Juniper Publishers Journal of Anesthesia and Intensive Care Medicine

Juniper Publishers - Journal of Anesthesia Abstract Significant carbon dioxide embolism is an extremely rare but potentially fatal complication during laparoscopic surgeries. Until now, carbon-Di-oxide (CO 2 ) is the agent of choice to create the pneumoperitoneum; consequently, there is inherit risk of CO 2 embolism. Clinical symptoms of this embolism may be asymptomatic to cardiovascular collapse to neurological injury depending on the amount and rate of carbon dioxide absorption into body. Here we describe a case of near fetal gas (CO 2 ) embolism in a morbidly obese patient undergoing laparoscopic cholecystectomy. Keywords: Carbondioxide embolism; Laparoscopy; Cholecystectomy; Carboperitoneum Abbreviations: ASA: American Society of Anaesthesiology; BMI: Body Mass Index; INR: International Normalisation Ratio; IPPV: Intermittent Positive Pressure Ventilation; TOF: Train Of Four; CPR: Cardiopulmonary Resuscitation; ROSC: Return of Spontaneous Circ...

Juniper Publishers - Journal of Anesthesia Abstract Mitochondrial diseases (MD) are characterized by impairments of mitochondrial function that precipitate metabolic acidosis. An 8-year-old MD female with prior anesthesia exposure complicated by metabolic acidosis, seizures and propofol infusion syndrome, presented for glaucoma surgery. We present a multimodal balanced anesthetic technique used to successfully manage this complex case. Introduction Mitochondrial disorders (MD) are a heterogeneous group of genetic disorders that impair mitochondrial integrity and result in deficient energy production. The disorder has an incidence of 1:5000 live births [1], and affects tissues with high-energy requirements such as the central nervous system, retina, heart and muscle [2]. Consequently, these patients have multiple co-morbidities that include cardiac, endocrine, and neurologic dysfunction [3-5]. Current evidence s...

Juniper Publishers - Journal of Anesthesia Abstract Ultrasound guided Quadratus lumborum (QL) block is a relatively new regional anesthetic technique which provides effective postoperative analgesia for abdominal surgeries as a part of multimodal analgesic regimen. We report a case of hysterectomy where effective postoperative analgesia was provided by ultrasound guided bilateral QL-3 block and infusion of local anesthetic through catheters inserted postoperatively. Keywords: Local anaesthetic; ropivacaine; Postoperative analgesia; Quadratus lumborum blocks; type-1, 2 and transmuscular (type-3); Truncal blocks; Ultrasound guided blocks Introduction Postoperative analgesia is an integral part of successful surgical outcome. Epidural analgesia with catheter technique remains the most effective analgesic technique after abdominal surgery. However, it haslimitation in patients who are either on anticoagulants and have cardiac mor...

Juniper Publishers - Journal of Anesthesia Abstract Background: Neuraxial techniques are safe and possess many benefits with drawback of short duration of anesthetic action. A small mass of local anesthetic can produce profound and reproducible surgical anesthesia. The present was aimed to compare the clinical efficacy and safety of clonidine versus fentanyl as spinal adjuvant to 0.5% hyperbaric bupivacaine for knee arthroscopy. Patients and Method: Sixty adult patients of American Society of Anaesthesiologists (ASA) physical status I and II of both genders, aged 18 to 58 years, were randomized into two groups of 30 patients each to receive either with 0.5 ml of clonidine, 30 μg (Group I BC) or 0.5 ml of fentanyl, 25 μg (Group II BF) with 3.5 mL0.5% hyperbaric bupivacaine. Sensory and motor block characteristics and time to first rescue analgesic (i.v. tramadol 100 mg) were recorded as primary end points. Drug related side effects of pruritus, nausea, vomiting a...

Juniper Publishers - Journal of Anesthesia Abstract Aim: To determine the accuracy of ultrasound in confirming endotracheal tube placement compared with standard techniques in the intensive care unit. Subject and Methods:: This was a prospectively designed study. Eligible patients were 18 years or older, that were admitted to the medical intensive care unit, that required endotracheal intubation due to their underlying clinical condition. An immediate post intubation Ultrasound examination was performed by an intensivist, who was not involved in clinical management of the patient and was blinded to the result of the standard confirmatory methods of endotracheal tube placement. The clinician performing the intubation was blinded to the results of the ultrasound examination findings. Results:: According to the standard method used to confirm proper endotracheal tube position, which includes clinical assessment by chest and epigastric auscultation, and a colome...