Journal of the Indian Medical Association
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Blast lung is a clinical condition which is characterised by respiratory difficulty and hypoxia without obvious external injury to the chest in bomb blast cases. Two patients of the bomb blast episode were brought at emergency department at Chhattisgarh Institute of Medical Sciences, Bilaspur in a state of shock. After proper wound care, resuscitation and investigation both the cases proved to be that of blast lung. In bomb blast cases although there might not be any external injury over chest wall, it will be sensible to rule out blast lung in all cases with the help of computerised tomography.
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Randomized Controlled Trial Comparative Study
Evaluation of airway blocks versus general anaesthesia for diagnostic direct laryngoscopy and biopsy for carcinoma larynx.
A prospective randomised study of 100 patients divided into two groups was done to compare the effects of regional airway nerve blocks versus general anaesthesia to evaluate intra-operative haemodynamic changes and compare the level of postoperative analgesia and sedation in both the groups. In group I whole airway block including bilateral superior laryngeal nerve block with bilateral glossopharyngeal block and recurrent laryngeal nerve block was given and in group II general anaesthesia was given. The mean duration was 27 +/- 5 minutes in all cases, all patients were of ASA grade 3 or 4. ⋯ Whereas in group I there was a stability in mean arterial pressure and pulse rate peri-operatively. The postoperative analgesia was significantly higher in group I and lasted longer as compared to group II and patients were less agitated and calm as assessed by the sedation score, in group II most of the patients required postoperative nebulisation as compared to group I where no patient needed nebulisation. In conclusion we suggest that regional airway block for anaesthesia in the short procedures of upper airways and also in cases of predicting difficult airway cases for securing the safe airway can be very useful alternate to general anaesthesia.