Indian journal of anaesthesia
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Pulmonary aspiration of gastric contents is a serious complication of anaesthesia. The aim of this study was to determine, with the help of ultrasound, the gastric volume and content in fasted patients presenting for elective surgeries and correlate the results with fasting times and co-morbidities of the patients. ⋯ Our study showed that fasting for more than 6-10 hours does not guarantee an empty stomach. Those with co-morbidities like diabetes mellitus, obesity and chronic kidney disease (CKD) appear more prone to have unsafe gastric contents.
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Erector spinae plane block (ESPB) is a new truncal block which has been used successfully to manage many acute and painful conditions including multiple fractured ribs. This block is primarily an ultrasound-guided block. We have evaluated the feasibility of fluoroscopic guidance for this block. We have reported two cases of severe chest pain due to multiple fractured ribs managed successfully with ESPB given under fluoroscopic guidance.
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Erector spinae plane (ESP) block is an interfascial plane block where a local anaesthetic is injected in a plane preferably below the erector spinae muscle. It is supposed to work at the origin of spinal nerves based on cadaveric and contrast study. ⋯ It has a wide variety of applications ranging from control of acute postoperative pain to chronic pain. In this series, we report a series of six cases, which include postoperative pain management in breast, thoracic, and abdominal surgeries along with management of two chronic pain cases to illustrate the potential uses of continuous and single-shot ESP block.
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An increasing number of caesarean sections are being performed for both elective as well as emergency cases. Category 4 caesarean section refers to a planned elective surgery after 39 weeks of gestation at a time suitable to the mother and the maternity team. ⋯ The management should include adequate postoperative pain relief, early ambulation, and thromboprophylaxis to ensure early recovery. This review will discuss the anaesthetic management including regional anaesthesia, general anaesthesia, and postoperative analgesia for elective, low-risk (Category 4) caesarean section.
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Obstetric emergencies are a challenge both for the obstetrician and the anaesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015-16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pains. ⋯ In category 2 and 3 caesarean sections, spinal anaesthesia still remains the technique of choice. Failed intubation, failed neuraxial block, extensive neuraxial block, awareness under anaesthesia, thromboembolism, amniotic fluid embolism, haemorrhage and maternal collapse are some of the complications. Haemorrhage is said to be the leading cause of mortality worldwide.