ABSTRACTImportanceWhen a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep... more ABSTRACTImportanceWhen a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep plane of anesthesia, the upper airway muscle tone and protective upper airway reflexes may be obtunded.ObjectiveTo determine whether the supine or lateral position is safer for the removal of a PLMA in deeply anesthetized children by comparing the incidence of upper airway complications.MethodsThis randomized single‐blind comparative trial was conducted at a tertiary care hospital between January 2020 and September 2020. Forty children of the American Society of Anesthesiologists class I/II of ages 1–12 years age undergoing surgery under general anesthesia with PLMA used as the definitive airway device were recruited. Patients were randomly allocated to lateral group or supine group for PLMA removal in a deep plane of anesthesia in the lateral or supine position. The primary outcome was the number of patients experiencing one or more upper airway complications and the secondary outcomes...
Background: It is important to have good postoperative pain control and early recovery after lapa... more Background: It is important to have good postoperative pain control and early recovery after laparoscopic cholecystectomy (LC). Intravenous lidocaine has anti-hyperalgesic, anti-inflammatory and analgesic effects while dexmedetomidine provides anti-nociception, analgesic, sedative and sympatholytic effects. Both these drugs can be used as adjuvants to improve recovery after LC. Aim: To evaluate the effects of perioperative infusion of lidocaine versus dexmedetomidine in patients undergoing LC with regards to: postoperative pain scores, analgesic consumption and recovery profile. Methods: Eighty patients of either sex, aged 20-60 years, ASA I and II undergoing LC were randomly allocated to Group L and Group D. In Group L, patients received intravenous lidocaine 1.5 mg kg followed by an infusion of 2 mg kg hr and in Group D, patients were given 1 μg kg dexmedetomidine followed by an infusion of 0.4 μg kg hr. Postoperative sedation score, pain scores and analgesic consumption and quali...
Klippel feil syndrome is a rare skeletal disorder primarily characterized by abnormal union or fu... more Klippel feil syndrome is a rare skeletal disorder primarily characterized by abnormal union or fusion of two or more cervical vertebrae which is often associated with cervical canal stenosis. This results in a short neck, a low hairline at the back of the head, a limited range of motion in the neck and infrequently an atlanto- axial instability. Here we report a case of type 3 paediatric Klippel Feil syndrome who underwent Sprengel deformity repair in prone position and its anesthetic implications. A careful assessment of airway and an algorithmic approach towards management is needed in children with KFS. The various spine deformities associated with KFS demand careful positioning and a reconfirmation of appropriate ETT position, airway pressures and lung compliance is recommended in these children. Keywords: Klippel Feil syndrome, Paediatric, Airway management, Prone positioning, Difficult airway.
ABSTRACTImportanceWhen a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep... more ABSTRACTImportanceWhen a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep plane of anesthesia, the upper airway muscle tone and protective upper airway reflexes may be obtunded.ObjectiveTo determine whether the supine or lateral position is safer for the removal of a PLMA in deeply anesthetized children by comparing the incidence of upper airway complications.MethodsThis randomized single‐blind comparative trial was conducted at a tertiary care hospital between January 2020 and September 2020. Forty children of the American Society of Anesthesiologists class I/II of ages 1–12 years age undergoing surgery under general anesthesia with PLMA used as the definitive airway device were recruited. Patients were randomly allocated to lateral group or supine group for PLMA removal in a deep plane of anesthesia in the lateral or supine position. The primary outcome was the number of patients experiencing one or more upper airway complications and the secondary outcomes...
Background: It is important to have good postoperative pain control and early recovery after lapa... more Background: It is important to have good postoperative pain control and early recovery after laparoscopic cholecystectomy (LC). Intravenous lidocaine has anti-hyperalgesic, anti-inflammatory and analgesic effects while dexmedetomidine provides anti-nociception, analgesic, sedative and sympatholytic effects. Both these drugs can be used as adjuvants to improve recovery after LC. Aim: To evaluate the effects of perioperative infusion of lidocaine versus dexmedetomidine in patients undergoing LC with regards to: postoperative pain scores, analgesic consumption and recovery profile. Methods: Eighty patients of either sex, aged 20-60 years, ASA I and II undergoing LC were randomly allocated to Group L and Group D. In Group L, patients received intravenous lidocaine 1.5 mg kg followed by an infusion of 2 mg kg hr and in Group D, patients were given 1 μg kg dexmedetomidine followed by an infusion of 0.4 μg kg hr. Postoperative sedation score, pain scores and analgesic consumption and quali...
Klippel feil syndrome is a rare skeletal disorder primarily characterized by abnormal union or fu... more Klippel feil syndrome is a rare skeletal disorder primarily characterized by abnormal union or fusion of two or more cervical vertebrae which is often associated with cervical canal stenosis. This results in a short neck, a low hairline at the back of the head, a limited range of motion in the neck and infrequently an atlanto- axial instability. Here we report a case of type 3 paediatric Klippel Feil syndrome who underwent Sprengel deformity repair in prone position and its anesthetic implications. A careful assessment of airway and an algorithmic approach towards management is needed in children with KFS. The various spine deformities associated with KFS demand careful positioning and a reconfirmation of appropriate ETT position, airway pressures and lung compliance is recommended in these children. Keywords: Klippel Feil syndrome, Paediatric, Airway management, Prone positioning, Difficult airway.
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