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Supraorbital/Supratrochlear Nerve blocks: Clinical Significance of the Superior and Anterior Approaches-Juniper Publishers

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Juniper Publishers - Journal of Anesthesia Introduction Hair restoration is one of the commonest cosmetic surgery procedure in men [ 1 ]. The procedure is performed under local anaesthesia. Many of the patients are anxious about the degree of pain to be expected during and after the surgery. The pain of the local anaesthetic agent is dependent on various factors like needle gauge, composition, temperature, pH, speed of injection, anatomical structure/area etc. Various maneuvers are used to decrease the pain during the administration of local anaesthesia like vibration anaesthesia Cryotherapy etc [ 2 - 4 ]. With the introduction of newer drugs for local anaesthesia, the safety is increased. Peripheral nerve blocks constitute a major tool in the armamentarium in the office-based cosmetic surgery procedures. Supraorbital (SO) and supratrochlear (ST) nerve are the terminal branches of the frontal nerve [ 5 ]. These nerves supply mainly the skin of the forehead. These n...
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Tourniquet Pain after Ultrasound-Guided Axillary Blockade-Juniper Publishers

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Juniper Publishers - Journal of Anesthesia Abstract Objective: To analyse tourniquet pain after ultrasound guided axillary block (AXB) as the sole anesthetic technique with no injection of local anaesthetic into the subcutaneous tissue of the posterior half of the axilla to prevent tourniquet pain. Material/patients and methods: 84 patients older than 18 years ASA I-IV undergoing surgery at hand, wrist, forearm and elbow under ultrasound guided AXB requiring upper arm tourniquet, we studied prospectively. Exclusion criteria included refusal to participate, communication problems, pre-existing neuropathy, coagulopathy or allergy to local anaesthetics. Tourniquet pain was assessed according to visual analogue scale (VAS) every 15 minutes. We also analysed differences in tourniquet pain between sedated and non-sedated patients. Main results: VAS was 0 during ischemia in 83 patients. One patient reported tourniquet pain. This was mild (VAS = 3) and reported duri...
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Pulmonary Aspiration during Induction of General Anesthesia in a Patient with Chronic Inflammatory Demyelinating Polyneuropathy-Juniper Publishers

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Juniper Publishers - Journal of Anesthesia Abstract Chronic inflammatory demyelinating polyneuropathy (CIDPJ-a rare immune-mediated disorder affecting the peripheral nervous system-is the most common treatable neuropathy. Its clinical features include progressive or relapsing muscle weakness and decreased motor ability and or sensation in the extremities. Patients with CIDP are not encountered frequently in the operating room; thus, there is insufficient knowledge regarding their anesthetic management. Here, we report a case of pulmonary aspiration during induction of general anesthesia in a 64-year-old man with CIDP undergoing emergency surgery for gastric ulcer perforation. Keywords: Piriformospora indica; Pulmonary aspiration; Chronic inflammatory demyelinating polyneuropathy; General anesthesia Abbreviations: CIDP: Chronic Inflammatory Demyelinating Polyneuropathy; MNGIE: Mitochondrial Neurogastrointestinal Encephalomyopathy; Fio 2 : Fraction of Inspired Oxyge...
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