Informatics Publishing Limited

Swati Mehta ¹, Richa Saroa ¹, Sanjeev Palta ¹, Divya Mehta ¹

Affiliations
1 Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, IN

Abstract

Background and Aims: Aspiration of gastric contents in the lungs is one of the most feared complications of anaesthesia. Although the incidence of this complication is very low, it has high morbidity and mortality. The present study was carried out to evaluate and compare the efficacy of omeprazole, lansoprazole, and dexrabeprazole in reducing gastric volume and increasing the fasting pH in patients undergoing elective surgery. Methods: After obtaining institutional approval and written informed consent from the patients, 150 patients of ASA physical status 1 and 2, between age 18-55 years undergoing elective surgery under general anaesthesia were included in the study. The patients were randomly assigned to one of the three groups i.e. omeprazole (20 mg) group, lansoprazole (30 mg) group or dexrabeprazole (10 mg) group. Comparison of fasting interval, pH, volume and volume/weight of the aspirate was done using Kolmogorov-Smirnov test and Student Newman-Keuls test. A p-value <0.05 was considered statistically significant. Results: The mean pH was significantly lower in omeprazole group as compared to other two groups. The volume of gastric aspirate was significantly higher (p-value <0.005) in omeprazole group than in dexrabeprazole and lansoprazole group. There was no significant difference in the pH and volume of gastric contents in lansoprazole and dexrabeprazole group. Conclusion: Newer proton pump inhibitors like dexrabeprazole and lansoprazole are better than omeprazole in controlling gastric fluid environment.

Keywords

Anaesthesia, Aspiration, Gastric pH, Gastric Volume.

Full Text

   

Sanjeev Palta ¹, Sukhbir Singh ¹, Richa Saroa ²

Affiliations
1 Government Medical College and Hospital, Chandigarh, IN
2 Government Medical College and Hospital, Chandigarh – 160030, IN

Abstract

Discovering intraoperative airway obstruction in a prone position can be aptly described as an anesthetist's nightmare, more so when no observable and common cause can be detected. We report a case of intraoral endotracheal tube kinking in a 45-year old female patient who was undergoing removal of epidermoid cyst of the 4th ventricle in a prone position. The kink, that was intraoral, was noticed at an unusual position 2 cms beyond the inflation lumen cut off point. This case report reinforces upon anesthesiologist to be more vigilant in patients undergoing surgery in the prone position.

Keywords

Endotracheal Tube, Kinking, Prone Position.

Full Text

   

Puja Saxena ¹, Richa Saroa ¹, Sanjeev Palta ¹, Esha Sethi Chaudhary ¹

Affiliations
1 Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Sector – 32, Chandigarh, IN

Abstract

Background and Aims: Although mostly performed under general anesthesia, regional anesthesia has been sparingly employed in patients undergoing laparoscopic cholecystectomy. Recent evidence labels regional anesthetic techniques to be safe and highly acceptable for laparoscopic cholecystectomy. The present study was undertaken to evaluate and compare the effects of general or regional anaesthesia on haemodynamics, blood gases, postoperative pain and recovery scores, rescue analgesic consumption, and side effects in patients undergoing elective laparoscopic cholecystectomy. Methods: 80 patients were randomized in two groups of 40 each to receive either general or spinal anaesthesia for pain, hemodynamic variables, respiratory rate and cumulative rescue analgesic consumption. Intraoperative shoulder pain, oxygen saturation and arterial blood gas parameters were compared in both the groups. Intraoperative consumption of vasopressors was also observed. Modified Aldrete scoring was used to evaluate the recovery characteristics of both the techniques. Patient and surgeon feedback was assessed by the use of preformed questionnaire. At the end of study, data was compiled and analysed with appropriate statistical tests. Results: Spinal anaesthesia provided better postoperative analgesia in patients undergoing laparoscopic cholecystectomy as evident by lower VAS scores and lesser total analgesic consumption. There were more incidences of bradycardia, hypotension, and significant arterial blood gas changes under spinal anaesthesia. Patients in spinal anaesthesia group demonstrated better recovery score as well as lesser incidence of PONV IN PACU. Conclusion: Spinal anesthesia can be used as sole anesthetic technique in patients undergoing elective laparoscopic cholecystectomy especially in patients where general anesthesia carries its own inherent risks.

Keywords

Laparoscopic Cholecystectomy, General Anaesthesia, Spinal Anaesthesia.

Full Text

   

Richa Saroa ¹, Puja Saxena ¹, Satinder Gombar ¹, Swati Jindal ¹, Arjun Dass ²

Affiliations
1 Department of Anesthesia and Critical Care, Government Medical College & Hospital, Chandigarh, IN
2 Department of Ear, Nose and throat (ENT), Government Medical College & Hospital, Chandigarh, IN

Abstract

Intraoral mass in neonates impose unique anaesthetic challenges especially during induction and thus require careful planning to prevent obstruction, hypoxia and subsequent consequences. The success and safety of various techniques to secure the airway is yet not established in neonates with an intraoral mass1. We describe anaesthetic management in a neonate with an intraoral mass scheduled for excision under general anaesthesia.

Keywords

Airway Management, Intra Oral Mass, Neonate.

Full Text