Respiratory obstruction and strido r in infants and children are not uncommon. A rare cause ofthese life-threat enin g symptoms is conge nital saccular cyst. An accurate diagn osis ofsaccular cyst can be made by eliciting a goo d history. by endoscop ic visualization ofthe lesion. and by computed tom ography. Endoscopic excision is thepref erred treatm ent fo r infants. whereas an external approach is reserved fo r older children. It can be difficultfo r anesthetists to intubat e infa nts whe n the anatomy ofthe laryn x is distorted, but the choice oftracheotomy for an inf ant has many drawbacks as well. We discuss the clinica l presentation and management of a 3-mo nth-old boy who was brought to us with a conge nital laryn geal saccular cyst.
Background: To compare the efficacy of saline, lignocaine 2% and Lignocaine 4% in the endotracheal tube cuff to decrease the incidence of post operative cough and sore throat. A unique, efficient and easy method designed to decrease cough and sore throat during emergence. Hence there was a need for the study. Methods: After approval from institutional Ethical Committee, Kasturba Medical college, Mangaluru and written informed consent from 120 patients of A.S.A class I & II, aged between 18-60 years posted for various surgeries were included. Randomization was done into three groups of 40 patients each. Group 1 – Normal saline, group 2 - 2% Lignocaine and group 3 - 4% Lignocaine. Postoperatively patients were assessed for incidence of cough and sore throat pain based on visual analogue scale (VAS) Results: 65% of patients in group 2 and 72% of patients in group 3 were extubated smoothly, whereas only 20% of patients in group 1 had smooth extubation, p<0.001. There was significant difference in sore throat pain and cough in group 2 and 3 when compared to group 1. Conclusion: The incidence of sore throat and cough was significantly reduced with Lignocaine in the endotracheal tube cuff when compared to saline. Lignocaine 4% was found to be far more better than 2% in reducing sore throat.
Post-operative pain is an acute pain which starts with the surgical trauma and usually ends with tissue healing. Our study was done to evaluate and compare the postoperative analgesic effect of Butorphanol, Parecoxib and Tramadol in patients undergoing major surgical procedures. Randomized double blinded study. Sixty patients of ASA I and II grades of the age group 20 to 50 years, undergoing major surgeries were included in the study. They were divided into three groups with 20 patients each. Group P-Parecoxib, Group B-Butorphanol group, and Group T –Tramadol group. Pain intensity score, pain relief score, sedation score, rescue analgesia and adverse events were noted. Hemodynamic parameters, respiratory rate and saturation were also recorded at regular intervals. The parameters observed were compared by ANOVA test. There was significant decrease in pain intensity scores from 10 minutes onwards which was observed in all the three groups but this decrease was more in Butorphanol group. In our study, higher sedation score was observed for Butorphanol group. Adverse effects like nausea, vomiting were more with tramadol group. Higher doses of rescue analgesia was required in Parecoxib group. Thus Butorphanol is a superior analgesic compared to tramadol and parecoxib, while side effects like nausea, vomiting was more in tramadol group.
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