Background: Small dose of succinylcholine combined with propofol facilitates Laryngeal mask airway (LMA) insertion. This study was designed to compare the efficacy of two different small doses of succinylcholine for LMA insertion. Aims and Objectives: The aim of our study is to compare the usefulness of two different doses of succinylcholine to facilitate the insertion of laryngeal mask airway under intravenous anaesthesia. Material and Methods: Seventy patients of ASA I and II posted for elective day care procedure under general anaesthesia with Laryngeal mask airway (LMA) were randomly allocated into two groups of 35 each. 35 patients in group PS1 received Inj. propofol 2.0 mg/kg + succinylcholine 0.1 mg/kg (diluted to 2 ml). 35 patients in group PS2 received Inj. propofol 2.0 ml/kg + succinylcholine 0.2 mg/kg (diluted to 2 ml). During insertion of laryngeal mask airway jaw relaxation, gagging/coughing, head and limb movements, presence or absence of laryngospasm and duration of apnoea were noted. Results: Patients in PS2 had better conditions for LMA insertion, reduced the upper airway responses to the LMA insertion, and reduced the supplement doses of propofol compared to PS1. Conclusion: Succinylcholine in 0.2 mg/kg compared to 0.1kg provides optimal conditions for LMA insertion.
Graphical abstract
Background: The prevalence of anemia in India is so high that majority of women presenting for hysterectomy are already with borderline hemoglobin status and the perioperative blood loss puts them at risk of death and prolongs recovery. Antifibrinolytic agents, mainly Tranexamic acid (TXA) have been demonstrated to reduce blood loss and transfusion requirements in various surgeries. The present study was done to assess the efficacy of TXA in effectively reducing intraoperative blood loss and the need for transfusion in Indian population undergoing abdominal hysterectomy for benign indications.Methods: This randomized, double-blind, placebo-controlled study was conducted on hundred patients undergoing abdominal hysterectomy. Group T (n = 50)- received TXA 15 mg/kg in 100 ml Normal saline and Group N (n = 50)-received the same volume of Normal saline infused over 15 minutes. Estimated blood loss need for blood transfusion, duration of surgery, postoperative hemoglobin and incidence of adverse events were noted.Results: There was statistically significant reduction in mean blood loss in group T when compared to group N (360 ml versus 540 ml). Accordingly, there was significant difference in the number of patients requiring blood transfusion (12% versus 42%) and also the postoperative hemoglobin levels. The group T patients had a significantly shorter operating time (127.86 versus 148.64 minutes). None of the patients developed any major adverse events.Conclusions: The prophylactic TXA safely and effectively reduces the blood loss and transfusion requirements in Indian patients undergoing abdominal hysterectomy for benign indications.
ABSTRACT:Patients presenting for an elective or emergency surgery with pre-existing chronic renal failure (CRF) has certain anesthetic considerations. Central neuraxial block for these patients is controversial, because all these patients will be invariably on fluid restriction. If such patient presents with pulmonary complications and cardiac complications which are relative contraindications for general anesthesia then the anesthetic management becomes trickier. We had a patient with CRF, presented with inter-trochanteric fracture of femur for surgical fixation. The patient also had left side loculated pneumothorax, right side bronchiectatic changes and permanent cardiac pacemaker for complete heart block which were challenges for general anesthesia too. Finally the surgery was done under central neuraxial block with dopamine support successfully. KEYWORDS: Surgery, Renal failure, cardiac, pulmonary, complications. INTODUCTION:Patients with CRF subjected for surgery generally presents with fluid and electrolyte imbalance. Most of these patients will be on regular dialysis and on fluid restriction. Central neuraxial block is tricky in these patients because hypotension following sub-arachnoid block cannot be treated with fluid boluses. 1 So general anesthesia is preferred in these patients. Elderly patients with CKD subjected for fracture femur surgery has poor outcome because of associated perioperative complications 2 . We are reporting the anesthetic management of a CRF patient presented with intertrochanteric fracture of right femur. The patient also had loculated pneumothorax on left lung, bronchiectatic changes on right lung and a cardiac pacemaker for complete heart block. The lung pathologies were not favorable for general anesthesia and sub-arachnoid block was chosen as an anesthetic technique with some precautions and modifications.CASE REPORT: 82yr male presented to our casualty with history of fall and pain in right hip. X-ray hip antero-posterior view revealed inter-trochanteric fracture of right femur. The patient was a known case of CRF on thrice weekly dialysis and on 300ml fluid restriction per day. The patient was evaluated for a fainting attack 4years back, diagnosed to have complete heart block and was put on permanent pacemaker. The patient was admitted 4 months back with dyspnea and diagnosed to have left side massive empyema thorax for which inter-costal drain (ICD) was inserted. But the collapsed lung did not expand after ICD and left with loculated pneumothorax.On examination patient was conscious, oriented, afebrile, dyspnoeic and hemodynamically stable. Room air saturation (SpO2) was 92%. Cardiovascular system was normal. Diffuse crepitations were present on left side lung zones and right upper zone. The patient had dialysis two days prior to admission. On investigation hemoglobin was 8.2gms%, urea-102 mg%, creatinine-3, potassium-4.5meq/l and INR-1.3. Chest X-ray revealed loculated pneumothorax on left side, and bronchiectatic changes on right side (Figure-1). Pulmonary function test...
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.