11 results on '"P Butala"'
Search Results
2. Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO 2 pneumoperitoneum on cardiovascular, respiratory and renal function
- Author
-
Beena Kandarp Parikh, Veena R Shah, Pranjal R Modi, Beena P Butala, and Geeta P Parikh
- Subjects
CO 2 pneumoperitoneum ,laparoscopic kidney transplantation ,Trendelenburg position ,Anesthesiology ,RD78.3-87.3 - Abstract
Background: Laparoscopic donor nephrectomy is a routine practice since 1995. Until now, the recipient has always undergone open surgery for transplantation. In our institute, laparoscopic kidney transplantation (LKT) started in 2010. To facilitate this surgery, the patient must be in steep Trendelenburg position for a long duration. Hence, we decided to study the effect of CO2 pnuemoperitoneum and Trendelenburg position in chronic renal failure (CRF) patients undergoing LKT. Methods: A total of 20 adult CRF patients having mean age of 31.7±10.36 years and body mass index 19.65±3.41 kg/m 2 without significant coronary artery disease were selected for the procedure. Cardiovascular parameters heart rate (HR), mean arterial pressure (MAP), Central venous pressure (CVP) and respiratory parameters (ETCO 2 , peak airway pressure) were noted at the time of induction, after induction, 15 min after creation of pnuemoperitoneum, 30 min after Trendelenburg position, 15 min after decompression of pnuemoperitonuem and after extubation. Arterial blood gas analysis was carried out after induction, 15 min after creation of pnuemoperitoneum, 30 min after Trendelenburg position and 15 min after clamp release. Total duration of surgery, anastomosis time, time for the establishment of urine output and total urine output were noted. Serum creatinine on the 1 st and 7 th post-operative day were recorded. Results: Significant increase in HR was observed after creation of CO 2 pneumoperitoneum and just before extubation. Significant increase in the MAP and CVP was noted after creation of pneumoperitoneum and after giving Trendelenburg position. No significant rise in the ETCO 2 and PaCO 2 was observed. Significant increase in the base deficit was observed after the clamp release, but none of the patients required correction. Conclusion: LKT performed in steep Trendelenburg position with CO 2 pneumoperitoneum significantly influenced cardiovascular and respiratory homeostasis; however, measured parameters remained within clinically acceptable range without affecting early function of the transplanted kidney.
- Published
- 2013
- Full Text
- View/download PDF
3. Acute hypoxaemia due to intraoperative lung collapse after repositioning the patient
- Author
-
Bina P Butala, Veena R Shah, and Guruprasad P Bhosale
- Subjects
Hypoxaemia ,lung collapse ,mucus plug ,postural drainage ,Anesthesiology ,RD78.3-87.3 - Abstract
Desaturation after induction of anaesthesia and repositioning due to mucus plug causing atelectasis (lung collapse) is a rare event. We present a case of intraoperative right lung collapse due to mucus plug in a patient undergoing left laparoscopic nephrectomy. Hypoxaemia occurred after the induction of anaesthesia and repositioning. X-ray chest revealed right lung collapse and surgery was subsequently postponed. Lung re-expanded after postural drainage and suction. Postoperatively patient was diagnosed to have retrocardiac bronchiectasis. After preoperative preparation with postural drainage, chest physiotherapy, and antibiotics, the patient underwent surgery uneventfully.
- Published
- 2011
- Full Text
- View/download PDF
4. Anaesthetic management of a case of idiopathic intracranial hypertension
- Author
-
Bina P Butala and Veena R Shah
- Subjects
Cerebrospinal fluid ,idiopathic intracranial hypertension ,intra cranial pressure ,lumbar puncture ,papilledema ,Anesthesiology ,RD78.3-87.3 - Abstract
Idiopathic intracranial hypertension (IIH) is a rare headache syndrome characterized by prolonged elevation of intracranial pressure without related pathology in either the brain or the composition of cerebrospinal fluid. Herein, we provide a brief review of the clinical presentation of IIH and the anaesthetic considerations in a female posted for transcervical resection of the endometrium and right nephrectomy with the disorder. Most of patients with IIH are reported during pregnancy and came for management of labour and delivery. To our knowledge no such case has been described previously.
