International Journal of Medical Anesthesiology

Journal Information
ISSN / EISSN : 2664-3766 / 2664-3774
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 328
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Latest articles in this journal

Pooja Kamat, Pratima Killekar, Govinda Innani
International Journal of Medical Anesthesiology, Volume 5, pp 35-38; https://doi.org/10.33545/26643766.2022.v5.i2a.349

Abstract:
Background: Hemorrhagic shock is a form of hypovolemic shock resulting from decreased blood volume (hypovolemia) caused by blood loss which leads to reduced cardiac output and organ perfusion. It a life-threatening emergency if hemorrhage continues unchecked, death quickly follows. We report perioperative management of a 25 year-old anemic patient who was in hemorrhagic shock with a ruptured ectopic pregnancy for emergency laparotomy it’s an anesthesia challenge.
Pooja Kamat, Manognya Bethapudi
International Journal of Medical Anesthesiology, Volume 5, pp 32-34; https://doi.org/10.33545/26643766.2022.v5.i2a.348

Abstract:
Background: Pregnancy in dwarfism generally present with contracted pelvis and cephalopelvic disproportion. Cesarean section is generally indicated for deliver. However, Anaesthesia management in dwarf pregnant patient is difficult and challenging as they are other concurrent conditions like atlanto-axial instability, spine deformities like kyphoscoliosis and narrowed pharynx leading to higher risk for both general as well as regional anaesthesia. Here, we are presenting a successful case of anaesthesia management in dwarf patient with failed spinal anaesthesia and unanticipated difficult airway for emergency cesarean section.
V Velkumar
International Journal of Medical Anesthesiology, Volume 5, pp 21-23; https://doi.org/10.33545/26643766.2022.v5.i1a.337

Abstract:
Objectives: This prospective study was conducted to compare the postoperative analgesic efficacy of epidural 0.2% Ropivacaine and 0.2% Ropivacaine with Tramadol in patients undergoing abdominal surgeries under general anesthesia.Observations:•The duration of analgesia in postoperative period in patients who received epidural 0.2% Ropivacaine with Tramadol was comparatively longer than that of patients who received epidural 0.2% Ropivacaine.•The Ramsay sedation score was observed to be more in patients who received epidural 0.2% Ropivacaine with Tramadol compared to patients who received epidural 0.2% Ropivacaine.•There was no significant difference in the postoperative nausea and vomiting episodes in both the groups.•There was no significant difference in occurrence of pruritus in both the groups.•There was no statistical difference between the two groups with respect to heart rate, mean arterial pressure, oxygen saturation and respiratory rate.
Reshma P, Robin Manidas, Senthil Ks, Lakshmi R
International Journal of Medical Anesthesiology, Volume 5, pp 30-32; https://doi.org/10.33545/26643766.2022.v5.i1a.340

Abstract:
The airway is not only shared but operated upon during laryngeal cancer surgery. Patients with laryngeal cancer require general anaesthesia for major cancer resectional surgery. This review outlines the importance of careful assessment of the airway and medical comorbidities and discusses the options for anaesthetic and ventilatory management whilst ensuring a safe airway, adequate oxygenation and the best possible view of the surgical field.
Sejal Darshan Shelat, Avanee Chandrakantbhai Patel, Dimple Pandya, Khushbu Jayant Sagparia, Karan Amul Batavia
International Journal of Medical Anesthesiology, Volume 5, pp 17-20; https://doi.org/10.33545/26643766.2022.v5.i1a.336

Abstract:
Most patients undergoing general anesthesia, laryngoscopy and endotracheal intubation are required that can cause a large haemodynamic stress response, caused by sympathetic adreno-medullary response due to cortisol, norepinephrine, and epinephrine production. These can lead to tachycardia, hypertension, occasional dysrhythmias, angina, myocardial infarction or stroke. Considering the clinical significance of these changes stress attenuation is needed to blunt these responses. This is done by a variety of medications like lidocaine, deep inhalation anesthetic, ganglion blocking drugs, calcium channel blockers, vasodilators, opioids, and adrenergic blockers. An observational comparative study was designed to compare the effectiveness and safety of intravenous esmolol 1 mg/kg with labetalol 0.4 mg/kg for suppression of haemodynamic response to laryngoscopy and endotracheal intubation.
Neepa Patel, Sandeep K Dhuliya
International Journal of Medical Anesthesiology, Volume 5, pp 09-13; https://doi.org/10.33545/26643766.2022.v5.i1a.334

Abstract:
Introduction: Caesarean section is one of the common lower abdominal surgeries in young females with significant postoperative pain. Caesarean delivery and subsequent manipulation performed through Pfannenstiel incision are associated commonly with a significant degree of pain in the postoperative period.Aim: This study aims to compare TAP block versus II/IH block for post-caesarean delivery analgesia.Materials and Method: Study was conducted with 56 Pregnant women aged between 18-35yr scheduled for caesarean section under spinal anaesthesia were randomized to either TAP block (Inj. Bupivacaine plain 0.25%20cc bilateral) or II/IH block (Inj. Bupivacaine plain 0.25%20cc bilateral) given for postoperative pain management at the end of surgery. Pain score, Total tramadol consumption, time to first analgesic request was assessed during the first 48 h postoperatively.Result: The cumulative median tramadol consumption over 48 h were 16.96+/-32.66mg for TAP group and 56.25+/-567.98mg for II/IH. Pain score was statistically significantly lower in group TAP compared to group IIIH at 8hr, 12hr, 24hr and 48hrs (p=<0.05). Time for first request for rescue analgesia was also prolonged in the TAP block compared to IIIH block.Conclusion: TAP block was superior over IIIH block for post caesarean delivery pain management via Pfannenstiel incision.
Masarat Ara, Shireen Shamas, Imran Nazir, Rukasana Najeeb
International Journal of Medical Anesthesiology, Volume 5, pp 06-08; https://doi.org/10.33545/26643766.2022.v5.i1a.333

