Journal of the Indian Medical Association
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Cardiopulmonary resuscitation (CPR) provides artificial circulation and ventilation during cardiopulmonary arrest. CPR is further categorised as basic life support (BLS), advanced cardiac life support (ACLS) and postresuscitation support. BLS consists of provision of a patent upper airway, ventilation and circulation of blood by closed chest cardiac compressions. ⋯ The routine administration of bicarbonate and calcium is no longer recommended but situations exist where they can be used appropriately. Administration of drugs during CPR should preferably be via a central route, but epinephrine, lidocaine and atropine can be administered via the endotracheal tube if intravenous access has not been established. Postresuscitation care includes mechanical ventilation if necessary to optimise oxygenation and ventilation and steps to maintain vital organ and optimal brain protection, which includes avoidance of hypertension, hypotension and hyperglycaemia.
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Comparative Study Clinical Trial
Inguinal herniorrhaphy under local anaesthesia and spinal anaesthesia--a comparative study.
A prospective study was conducted at JIPMER, Pondicherry from September 1993 to June 1995. Fifty cases of inguinal herniorrhaphy were done under local anaesthesia (LA) and 60 cases under spinal anaesthesia (SA). The aim was to assess the safety and efficacy of inguinal herniorrhaphy under LA. ⋯ The LA group patients had better postoperative analgesia and earlier return to ambulation. They did not suffer the postspinal complications of headache and urinary retention. However, intra-operative discomfort was significantly more in this group compared to the SA group.
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Comparative Study Clinical Trial
Is spinal anaesthesia safe in pre-eclamptic toxaemia patients?
Thirty-three patients of pre-eclamptic toxaemia underwent caesarean section (CS) under general anaesthesia (n = 16) and spinal anaesthesia (n = 17). The Apgar score at 1, 5 and 10 minutes of the babies following spinal anaesthesia (SA) were only marginally better than that of general anaesthesia (GA; P > 0.05). The incidence of complication following GA (68.8%) were significantly (P < 0.05) more than that of SA (47.1%). ⋯ While following SA complications were intra-operative hypotension (47.1%), difficult SA (29.4%) and intra-operative vomiting (5.9%). The nature of complications following GA were more serious which may even lead to mortality (4.3%), whereas following SA it was less serious and easily manageable. Hence SA is not as unsafe as it is thought.