Anesthesia, essays and researches
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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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Preanesthesia assessment is an important aspect of patient care. If a patient shows lack of interest during preanesthesia check-up or tries to rush through, it may result in incomplete history and general physical examination, compromising patient care. ⋯ Patients had insufficient knowledge about preanesthesia assessment and its role in improving the outcome of surgery.
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General anesthesia as a technique for laparoscopic cholecystectomies has disadvantage in terms of the stress response, lack of postoperative analgesia and emesis. Regional anesthesia offers advantages over general anesthesia in terms of cost, postoperative analgesia, intact respiratory control mechanism and early ambulation. Shoulder tip pain remains the main concerns that can be alleviated by adding various adjuvants to local anesthetics. ⋯ Intrathecal dexmedetomidine provides stable hemodynamics, excellent sedation and analgesia and abolishes shoulder tip pain.
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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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Head and neck cancer (HNC) surgery is associated with high intraoperative blood loss which may require urgent blood transfusion. Many strategies have been recommended to decrease the need for allogenic transfusion. Use of perioperative tranexamic acid (TA) has a promising role. ⋯ Thus, TA significantly reduces blood loss and chances of colloid, blood, and crystalloid transfusion caused by HNC surgery.