Abstract:
Background: The costoclavicular space (CCS), which is located deep and posterior to the midpoint of the clavicle, may be a better site for infraclavicular brachial plexus block than the traditional lateral paracoracoid site. The aim of this stdy was that triple injections in each of the 3 cords in the CC space would result in a greater spread in the 4 major terminal nerves of the brachial plexus than a single injection in the CC space without increasing the local anesthetic (LA) volume. Materials and Methods: Seventy patients who underwent upper extremity surgery randomly received either a single injection (S group, n = 35) or a triple injection (T group, n = 35) using the CC approach. Ten milliliters of 1% xylocaine, 10 mL of 0.5% ropivacaine, and 5 mL of normal saline were used for BPB in each group (total 25 mL). Sensory-motor blockade of the ipsilateral median, radial, ulnar, and musculocutaneous nerves was assessed by a blinded observer at 5 minutes intervals for 30 minutes immediately after LA administration. Results: Thirty minutes after the block, the blockage rate of all 4 nerves was significantly higher in the T group than in the S group (52.9% in the S group vs 85.3% in the T group, P = .004). But there was no significant difference in the anesthesia grade between the 2 groups (P = .262). The performance time was similar in the 2 groups (3.0 ± 0.9 minutes in the SI group vs 3.2 ± 1.2 minutes in the T group, respectively; P = .54). Conclusion: The triple injection increases consistency in terms of blocking all 4 nerves without increasing the procedure time despite administering the same volume of the LA.
Rupal B Shah, Upasna Bhatia, Dipti K Patel, Sushmita K Shah
International Journal of Medical Anesthesiology, Volume 5, pp 01-05; https://doi.org/10.33545/26643766.2022.v5.i1a.332

Abstract:
Background and Aims: There has been increasing number of mucormycosis cases as post covid sequalae during second wave of covid pandemic. Our study focussed on challenges in anaesthetic management of surgical resection of post covid rhino-orbito-cerebral mucormycosis. Methods: We did a retrospective case study of 60 patients posted during May-June 2020 posted for surgical resection of Rhino-orbito-cerebral mucormycosis under General Anaesthesia. All patients were operated irrespective of altered laboratory biomarkers, remnant of covid -19 disease. Results: Demographic and clinical parameters, and laboratory biomarkers were reviewed for each patient. Patients had median age of 55 years (23-85 years). Patients belonged to ASA physical status I: II: III (10: 40:10). The most common associated co-morbidity with median elevated Fasting blood sugar level 162 (63-711) followed by hypertension (48%). 85% patients were on steroid therapy (continued from covid disease treatment). 6% were hypothyroid patients. Invasive arterial monitoring was performed in 13.3% patients with femoral central line cannulation done in 85% of cases. 21% patients were shifted to ICU intubated and the rest were shifted with NRBM as a preventive measure. 23% had revision surgery whose mallampatti score was upgraded from I to III. Conclusions: Necessary precautions should be taken for difficult airway caused by fungal debris in oropharyngeal airway and supraglottic edema. So is the importance of Post ICU care because of co-morbidities and post covid sequalae’s.
Shivakumar Kg, Meghna Mukund, Vandana A Kamble, Ananthprasad Rao Ht
International Journal of Medical Anesthesiology, Volume 5, pp 14-16; https://doi.org/10.33545/26643766.2022.v5.i1a.335

Abstract:
Background: Malignancy related/ chronic abdominal and pelvic pain, most of the times is debilitating and affects survival and quality of life. Several modalities of chronic pain management for upper abdominal cancers have been proposed. Coeliac plexus block is widely used for the chronic pancreatic pain management. Most commonly used drug for celiac plexus block is 100% alcohol. This study is comparison between two drugs used for celiac plexus block.Objectives: To compare the efficacy in view of duration and pain relief with Inj. Methylprednisolone 80mg versus alcohol 50% in coeliac plexus block in chronic abdominal pain management.Materials and Methods: A Retrospective study was conducted on 18patients (group A-9 and group B-9) with chronic abdominal pain who underwent coeliac plexus block for chronic pain management, in Yenepoya Medical College and Hospital from January 2016 to December 2018.Group-A: 50% alcohol as adjuvant with 1%lignocaineGroup B: 80mg Methylprednisolone, as adjuvant with 1% lignocaineComparison of pain scores (average) were done at the end of every month for 6 months using Numerical Rating score (NRS) as per the data collected.Results: Group A had lesser NRS scores when compared to Group B. The statistical analysis was carried out using Mann Whitney U test. The U value is 5. The critical value of U at p<0.05 is 5 and hence the result is significant with P value of <0.05.Conclusion: Alcohol 50% gives better longer pain relief over methyl prednisolone 80mg in coeliac plexus block in chronic pain management.
Reshma P, Navaneetha Krishnan, Lakshmi R
International Journal of Medical Anesthesiology, Volume 5, pp 28-29; https://doi.org/10.33545/26643766.2022.v5.i1a.339

Abstract:
Tongue is the most common site of oral cancer which is primarily a disease of epithelial origin. Cancer tongue patients have difficult airway. Proper management in the perioperative period will decrease morbidity and mortality. We report a case of carcinoma tongue on the right lateral aspect which was managed efficiently.
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