Indian journal of anaesthesia
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Studies have demonstrated that poor assessment and planning contribute to airway complications and that current airway assessment strategies have a poor diagnostic accuracy in predicting difficult intubation in the general population. Patients with head and neck pathology are at higher risk for difficulties during airway management and are more likely to need emergency surgical access. ⋯ The addition of virtual endoscopy (VE) to clinical history and computerised tomography imaging has been shown to improve diagnostic accuracy for supraglottic, glottic and infraglottic lesions and has a positive influence in formulating a more cautious and thorough airway management strategy in this high-risk group of patients. This article reviews whether VE can enhance airway assessment in patients with head and neck pathology and help reduce airway complications.
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Post-operative nausea and vomiting (PONV) is a common and distressing complication after laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the effect of intravenous (IV) dextrose administration for the prophylaxis of PONV after LC. ⋯ Administration of IV dextrose before anaesthesia induction may be recommended as an effective, and safe method for the prophylaxis of PONV after LC.
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Abdominal field blocks are commonly used as part of multimodal analgesia for post-operative pain relief in patients undergoing abdominal surgery. Conventionally, transversus abdominis plane block is used, but has the disadvantage of limited spread only to T10-T12 segments, providing only partial pain relief. ⋯ Opioid-induced cough depression, urinary retention, and drowsiness can be problematic in patients with Prune belly syndrome, who have deficient abdominal muscles and myriad of genitourinary problems. We report a case of a young male with Prune belly syndrome, who had a pain-free post-operative period after high inguinal orchidectomy with unilateral QL block.
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Awake fibre-optic intubation (AFOI) is an integral part of anaesthetic management of difficult airways. Conscious sedation is essential to assist AFOI. This study compared two different doses of dexmedetomidine in combination with topical spray and airway blocks for awake orotracheal fibre-optic intubation in patients undergoing elective cervical spine surgery with rigid cervical collar in situ. ⋯ The 0.5 μg/kg dose of dexmedetomidine was found optimal and effective in combination with topical spray and airway blocks for awake orotracheal fibre-optic intubation for patients undergoing elective cervical spine surgery.