Indian journal of anaesthesia
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Carotid endarterectomy(CEA) is being increasingly performed under regional anaesthesia supplemented with sedation, the world over. Deep or superficial cervical plexus blocks or a combination of both have been found to be equally effective. ⋯ These are especially useful given the varying landmarks quoted by various authors as also inter-individual differences in anatomy. We present a case report of how fluoroscopy aided us in administering cervical plexus block.
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The LMA CTrach is a variant of the intubating LMA. It provides visualization of larynx during intubation and is a promising addition to airway management cart. A preliminary study of 20 patients posted for elective surgery requiring GA were enrolled for the study. ⋯ None of our patient had any complications and haemodynamic parameters and SpO(2) remained within normal limits throughout the procedure. The post operative period was uneventful. We successfully ventilated and intubated all the patients using LMA CTrach.
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Sixty ASA grade I & II adult patients of either sex were randomly assigned into two groups. Group I (n=30) for I-gel and Group P (n=30) for LMA - ProSeal. We assessed the airway sealing pressure, ease of insertion, success rate of insertion, ease of gastric tube placement, airway trauma by post operative blood staining of the device, tongue, lip and dental trauma, hoarseness, regurgitation / aspiration and cost effectiveness. ⋯ There was no evidence of bronchospasm, laryngospasm, regurgitation, aspiration or hoarseness in either group. To conclude I-gel is a novel supraglottic device with an acceptable airway sealing pressure (25.27 cm H(2)O). It is easier to insert, requires less attempts of insertion, has easier gastric tube placement and is less traumatic as compared to LMA-ProSeal.
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Shivering-the "Big Little Problem" has an incidence of 60% in early recovery phase following general anaesthesia. A number of techniques have been tried to prevent postoperative shivering. Previous study showed that, ondansetron in higher doses reduces postoperative shivering. ⋯ Groups P and G differ significantly than in Group S (p<0.05). However, the difference between Groups P and G was not statistically significant (p>0.05). The prophylactic use of granisetron (40mcg.kg(-1)) and pethidine(25mg) intravenous were found to be effective in preventing postoperative shivering.
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Direct trauma to the airway is a rare injury which can lead to disastrous consequences due to compounding effect of bleeding, aspiration of blood, airway obstruction and severe sympathetic stimulation. Here we are presenting two cases of open tracheal injury in two adult males following assault with sharp weapon. Two different techniques of securing the airways were employed depending upon the severity and urgency of the situation. In the first case, orotracheal intubation helped the surgeon to repair airway around the endotracheal tube whereas in the second patient this stenting effect was absent as he was intubated through the distal cut-end of trachea in the face of airway emergency.