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Attri, Joginder Pal
- Post thoracotomy pain management: A review of current available modalities
Authors
1 Department of Anaesthesia, Government Medical College, Amritsar, Punjab, IN
Source
Northern Journal of ISA, Vol 1, No 1 (2016), Pagination: 7-10Abstract
Pain after thoracotomy is probably the most severe pain experienced by the patient as incision penetrate several layers of muscle tissue, neurovascular bundles and other structures of the thoracic region. It may be sharp, stabbing, constant shooting neuropathic pain which can be acute (within 30 days of thoracotomy) or chronic (2 to 6 months after thoracotomy). Because of pain, there is shallow breathing and inadequate coughing leading to various types of pulmonary function impairment and complications like retention of secretions, atelectasis, hypoxemia, hypercarbia, respiratory failure and increased chances of re-intubation. Pain also leads to longer stay in the intensive care unit and a delayed mobilization of the patient which ultimately causes increased morbidity and mortality. The chances of deep vein thrombosis are also increased because of delayed mobilization. Sometimes patient may experience post thoracotomy pain syndrome along with changes in psychological behaviour like depression. So management of pain relief is very essential to resume normal activities as soon as possible. This will also lead to increased overall patient’s satisfaction. In this article we have highlighted various causes of pain in thoracotomy, its pathophysiology and modalities to relieve pain. This review article aims to highlight all the current practices and modalities so as to manage post-operative pain of thoracotomy in a better manner.
Keywords
NSAIDS, Pain Management, Regional Anaesthesia, Thoracotomy.Full Text
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- Anaesthetic Management in a Rare Case of Bird Face Deformity, Hypertrophied Adenoids and Temporomandibular Joint Ankylosis
Authors
1 Department of Anaesthesia, Government Medical College, Amritsar, Punjab, IN
2 Department of Anaesthesia, Government Dental College, Amritsar, Punjab, IN
Source
Northern Journal of ISA, Vol 1, No 1 (2016), Pagination: 39-41Abstract
Various methods have been described for nasal intubation in children with temporomandibular joint ankylosis with limited mouth opening. As younger children are uncooperative, they require intubation under anaesthesia. When associated with hypertrophied adenoid, there is high risk of airway obstruction and bleeding into the unprotected airway resulting in laryngospasm and/ or bronchospasm. We here describe successful intubation in a paediatric patient in whom the airway was obstructed with hypertrophic adenoids.
Keywords
Bronchospasm, Fibreoptic Laryngoscope, Obstructive Sleep Apnoea, Temporomandibular Joint.Full Text
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