We found that the incidence of perioperative AKI among patients who underwent laparoscopic bariatric surgery is at 2.9 %. Impaired renal function, use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers and raised body mass index were found to be independent predictors of AKI. Patients with these risk factors could be considered at risk for developing perioperative AKI, and extra perioperative vigilance should be undertaken.
Thoracic epidural anaesthesia (TEA) reduces cardiac and splanchnic sympathetic activity and thereby influences perioperative function of vital organ systems. A recent meta-analysis suggested that TEA decreased postoperative cardiac morbidity and mortality. Objective is to Study of Breast Surgery under Thoraco Epidural Analgesia as sole anesthetic technique. This study was conducted on 20 cooperative female patients of age group 42-55 year with ASA grade I-III. Procedure was done in either sitting or lateral position. Under full aseptic precautions 18 G epidural needle was introduced between T3-T4 or T2-T3 space after infiltration of local anesthetic agent. After confirmation of the space epidural catheter was placed and 2.5 to 3.5 cm of catheter length was kept inside. After Proper Fixation of the catheter patients were made supine. A test dose of 2 ml Xylocaine 2% with adrenalin was injected before giving proper local anesthetic dosage. Patients pulse rate, Blood pressure and respiration were noted. Inj Xylocaine 1.5% 12 ml was injected through the catheter and analgesic effects were awaited. After checking adequate blockade surgery was allowed after positioning of sand bag under operative site. From Our study we conclude that midthoracic epidural analgesia technique is a safe alternative acceptable method for various breast surgery with excellent postoperative pain relief and early recovery.
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