BACKGROUND Most commonly used technique of anesthesia for caesarean section is spinal anesthesia and its most common side effect is hypotension. The aim of the study was to identify risk factors for developing hypotension after spinal anesthesia in patients undergoing caesarean section. METHODS A total of 12 variables were studied for correlation with hypotension following spinal anaesthesia. Each of the variables was divided into categories and Chi-square test was used to assess this association in a univariable analysis. p-Value of <0.05 was considered statistically significant. Multivariable analysis via multiple logistic regression was employed to determine the effect of each independent variable. RESULTS Incidence of hypotension was found out to be 61.5%. Sensory block height of T4 (as compared with T6) was identified as a strong risk factor. Age >35 years was found to be a negative risk factor in a small number of participants. CONCLUSIONS The incidence of hypotension after spinal anaesthesia is high in patients undergoing caesarean section. A high sensory block (T4) is a strong risk factor for developing hypotension. As there are many factors playing a role in spinal hypotension, no other single factor was found to be responsible for hypotension in the present study.
BACKGROUND The aim of this study is to compare the McCoy blade laryngoscope and TruView laryngoscope in patients with anticipated difficult tracheal intubation with respect to ease of intubation, haemodynamic stress response and incidence of complications. MATERIALS AND METHODS Out of 120 patients anticipated to have difficult intubation using the standard criteria of airway assessment preoperatively including modified Mallampati classification, mouth opening, neck extension, SLUX, Upper Lip Bite Test (ULBT) and thyromental distance. The patients are randomised into 2 groups using computer generated randomisation chart. Group T (n=60)-intubation with TruView blade and Group M (n=60)-intubation with McCoy blade. The two groups were studied using Chi-square tests. p<0.05 was considered statistically significant. RESULTS Overall, there was an improvement in the Cormack-Lehane grade (CL grade) after using either McCoy or TruView laryngoscopes. The number of patients with CL grade I (85.0%) in TruView group is significantly more as compared to grade I CL in McCoy group (50%), p=0.039, 13.3% of cases required ELM in the McCoy group, which was significantly more as compared to 3.3% cases in the TruView group. Mean total time taken for endotracheal intubation was 33.73 secs. in McCoy group, which was significantly less as compared to 64.03 secs. in TruView group. When compared between the groups, the increase in HR over the baseline was more in the McCoy group than the TruView group. CONCLUSION TruView laryngoscope provided excellent glottic view and showed better haemodynamic stability as compared to McCoy laryngoscope.
Sick sinus syndrome (SSS) is a generalized abnormality of cardiac impulse formation. Abnormalities encompassed by this syndrome may include inappropriate sinus bradycardia, sinus arrest, bradyarrhythmias, or tachyarrhythmias. We present a case of a 54-year-old hypertensive male posted for L4-L5 decompression, whom we suspected to develop SSS due to overdose of combined beta-blocker (BB) and calcium channel blocker (CCB) therapy.
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