Indian journal of anaesthesia
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The aim of the study was to assess and compare laryngoscopic view of Truview evo2 laryngoscope with that of Macintosh laryngoscope in patients with one or more predictors of difficult intubation (PDI). Moreover ease of intubation with Truview evo2 in terms of absolute time requirement was also aimed at. Patients for elective surgery requiring endotracheal intubation were initially assessed for three PDI parameters - modified Mallampati test, thyro-mental distance & Atlanto-occipital (AO) joint extension. ⋯ Intubation with Truview evo2 was possible in 88% cases within stipulated time of one minute and mean time of 28.6 seconds with SD of 11.23 was reasonably quick. No significant complication like oro- pharyngeal trauma or extreme pressor response to laryngoscopy was noticed. To conclude, Truview evo2 proved to be a better tool than conventional laryngoscope in anticipated difficult situations.
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Anaesthesiologists are playing a decisive role in patient management. Present day anaesthesiology is based on the use of newer and safer drugs, better patient monitoring, pain management and critical care. But the general public knows little of these developments. ⋯ Among the population who knew something about general anaesthesia, none from upto matriculation and 33.87%, 44.83% and 100% from the graduate, post graduate and medical undergraduate groups respectively knew that anaesthesia is administered with specialized equipments along with monitoring. Illiterates did not know about regional anaesthesia, while most of others had some knowledge about it. The results of the study reflect the wide spread ignorance and misconceptions about anaesthesiology and anaesthesiologists still prevalent in public in India.
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Chronic low back pain (CLBP) is challenging to treat with its significant psychological and cognitive behavioural element involved. Mindfulness meditation helps alter the behavioural response in chronic pain situations. ⋯ The current evidence in the field, though not grade one, shows that there is a place for mindfulness meditation in managing chronic pain conditions including CLBP. Further research to test the usefulness of mindfulness in CLBP should involve good quality randomized controlled trials of pure mindfulness based technique in matched subjects.
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Sometimes in practice of anaesthesia, anaesthesiologist encounters patients with rare congenital diseases. To anaesthesiologist, these patients are a challenge due to inherent complications associated with the disease. Here, we are reporting a case of osteogenesis imperfecta who was posted for the surgery for vesical calculus. ⋯ Caudal epidural was chosen as anaesthesia technique of choice as spinal anaesthesia was anticipated to be difficult due to associated kyphoscoliosis. GA was avoided due to anticipated difficult airway, restrictive lung disease and susceptibility to malignant hyperthermia. We emphasize the importance of proper preanaesthetic evaluation, intellectual, mental and logistical preparation which should be done before anaesthetising these types of patients.
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This preliminary study on I-gel (Intersurgical Ltd, Wokingham, U K) was conducted on 50 consecutive patients of ASA physical status I-III, to determine the ease of insertion, time to achieve effective airway, oropharyngeal seal pressure and airway stability on head and neck movement. After premedication with midazolam and fentanyl, induction was done with propofol and I-gel was inserted according to manufacturer's instruction. An effective airway was confirmed by bilateral chest movement, square wave on capnograph and SpO(2)>95%. ⋯ Gastric tube placement was done in 50% of the cases; it was easy and successful in all the cases. No significant adverse event was noted in any of the patient in perioperative period. Our initial experience showed that I-gel is a simple, easy to use supraglottic airway device with a high success rate at first time insertion.