Anesthesia, essays and researches
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Ventilator associated pneumonia is one the most common nosocomial infection encountered in the ICU patients. Despite of the implementation of the VAP prevention bundle, the incidence remains high. This can be attributed to the peritubal leak and the aspiration of the oropharyngeal secretions. The secretions further forms a nidus for the growth of organisms in the lower respiratory tract. In this study, a specialised tube, named 'suction above cuff endotracheal tube' is used, which has an additional suction port opening above the cuff. This is to facilitate timely aspiration of the secretion which pent-up above the cuff and gradually trickles down the trachea resulting in pneumonia. ⋯ In this study involving neurological population, there was no significant difference in incidence of clinical and microbiological VAP between SETT and SACETT group, when other strategies for VAP prevention were similar. Other outcomes were similar with use of either tube for intubation.
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Phenylephrine(PE) bolus and infusion have been compared for post spinal hypotension and neonatal effects during cesarean section(CS) under spinal anesthesia(SA). ⋯ There was a tighter control of BP in the infusion group vs. the bolus group while the neonatal outcome was similar in both the groups.
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Several video laryngoscopes had demonstrated their superiority over conventional oral and nasal intubation techniques. King Vision video laryngoscope has fewer studies supporting its suitability for oral intubations. However, its suitability as a nasal intubating device has not been yet evaluated. We evaluated the suitability of King Vision video laryngoscope for nasotracheal intubation comparing with TruviewPCD. ⋯ King Vision video laryngoscope is just as effective as TruviewPCD video laryngoscope for successful nasotracheal intubation.
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Both intubation and extubation are associated with pressor response. ⋯ Ropivacaine when used through nebulization preinduction effectively reduced both intubation and extubation responses when compared to saline. However, there was no significant difference between the ropivacaine and lignocaine on extubation response.
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Positioning fracture femur cases for sub arachnoid block (SAB) is challenging. Fascia iliaca compartment block (FICB) is low skilled, helps positioning, and provides analgesia. Dexmedetomidine as an adjuvant prolongs analgesia. ⋯ FICB ensures patient comfort during positioning for SAB and provides postoperative analgesia. Dexmedetomidine significantly prolongs postoperative analgesia.