Indian journal of anaesthesia
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Sufentanil is an excellent adjuvant in total intravenous anaesthesia (TIVA). The present study evaluates effectiveness of different concentrations of Sufentanil mixed in propofol for TIVA in laparoscopic cholecystectomy. Sixty adult patients of ASA physical status I or II (randomly divided into 3 groups of twenty each) undergoing elective laparoscopic cholecystectomy were included in this randomised control study. ⋯ Fewer Group S2 patients required additional Sufentanil boluses to maintain adequate depth of anaesthesia compared to other two groups. Group S2 patients had better post-operative analgesia (p=0.01) but prolonged recovery time (p=0.001) compared to the other two groups. Sufentanil mixed with propofol provides better haemodynamic stability in laparoscopic cholecystectomies, with lesser requirement for additional Sufentanil boluses, and good postoperative analgesia.
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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.
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Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins 'separation surgery mainly centered on the following concerns: 1. ⋯ Long marathon surgery with massive fluid shifts and loss of blood & blood components and their rapid replenishment. 3. Meticulous planning for organized management of long hours of anaesthetic administration in two paediatric subjects simultaneously with multi surgical specialties' involvement and their unique requirements. We report the anaesthetic and intensive care management of one pair of Pygopagus separation surgery and also the review of literature and world statistics.
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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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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.