In pediatric day care surgery, entropy monitoring resulted in statistically though not clinically significant faster awakening and significantly lower end – tidal isoflurane concentrations.

Dexamethasone at a dose of 8 mg given intravenously 2 h before induction, delays patient request for analgesia and reduces total fentanyl consumption and PONV in patients undergoing TLH.

Robotic surgery is becoming popular for minimally invasive surgical procedures as robotic devices allow unprecedented control and precision. We report a case of robotic radical cystectomy with ileal conduit urinary diversion surgery having perioperative neurological complications related to prolonged surgery in the steep head-down position. There was a neurological deficit in the form of hemiparesis, which resolved with conservative management. We suggest that duration and positioning should be optimized for such prolonged surgery in the steep head-down position, and make some recommendations. Moreover, in such surgeries great vigilance must be observed in the perioperative period.

Summary Background:  Air‐QTM intubating laryngeal airway (ILA) has been used successfully as a conduit for tracheal intubation in pediatric difficult airway. However, its use as an airway device and conduit for intubation in infants is not yet evaluated. Aims:  The primary objective was to evaluate ILA as a conduit for tracheal intubation in infants, and secondary objectives were to evaluate ILA in terms of ease of insertion and ventilation, oropharyngeal leak pressure (OLP), glottic view, and complications. Methods:  Twenty infants with normal airway were included. After induction of general anesthesia and neuromuscular blockade, ILA (size 1.0/1.5) was inserted. Fiberoptic bronchoscope (FOB)–guided intubation and removal of ILA with the stabilizing stylet was attempted. Results:  The mean age and weight of the infants were 7.5 ± 2.3 months and 7.3 ± 1.8 kg. The ILA sizes 1.0 and 1.5 were inserted in 10 infants each according to the weight of the infants. The mean OLP was 18.5 ± 1.8 cm H2O, and mean time for insertion of ILA was 13.3 ± 3.9 s. Glottic view was grade I in 6, grade II in 1, grade III in 4, and grade IV in nine infants. Tracheal intubation was successful in 19/20 infants. The mean endotracheal tube (ETT) insertion time and mean total time (ILA insertion to the confirmation of ETT placement) were 95.6 ± 32.3 s and 306.42 ± 120.2 s respectively. Conclusion:  The ILA is a safe and easy‐to‐use supraglottic airway device for intubation with FOB in infants with normal airway. Insertion and removal of ILA are easy with satisfactory oropharyngeal seal and ventilation.

Dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) have emerged as public health problems of international concern. During a dengue outbreak in north India in October 2006, more than 10000 patients presented to hospital with fever. We retrospectively analysed the presenting features, treatment given and the outcome of patients admitted to the Intensive Care Unit (ICU), All India Institute of Medical Sciences (AIIMS): a tertiary care hospital in New Delhi. A total of 72 critically ill patients were referred for admission to the ICU. The common symptoms were fever (100%), myalgia (40%) and gastrointestinal bleed. Menorrhagia and haematuria were seen as the sole presenting features in many females. Treatment consisted of bed rest, oxygen therapy, intensive monitoring, antipyretics, platelet transfusions, hydration and electrolyte correction. On average, six units of platelets were required per patient. The average duration of stay in the ICU was 3 d. There were eight deaths. Adequate hydration and platelet replacement with transfusions, especially apheresis platelets to a target level above 60000 platelets/mm3, were effective means of combating the disease.