Papers by himaunshu Dongre
Journal of medical ultrasound, Jan 24, 2023
Indian Journal of Pain, Nov 30, 2023
Revista Española de Anestesiología y Reanimación, 2020
Resumen La cirugia de correccion de la columna es un procedimiento quirurgico invasivo que origin... more Resumen La cirugia de correccion de la columna es un procedimiento quirurgico invasivo que origina dano postoperatorio severo. Reportamos 6 casos de bloqueo en el plano del musculo erector de la columna para cirugia de escoliosis. Nuestro objetivo fue aportar tratamiento efectivo para el dolor perioperatorio, y lograr estabilidad hemodinamica intraoperatoria, sin interferir en la neuromonitorizacion. Tambien se destacan los retos tecnicos. El escaner ecoguiado es necesario para identificar las prominencias oseas y determinar los posibles puntos de inyeccion multiples. El bloqueo en el plano del musculo erector de la columna en cirugia de escoliosis es una tecnica mas facil y segura, en comparacion con la anestesia epidural, pudiendo utilizar cirugia de columna compleja instrumentada. Este bloqueo parece desempenar un papel en la via del dolor perioperatorio, complementando el regimen anestesico multimodal y no interfiriendo en los potenciales evocados en adultos. Sin embargo, el mecanismo de difusion de este bloqueo es poco conocido aun y, por tanto, debemos ser conscientes de la toxicidad del anestesico local.
Revista española de anestesiología y reanimación, Mar 1, 2020
Spinal correction surgery is a very invasive surgical procedure and results in severe postoperati... more Spinal correction surgery is a very invasive surgical procedure and results in severe postoperative pain. We report six cases in which Bilateral Erector Spinae Plane Block was performed for scoliosis surgery. Our aim was to provide an effective perioperative pain management and to achieve intraoperative hemodynamic stability with no interference on neuromonitoring. The technical challenges are also highlighted. An ultrasound guided scout scan is necessarry to identify the bony prominences and determine the possible multiple injection points. Erector Spinae Plane Block in scoliosis surgery is an easier and safer technique compared to epidural anesthesia and can use instrumented complex spinal surgery. This block seems to have a role in perioperative pain pathway complementing the multimodal analgesic regimen and not have interference with evocated potentials in adults. However the diffusion mechanism of the this block is not well known hence it should be awake regarding local anesthetic toxicity.
Ain-Shams Journal of Anesthesiology
Background The role of neurostimulation-aided cervical epidural anesthesia (CEA) in shoulder surg... more Background The role of neurostimulation-aided cervical epidural anesthesia (CEA) in shoulder surgery has been described in the literature. The use of nerve stimulators and the infusion of local anesthetic (LA) in the cervical epidural space has also been mentioned. Epidural needle rotation prior to insertion of the catheter is not described, and it is not clear if general anesthesia was administered in these cases. Case presentation In this case series, we performed CEA at the level of C7-T1 in 12 patients undergoing various surgeries on the proximal open shoulder and mid humerus after informed consent. Ipsilateral motor responses elicited by continuous electrical stimulation were used to identify lateralization of the epidural catheter tip. The placement of catheters was confirmed under an intraoperative image intensifier. Using the median approach at the level of C7-T1, an ipsilateral twitch was noted in all patients. Neurostimulation persisted with an advancement of stimulating c...
Saudi Journal of Anaesthesia, 2023
Cureus, 2022
This case series describes the use of ultrasound (US)-guided dorsal sacral foraminal block (DSFB)... more This case series describes the use of ultrasound (US)-guided dorsal sacral foraminal block (DSFB) for providing postoperative analgesia in six patients who underwent foot and ankle surgeries under spinal anesthesia. Postoperatively, all of them received a US-guided DSFB at the level of the brim of the second sacral foramina (SF2). Needle placements were confirmed with fluoroscopic (FL) images and injected radiocontrast defined the diffusion with a postoperative CT scan. The images obtained depicted ipsilateral spread in the sacral epidural space, sacral nerve roots, and plexus. The US-guided DSFB could be effectively used as an alternative method for postoperative pain relief after foot and ankle surgery.
