JPMA. The Journal of the Pakistan Medical Association
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Randomized Controlled Trial Clinical Trial
Haemodynamic effects of intrathecal bupivacaine for surgical repair of hip fracture.
To determine the optimal dose of bupivacaine in providing adequate surgical anaesthesia with minimal haemodynamic disturbances. ⋯ This study concluded that low dose, 6 mg bupivacaine with 20 microg fentanyl provide adequate anaesthesia for surgical repair of hip fracture with stable haemodynamics.
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As life expectancy increases, the number of geriatric patients coming for surgery and anaesthesia will make up an increasing portion of our practice. Advancing age, comorbidities, altered pharmacokinetics and dynamics increase the morbidity and mortality of these patients. The importance of doing a thorough preoperative evaluation and identifying risk factors cannot be over emphasized in this frail and vulnerable group. ⋯ Addressed in this article is Post Operative Cognitive Dysfunction (POCD) which is being recognized as a significant issue facing the elderly patient. It is one of the problems specifically related to the geriatric age group. No ideal anaesthetic technique has been described, but if a thorough understanding of changes that occur in physiology and pharmacology is there, an optimal anaesthetic technique can be individually designed.
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We present a case of congenital bronchial atresia with unique features in a twenty eight years old asymptomatic, non-smoker male who presented to our department for X -ray chest as a part of routine annual medical check up. It revealed an incidental, well defined, branching opacity in the left upper lobe close to the hilum. A differential diagnosis of vascular malformation and bronchocoele was given with advice to the patient to follow up after five months. ⋯ It was non-enhancing and had a typical branching character with paucity of vessels in the surrounding lung. Lack of symptoms and CT features of the opacity were sufficient to label this patient as a case of congenital bronchial atresia with mucocoele formation. No frank emphysematous change had yet developed around the atretic bronchial segment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Haemodynamic response to tracheal intubation via intubating laryngeal mask airway versus direct laryngoscopic tracheal intubation.
To compare the haemodynamic response to tracheal intubation using either direct larygoscopy or Intubating Laryngeal Mask Airway. ⋯ We concluded that intubation through intubating laryngeal mask airway is accompanied by minimal cardiovascular responses than those associated with direct laryngoscopic tracheal intubation, so it can be used for patients in whom a marked pressor response would be deleterious.