Anaesthesia for pan-facial surgeries is challenging because the anaesthesiologist and surgeon have to share the common upper airway field. Oral and nasal routes for intubation are often not feasible. Submental intubation is alternative method to tracheostomy and other modes of intubation for management of airway during maxillofacial surgeries. Aim: To provide safe and easy airway with unobstructed intraoral surgical field without causing much morbidity. Materials and Methods: 30 ASA I and II patients who had pan-facial fracture, including Le Forte II, Le Forte III, with naso-orbital ethmoidal fracture requiring surgical correction admitted in MGM Medical College and MY Hospital Indore were selected for the study. The patients are intubated by submental route and various hemodynamic parameters were evaluated at different time interval during the surgery. In our study, we used two tube method of submental intubation in which another tube was drawn intra oral through submental incision and first tube was replaced. Result: There were no episode of desaturation and no difficulty was encountered in secondary intubation. The average duration of secondary intubation was 3-4 minute (Mean+SD = 3.45+0.95) which is less than the conventional one tube method. Conclusion: As per our experience in study and the review of literature, the submental intubation is very easy and safe method of intubation to provide the unobstructed surgical field for the Le forte II and III panfacial fracture surgeries.
Surgical procedure on thoracic and upper abdominal region result in most severe postoperative pain and if treated inadequately or inappropriately result in higher incidence of postoperative complication and physical morbidity. We evaluate the postoperative analgesic efficacy of thoracic epidural block by administering inj. Bupivacaine (0.25%) after thoracic and abdominal surgeries. We concluded that it is the technique of choice for adequate analgesia in the immediate postoperative period following the thoracic and abdominal surgeries, where due to pain severe respiratory embarrassment, increase morbidity, delayed recovery, prolong hospital stay was anticipated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.