Juniper Publishers Journal of Anesthesia and Intensive Care Medicine

Juniper Publishers - Journal of Anesthesia Abstract Unlike in children, where chickenpox is generally a non-complicated disease, adult chickenpox (varicella) can have serious complications. Thrombotic complications of the varicella zoster are rarely observed. There is one case report of varicella complicated by myocardial infarction.We present a case of adult varicella who developed complications of peripheral artery thrombosis as well as acute coronary syndrome, requiring angioplasty. Introduction Chickenpox (Varicella) is a benign illness caused by VaricellaZoster virus and primarily manifests in childhood and is quite infrequent in adults. Most complications and serious cases are observed in adults [ 1 ]. These include pneumonia, encephalitis, cardiac arrhythmias, seizures, rare neurological sequelae including optic neuritis and transverse myelitis [ 2 ]. Thrombotic complications of the varicella zoster are rare [ 3 , 4 ]. A...

Juniper Publishers - Journal of Anesthesia Abstract Total spinal block is one of the rare complications of regional anaesthesia. It can occur after spinal, epidural or nerve plexus block. Early detection and treatment is essential to prevent mortality. We report a case of total spinal block occurring in a man with perianal fistula after receiving uneventful spinal anaesthesia for caesarean section treated successfully with prompt cardiovascular resuscitation and general anaesthesia. Introduction Spinal anaesthesia is being increasing used as a mode of anaesthesia for performing treatment for perianal fistula [ 1 ]. Although it is a safe and effective means of giving anaesthesia, at times it can lead to complications like hypotension, shivering, respiratory distress, unconsciousness, etc [ 2 ]. Total spinal block is a rare complication of spinal anaesthesia. It is a life threatening complication presenting with symptoms of ...

Juniper Publishers - Journal of Anesthesia Abstract Invent of cardiopulmonary bypass has revolutionized the modern cardiac surgery. Mishaps during cardiopulmonary bypass, near misses and lethal incidents are known. We share one such rare case of break in polycarbonate connector due to the use of isoflurane in extracorporeal circuit and its successful management. Keywords: Cardiopulmonary bypass; Polycarbonate; Isoflurane; Atrial septal defect Cadiopulmonary bypass (CPB) Cadiopulmonary bypass has undergone many improvements since its first attempt to permit intracardiac surgery in humans at the University of Minnesota Hospital by Dennis et al. on April 5, 1951 [ 1 ]. These improvements have not come without complications. Equipment failure in cardiopulmonary bypass is lethal in most of the cases. In extra-corporeal circulation by CPB, volatile anesthetics are generally administered in the oxygen inlet line using a vaporizer ...

Juniper Publishers - Journal of Anesthesia Abstract The peripherally acting kappa receptors agonist CR845 (difelikefalin) is currently in late development by Cara Therapeutics, for the treatment ofuremic pruritus, post-operative pain and pain in osteoarthritis. The principle of treating pain via a peripheral acting opioid, is supposed to have special advantages, among which the absence of central opioid side effects, and has actually been defined already in the last century. Phase I development of CR845 started in 2008, phase II studies have been completed, and phase III is ongoing for two formulations: an intravenous formulation for postoperative analgesia and uremic pruritus, and an oral formulation for treatment of chronic pain in osteoarthritis. However, as primary scientific data on CR845 in peer reviewed journals to date are absent, we can only evaluate the documents produced by the company, among which press releases of CARA Therapeutics, presenting results ...

Juniper Publishers - Journal of Anesthesia Abstract Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based anesthesia is an emerging trend. Recent research have examined and compared these two models of office-based anesthesia services a survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) found that over 70% of board-certified US pediatric dentists use some form of sedation or anesthesia in their offices. Furthermore, less than 20% administer IV sedation and 20 to 40% use a dentist anesthesiologist. Therefore, the first purpose of this review is to explore the use of office-based sedation and anesthesia by pediatric dentists practicing in the United States. The second purpose of this review is to identify what graduate training programs in pediatric dentistry and dental anesthesiology a...

Juniper Publishers - Journal of Anesthesia Abstract Purpose: Oral midazolam (MID) sedation is often used for pediatric dental procedures, however the quality of procedural sedation is variable and maybe inadequate for successful procedure completion. Intranasal (IN) sedative administration can be a useful adjunct as it has a more rapid onset and can be repeated as needed. MID can also be given IN however it burns and often results in crying. Routinely we use adjunct IN sufentanil, but due to a prolonged drug shortage and unavailability (> 1 year) we decided to assess the efficacy and safety of IN remifentanil (REMI), an ultra short acting synthetic opiate. There are only a few papers on IN REMI use. One report of 150 children given IN REMI as an adjunct to intubation did not find any problems and the kinetics appeared to demonstrate a fast onset of IN REMI and a rapid elimination as expected. Methods: We performed at retrospective chart and QA database revie...