Anesthesia, essays and researches
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Nausea and vomiting causes distress to patients and increases surgical complications. Though various antiemetics are available, their effectiveness and fetal safety profile when used in parturient remains debatable. This randomized, double-blind, comparative study was designed with an aim to compare the antiemetic effects of ondansetron and glycopyrrolate during cesarean section. ⋯ Effect of glycopyrrolate on nausea and vomiting during cesarean section are comparable to ondansetron, but with an increased incidence of dry mouth. Glycopyrrolate has no effect on hypotension or additional analgesic requirements, but the incidence of bradycardia is significantly less.
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Dexmedetomidine a new drug, which is alpha-two agonist, is recommended by manufacturers as an adjuvant in epidural analgesia and anesthesia. ⋯ We conclude that epidural dexmedetomidine 0.5 µg/kg is a good adjuvant providing early onset of sensory and motor block, adequate sedation and prolonged postoperative analgesia with minimal side-effects.
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We report a case of severe maxillofacial injury, who while undergoing later stages of reconstruction surgeries, presented with an inimitable kind of air leak during mask ventilation and its interesting management using a nasopharyngeal airway. The case also enlightens the importance of evaluating the available computed tomography images as a part of preanesthetic check-up.
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To augment the subarachnoid block utility, the efficacy of newer molecules as an adjuvant is investigated constantly. Considering the favorable profile of dexmedetomidine, it could have a potential role as an adjuvant to ropivacaine. ⋯ Among the investigated doses, dexmedetomidine augments the efficacy of intrathecal ropivacaine in a dose-dependent manner, without any untoward side effects.
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Central venous catheterization (CVC) is routinely done procedure in ICU or during surgery for various indications. Right Internal jugular vein (IJV) is preferred vessel among different routes for CVC. Anatomic variations of neck vessels are not uncommon and may increase the complication rate especially in patients with altered coagulation profile. ⋯ Ultrasound (US) guided IJV Cannulation provides high success rate, less access time and lesser complications. Superiority of US over anatomic landmark technique has been established, but use of US in clinical practice is still limited. We report a case of idiopathic unilateral hypoplastic IJV in a patient with altered coagulation profile who required CVC, we also tried to find out the barriers for limited use of US.