualified. Thirty three percent identified the anaesthetist as a person who took care of patients during the surgery which increased to 38 % after clinic visit. Sixty seven percent of patients responded pre visit that an anaesthetist stays with the patient during surgery, this increased to 74% after visit. For postoperative care 42% indentified an anaesthetist as responsible before visit and 46% after it. Only 32% knew that the anaesthetist has role outside operating room which increased to 48 % after visiting the clinic. Majority wanted to know more about anaesthesia both before ( 77.1% ) and after ( 73.2) clinic visit. Fifty six percent patients were anxious before hospital admission and surgery was the main cause of their anxiety which decreased in 80% of visitors after the visit. Sixty five percent wanted more information after visiting the anaesthetist in the clinic. Conclusion : This audit shows poor perception of the role of the anaesthetist both inside and outside the operating room. However improvement was seen in some areas after preoperative the anaesthesia clinic visit.
{"title":"Change In Patient’s Perception And Knowledge Regarding Anaesthetic Practice After A Preoperative Anaesthesia Clinic Visit","authors":"Muhammad Imran, F. Khan","doi":"10.5580/2c38","DOIUrl":"https://doi.org/10.5580/2c38","url":null,"abstract":"Background: This survey was conducted to assess surgical patient’s perception about the role of the anesthetist in patient care and to determine any change in this perception after a visit to the preoperative clinic. Methods: Four hundred and eighty one patients filled a questionnaire prior to attending the preoperative anaesthesia clinic and again after the clinic visit over a four month period. Results: Seventy one percent of the patient knew that anaesthetists were medically qualified. Thirty three percent identified the anaesthetist as a person who took care of patients during the surgery which increased to 38 % after clinic visit. Sixty seven percent of patients responded pre visit that an anaesthetist stays with the patient during surgery, this increased to 74% after visit. For postoperative care 42% indentified an anaesthetist as responsible before visit and 46% after it. Only 32% knew that the anaesthetist has role outside operating room which increased to 48 % after visiting the clinic. Majority wanted to know more about anaesthesia both before ( 77.1% ) and after ( 73.2) clinic visit. Fifty six percent patients were anxious before hospital admission and surgery was the main cause of their anxiety which decreased in 80% of visitors after the visit. Sixty five percent wanted more information after visiting the anaesthetist in the clinic. Conclusion : This audit shows poor perception of the role of the anaesthetist both inside and outside the operating room. However improvement was seen in some areas after preoperative the anaesthesia clinic visit.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129781117","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}
Arvind Kumar, B. Shadangi, Jitendra Agarwal, V. M. Agnihotri
Purpose: Supraclavicular brachial plexus block technique, blocks the entire arm distally till mid arm level but risk of pneumothorax, phrenic nerve palsy and vascular puncture could be life threatening so to overcome these sequale we compared the lateral approach of supraclavicular brachial plexus block with conventional approach of supraclavicular block. Methods: Patients were randomly allocated in two groups; group 1 (n=50) received conventional approach of supraclavicular brachial plexus block and group 2 (n= 50) received lateral approach of supraclavicular brachial plexus block. Both the group received lignocaine with adrenaline (1:200000) 7 mg/kg and bupivacaine 2 mg.kg -1. The total volume of drug injected was 30 ml. Results: All the patients were assessed in terms of Time of onset of analgesia, Extent of sensory block, Quality of motor blocked, Tourniquet tolerance, Technical difficulty, Total duration of analgesia, Total duration of motor paralysis, and complications. Appropriate statistical analysis was done. Conclusion: We concluded that the Lateral Approach of Supraclavicular brachial plexus block justifies its own routine clinical uses because it has got better compliance of block in relation to onset, duration, extent and success rate. It is less traumatic and causes less adverse effects like puncture of vessels and pleura.
{"title":"Lateral Approach Of Supraclavicular Brachial Plexus As A Better Alternative To Conventional Supraclavicular Brachial Plexus Block","authors":"Arvind Kumar, B. Shadangi, Jitendra Agarwal, V. M. Agnihotri","doi":"10.5580/2b97","DOIUrl":"https://doi.org/10.5580/2b97","url":null,"abstract":"Purpose: Supraclavicular brachial plexus block technique, blocks the entire arm distally till mid arm level but risk of pneumothorax, phrenic nerve palsy and vascular puncture could be life threatening so to overcome these sequale we compared the lateral approach of supraclavicular brachial plexus block with conventional approach of supraclavicular block. Methods: Patients were randomly allocated in two groups; group 1 (n=50) received conventional approach of supraclavicular brachial plexus block and group 2 (n= 50) received lateral approach of supraclavicular brachial plexus block. Both the group received lignocaine with adrenaline (1:200000) 7 mg/kg and bupivacaine 2 mg.kg -1. The total volume of drug injected was 30 ml. Results: All the patients were assessed in terms of Time of onset of analgesia, Extent of sensory block, Quality of motor blocked, Tourniquet tolerance, Technical difficulty, Total duration of analgesia, Total duration of motor paralysis, and complications. Appropriate statistical analysis was done. Conclusion: We concluded that the Lateral Approach of Supraclavicular brachial plexus block justifies its own routine clinical uses because it has got better compliance of block in relation to onset, duration, extent and success rate. It is less traumatic and causes less adverse effects like puncture of vessels and pleura.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126330520","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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