IOSR Journal of Pharmacy (IOSRPHR)
Introduction: Laminectomy and Spine Surgeries are associated with increased blood loss due to ble... more Introduction: Laminectomy and Spine Surgeries are associated with increased blood loss due to bleeding from the extensive epidural venous plexuses. Controlled hypotension is a time tested technique utilized for reducing blood loss and creating a blood less operative field. Esmolol and Nitroglycerine(NTG) are reportedly used in various surgeries for this purpose. As dry operative field is a fundamental component of spine surgeries this study intended to compare the dry operative field created by esmolol with NTG. Material and Methods: This single blinded randomized controlled trial was carried out on 50 adult patients undergoing spine surgeries and divided into two groups of 25 each. Group-E received Esmolol infusion while the Group-N received NTG infusion.Dosages were titrated to achieve controlled hypotension and optimum bloodless operative field. Results: Systoloic, Diastolic and Mean arterial pressures were comparable in both the groups.Pulse rates in group-E were significantly lower(P<0.05) as compared to that in group-N.Mean scores for quality of surgical field were comparable in both the groups however group E required lower blood pressures to achieve it compared to group-N. Esmolol infusion required significantly higher cost than NTG for the above trial. Conclusion: Both Esmolol and NTG can be used as a sole agent to create dry operative field in spine surgeries by way of controlled hypotension with comparable efficacy however NTG is more economical than esmolol for this purpose. Also dry operative field with NTG can be achieved at higher mean blood pressure values compared with use of esmolol. I.
International Journal of Anatomy Radiology and Surgery, 2016
Introduction: Cervical spine trauma occurs in 1.5 to 3% of patients with major trauma and in 10% ... more Introduction: Cervical spine trauma occurs in 1.5 to 3% of patients with major trauma and in 10% of patients with major trauma and serious head injury. Imaging plays an important role in the diagnosis of spinal injuries. The various modalities used to evaluate cervical spine are plain radiography, computed tomography, CT myelography, intraoperative sonography and magnetic resonance imaging. Aim: This study compares the usefulness of conventional radiography and MR imaging in the diagnosis of acute cervical spine trauma. Materials and Methods: This prospective analytical study was carried out on 58 patients with history of cervical spine trauma. Evaluation was done on plain radiography and MR imaging. Findings were recorded on both the modalities and clinical correlation was done. Results: In this study, 94.83% were males. Hyperflexion injuries were seen in 37.93% patients.C6 vertebral fracture was seen in 12% patients. Herniation of the disc was commonly seen at C4-5 and C5-6 disc level on MRI. 64 levels were found to be affected with simple cord edema. Conclusion: MRI combined with plain radiographs provides an accurate and non invasive modality for evaluation of patients with cervical spine trauma.
Background: It has been known for a long time that music has characteristic psychological and phy... more Background: It has been known for a long time that music has characteristic psychological and physiological effects in humans. It is a non-pharmacological technique that is inexpensive, non invasive and has no major side effects. Surgery with music is being increasingly reported at many of the today‟s modern hospitals, documenting music‟s powerful soothing, calming, sedating effects on subjects including a significant reduction in the amount of anesthesia needed. Aims and Objectives: To find out whether patients undergoing elective surgery under regional anesthesia, who hear a preselected music during surgery through a headphone, need a lower dose of intra-operative sedatives and have a reduced recall of intra-operative processes Methods: 60 Patients undergoing elective orthopedic,gynaecological or urological Surgeries under regional anaesthesia between June to August 2009 were randomized into either listening to Music(group M,n=30),or not listening to music(group C,n=30). Midazolum...
Manual of Infection Control in Orthopaedic Surgery, 2015
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Papers by himaunshu Dongre