- Published
- 2013
- Full Text
- View/download PDF
5. Medication error: Subarachnoid injection of tranexamic acid
- Author
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Bina P Butala, Veena R Shah, Guruprasad P Bhosale, and Rajkiran B Shah
- Subjects
Myoclonic jerks ,spinal anaesthesia ,tranexamic acid ,Anesthesiology ,RD78.3-87.3 - Abstract
Some factors have been identified as contributing to medical errors, such as labels, appearance and location of ampoules. We present a case of accidental injection of tranexamic acid instead of Bupivacaine during spinal anaesthesia. One minute after the injection of 3 mL of the solution, the patient developed myoclonus of her lower extremities. Accidental intrathecal injection of the wrong drug was suspected and a used ampoule of tranexamic acid was discovered in the trash can. The ampoules of Bupivacaine (5 mg/mL, trade name "Sensovac Heavy") and tranexamic acid (500 mg/mL, Trade name "Nexamin") were similar in appearance. Her myoclonus was successfully treated with phenytoin, sodium valproate, thiopental sodium infusion, midazolam infusion and supportive care of haemodynamic and respiratory systems. The surgery was temporarily deferred. The patient′s condition progressively improved to full recovery.
- Published
- 2012
- Full Text
- View/download PDF
6. Early clinical experience with The Anesthetist Society (TAS) scope (an indigenous videolaryngoscope)
- Author
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Nisarg Patel, Ramneek Kaur, Beena K Parikh, and Bina P Butala
- Subjects
Epiglottis ,medicine.medical_specialty ,Glottis ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Laryngoscopy ,Tracheal intubation ,030208 emergency & critical care medicine ,Brief Communication ,lcsh:RD78.3-87.3 ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Laryngoscopes ,030202 anesthesiology ,Learning curve ,lcsh:Anesthesiology ,medicine ,Intubation ,Airway management ,Medical physics ,business - Abstract
Tracheal intubation is the preferred technique for mechanical ventilation. However, standard tracheal intubation via conventional direct laryngoscopy (DLS), performed by untrained medical personnel has high incidence of failure. Success rate by medical support staff, medical students and novice anaesthesia residents is stated to be between 35% and 65%.[1] Alternative approaches for improving the success rates include use of videolaryngoscopy (VLS), which provides better view of the glottis and higher success rate.[2] It does not depend on alignment of the optical axes in the pharynx and mouth.[3] It is more effective but can be time-consuming but the steepness of the learning curve may be less than that with DLS for a novice.[4] The main hurdle in DLS with Macintosh laryngoscope is the visual restriction inherent to the procedure caused by a need to get straight line of sight to visualise the glottis, blade flange, tongue and epiglottis making the procedure monocular at the level of the larynx.[5] Video laryngoscopes (VLS) represent a breakthrough in airway management. They are available in various designs and blade shapes, with specific applications in selected case groups. Most of the VLS available in market are cumbersome to use and expensive. The need of the hour is a user-friendly and economical VLS. TAScope (The Anaesthetist Society scope) is an indigenously designed VLS by a fraternity member. It is a channelled, anatomically angulated video intubation aid with an endoscopic camera which can be connected to mobile phones and tablets.[6] After satisfactory manikin trial in the institute, this preliminary human study was done to evaluate TAScope in comparison to Macintosh laryngoscope.
- Published
- 2019
7. Anaesthetic management of an unusual case of complete heart block for LSCS
- Author
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Dr Manisha P, Dr Beena Butala, and Dr Veena R
- Subjects
Anesthesiology ,RD78.3-87.3 - Published
- 2006
8. Bilateral Pneumothorax As A Complication of Laparoscopy
- Author
-
Veena shah, Beena Butala, Beena Parikh, and Raj Raval
- Subjects
Anesthesiology ,RD78.3-87.3 - Published
- 2003
9. Acute hypoxaemia due to intraoperative lung collapse after repositioning the patient
- Author
-
Veena R Shah, Guruprasad P Bhosale, and Bina P Butala
- Subjects
Suction (medicine) ,medicine.medical_specialty ,Lung Collapse ,medicine.medical_treatment ,Atelectasis ,Case Report ,Chest physiotherapy ,lung collapse ,lcsh:RD78.3-87.3 ,medicine ,Bronchiectasis ,Lung ,business.industry ,Laparoscopic nephrectomy ,respiratory system ,medicine.disease ,postural drainage ,Surgery ,respiratory tract diseases ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,lcsh:Anesthesiology ,Anesthesia ,mucus plug ,Postural drainage ,business ,Hypoxaemia - Abstract
Desaturation after induction of anaesthesia and repositioning due to mucus plug causing atelectasis (lung collapse) is a rare event. We present a case of intraoperative right lung collapse due to mucus plug in a patient undergoing left laparoscopic nephrectomy. Hypoxaemia occurred after the induction of anaesthesia and repositioning. X-ray chest revealed right lung collapse and surgery was subsequently postponed. Lung re-expanded after postural drainage and suction. Postoperatively patient was diagnosed to have retrocardiac bronchiectasis. After preoperative preparation with postural drainage, chest physiotherapy, and antibiotics, the patient underwent surgery uneventfully.
