Spastic type of cerebral palsy is the commonest disorder is associated with childhood disability. For spasticity corrections, orthopedic procedures are performed which are extremely painful. So, adequate pain relief is the priority during the immediate postoperative period for good perioperative outcomes. Ketamine being an N-Methyl D aspartate (NMDA) receptor antagonist blunts central pain sensation at a subanesthetic dose (0.3mg/kg or less IV) and is used as an adjuvant for perioperative analgesia. A subanesthetic dose has a minimal physiological impact as compared to an anesthetic dose. Ketamine, as a subanesthetic dose improves pain score and decreases opioid consumption during the perioperative period. We present, a case of a twelve-year-old female child known case of cerebral palsy came for spasticity correction of lower limbs under general anesthesia.
Coronavirus disease 2019 (COVID-19) is a highly contagious lethal infection that has successfully spread all across the world. The novel coronavirus that is behind the menace and spread of COVID-19, is the next in the lineage of the Coronaviridae family of viruses, which had previously given two deadly viruses with limited geographical extent. After sustaining for more than two years, the virus is still active and keeps on mutating to evade human immunity. The impact of COVID-19 is felt not only by patients of COVID-19 who go through the trauma but also by non-COVID-19 patients due to the non-pharmacological interventions (NPIs) enforced. Patients in the orthopedic departments suffered a huge blow as their rehabilitation practices were stalled due to a lack of health professionals and also restrictions imposed. But to soften the blow, usage of telemedicine was done in some instances so that the essential therapies can continue despite the movement restrictions imposed. COVID-19 has disrupted many aspects of human life including clinical practices and this endeavor is to review those aspects and provide conclusions if any. The aim of the study is to review the available resources regarding Indoor orthopedic practice during the COVID-19 pandemic and draw a conclusion that can help further research on the aforementioned topic.
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