Anesthesia, essays and researches
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In the past 25 years with the development of various supraglottic airway devices, the armamentarium for airway management has increased. In our study, the laryngeal mask airway (LMA)-ProSeal is compared with the LMA-Classic with respect to as follows: (a) Ease of insertion and number of insertion attempts, (b) Device positional stability and possible oropharyngeal leak, (c) Airway trauma, and (d) Hemodynamic changes; in children aged 3-15 years undergoing elective surgery under general anesthesia, hypothesizing that these would be different. ⋯ The complications of usage of the LMA are minimal and similar in both the devices. The LMA-ProSeal has advantages over LMA-classic such as the placement of gastric tube, adequate ventilation, and oxygenation without any gastric distension.
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Pneumoperitoneum and altered positioning 1in laparoscopic cholecystectomy predispose to alterations in cardiorespiratory physiology. We compared the effects of volume controlled, pressure controlled, and the newly introduced pressure controlled-volume guaranteed ventilation (PCV-VG) modes of ventilation on respiratory mechanics and oxygenation during laparoscopic cholecystectomy. ⋯ PCV and PCV-VG modes are superior to VCV mode in providing adequate oxygenation at lower peak inspiratory pressures.
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It is a well-known fact that severe pregnancy-induced hypertension (PIH) can be disastrous at times as it can cause a lot of complications to both pregnant women and her baby. Hence, it is always desirable to know the extent of severity by a real-time and easily accessible modality like ultrasound. ⋯ OSND is a surrogate marker for raised ICP in severe PIH patients. It is a rapid, bedside, noninvasive, and readily accessible tool and could be a part of a holistic approach for managing such patients.
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The supraclavicular approach is considered to be the easiest and most effective approach to block the brachial plexus for upper limb surgeries. The classical approach using the anatomical landmark technique was associated with higher failure rates and complications. Ultrasonography (USG) guidance and peripheral nerve stimulator (PNS) have improved the success rates and safety margin. ⋯ The ultrasound-guided supraclavicular brachial plexus block can be done quicker, with a faster onset of sensory and motor block compared to nerve stimulator technique.
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Intraocular pressure (IOP) is increased during laparoscopic surgery with Trendelenburg position and may contribute to deleterious effects on optic nerve in susceptible patients. ⋯ Propofol-based TIVA is more effective than inhalational anesthesia with sevoflurane in attenuating the increase in IOP during laparoscopic surgery requiring CO2 pneumoperitoneum with Trendelenburg position.