JPMA. The Journal of the Pakistan Medical Association
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Chylopericardium is a rare complication of cardiac surgery. It may be caused by a lesion in the thoracic duct or its tributaries or by thrombosis in the confluence of the jugular and left subclavian veins, obstructing the drainage of the thoracic duct. ⋯ We report the case of a 1 1/2 year-old male, who, in the late postoperative period of VSD repair, was hospitalized with low-grade fever and breathlessness for one week due to the presence of chylopericardium. The clinical findings and treatment performed are discussed.
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There is no agreed technique for minimizing PONV (Postoperative Nausea and Vomiting) although some techniques are associated with low rate. Best practice involves identifying high risk patients and surgeries and use of prophylactic antiemetic where appropriate. Laparoscopic gynaecological surgery has high incidence of PONV (54-92%). ⋯ This audit recommended institutional guidelines for the management of PONV. These should be based on evidence obtained from the published peer-reviewed studies. These guidelines could be communicated to health care workers involved in postoperative management of patients to help them achieve an optimal management strategy for this uncomfortable postoperative complication.
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Comparative Study
Reduced incidence of laryngospasm with remifentanil-midazolam anaesthesia compared to halothane-fentanyl.
To compare the incidence of laryngospasm by using halothane-fentanyl anaesthesia and midazolam-remifentanil anaesthesia in paediatric patients undergoing eye surgery. ⋯ The results of our study suggest that remifentanil combined with midazolam in children undergoing eye surgery provided a better condition for extubation of the patients.
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Sedation/analgesia is a mode of anaesthesia which facilitates an uncomfortable or painful procedure, such as gastrointestinal endoscopy, in a rousable and cooperative patient. The objective of the study was to assess the practice trends for administering sedation analgesia in non operative locations in Aga Khan Hospital, Karachi by anaesthetists. It was a descriptive study which retrospective reviewed anaesthesia records. ⋯ All our patients recovered uneventfully within 5 minutes of the end of procedure. The practice trends for drug regimens are similar to those reported in recent literature. However we need to provide BIS monitoring, target controlled and patient maintained sedation to enhance patient and operator comfort.
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Randomized Controlled Trial Comparative Study Clinical Trial
Haemodynamic response of intravenous tramadol and intravenous morphine during laryngoscopy and endotracheal intubation.
To compare the haemodynamic response of equipotent analgesic doses of morphine and tramadol to laryngoscopy and endotracheal intubation. ⋯ Morphine is a better drug as compared to tramadol for attenuation of laryngoscopy and endotracheal intubation response.