Irish journal of medical science
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Obese parturients are at high risk of complications during anaesthesia and early use of epidural analgesia in labour has been recommended for obese patients during labour. ⋯ The outcomes of obese patients attending the anaesthetic clinic were mixed. Not all patients who were to advised have epidurals did so but those who did requested them in early labour and there was no requirement for general anaesthesia during emergency caesarean section and adverse airway events were avoided in this group.
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Comparative Study
Correlation between BIS and GCS in patients suffering from head injury.
Glasgow coma scale (GCS) is considered an important parameter to predict the clinical outcome in head injury; however, in some cases such as the use of sedative drugs the estimate of GCS would not be precise. Bispectral index (BIS) is an electrophysiological parameter to determine the clinical state of anesthesia. The aim of the present study is to evaluate correlation between GCS and BIS in patients suffering from head injury and to see if we can use BIS values as a prognostic factor in head trauma. ⋯ We found significant correlation between GCS and BIS in patients with traumatic head injury, so BIS can be used in addition to GCS for prediction of outcome in these patients specially in patients who are sedated or are intubated or in other case in whom GCS values cannot be determined accurately.
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Epidural anaesthesia generally provides safe postoperative pain control, but does carry a small risk of nerve damage. ⋯ The episode raises a number of discussion points for our pain service around the use of epidurals for knee replacement surgery, the management of nerve injury and the ease at which the epidural can be blamed for coincident injuries. International evidence would suggest that neurological complications following knee replacement are more likely to be related to surgery can epidural analgesia.
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The practice of fasting from midnight prior to surgery is an outdated one. ⋯ Implementation of this protocol for reduced preoperative fasting achieved an appreciable reduction in fasting times and enhanced patient comfort. Patient safety was not compromised. Further modifications of our protocols are necessary to meet the international best practice. We recommend its implementation across all surgical groups in our institution.
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Struma Ovarii are mature teratomas. In rare circumstances thyroid tissue is found as part of the histopathological makeup. Malignant transformation may occur in 1-2% of these rare cases. ⋯ This is a rare tumour which necessitates surgical extirpation and removal of a normal thyroid gland to facilitate thyroglobulin monitoring.