- Published
- 2011
10. Anaesthetic management of a case of idiopathic intracranial hypertension
- Author
-
Veena R Shah and Bina P Butala
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,lcsh:RD78.3-87.3 ,Cerebrospinal fluid ,medicine ,lumbar puncture ,Papilledema ,Intracranial pressure ,Anaesthetic management ,Pregnancy ,medicine.diagnostic_test ,Lumbar puncture ,business.industry ,intra cranial pressure ,papilledema ,medicine.disease ,Nephrectomy ,Surgery ,Anesthesiology and Pain Medicine ,lcsh:Anesthesiology ,Anesthesia ,Presentation (obstetrics) ,medicine.symptom ,business ,idiopathic intracranial hypertension - Abstract
Idiopathic intracranial hypertension (IIH) is a rare headache syndrome characterized by prolonged elevation of intracranial pressure without related pathology in either the brain or the composition of cerebrospinal fluid. Herein, we provide a brief review of the clinical presentation of IIH and the anaesthetic considerations in a female posted for transcervical resection of the endometrium and right nephrectomy with the disorder. Most of patients with IIH are reported during pregnancy and came for management of labour and delivery. To our knowledge no such case has been described previously.
- Published
- 2013
11. Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO2 pneumoperitoneum on cardiovascular, respiratory and renal function
- Author
-
Beena K Parikh, Veena R Shah, Beena P Butala, Geeta P Parikh, and Pranjal R Modi
- Subjects
Mean arterial pressure ,business.industry ,medicine.medical_treatment ,Trendelenburg position ,Central venous pressure ,Renal function ,laparoscopic kidney transplantation ,medicine.disease ,CO2 pneumoperitoneum ,Nephrectomy ,Transplantation ,lcsh:RD78.3-87.3 ,Anesthesiology and Pain Medicine ,Pneumoperitoneum ,lcsh:Anesthesiology ,Anesthesia ,medicine ,CO 2 pneumoperitoneum ,Clinical Investigation ,business ,Kidney transplantation - Abstract
Background: Laparoscopic donor nephrectomy is a routine practice since 1995. Until now, the recipient has always undergone open surgery for transplantation. In our institute, laparoscopic kidney transplantation (LKT) started in 2010. To facilitate this surgery, the patient must be in steep Trendelenburg position for a long duration. Hence, we decided to study the effect of CO2 pnuemoperitoneum and Trendelenburg position in chronic renal failure (CRF) patients undergoing LKT. Methods: A total of 20 adult CRF patients having mean age of 31.7±10.36 years and body mass index 19.65±3.41 kg/m 2 without significant coronary artery disease were selected for the procedure. Cardiovascular parameters heart rate (HR), mean arterial pressure (MAP), Central venous pressure (CVP) and respiratory parameters (ETCO 2 , peak airway pressure) were noted at the time of induction, after induction, 15 min after creation of pnuemoperitoneum, 30 min after Trendelenburg position, 15 min after decompression of pnuemoperitonuem and after extubation. Arterial blood gas analysis was carried out after induction, 15 min after creation of pnuemoperitoneum, 30 min after Trendelenburg position and 15 min after clamp release. Total duration of surgery, anastomosis time, time for the establishment of urine output and total urine output were noted. Serum creatinine on the 1 st and 7 th post-operative day were recorded. Results: Significant increase in HR was observed after creation of CO 2 pneumoperitoneum and just before extubation. Significant increase in the MAP and CVP was noted after creation of pneumoperitoneum and after giving Trendelenburg position. No significant rise in the ETCO 2 and PaCO 2 was observed. Significant increase in the base deficit was observed after the clamp release, but none of the patients required correction. Conclusion: LKT performed in steep Trendelenburg position with CO 2 pneumoperitoneum significantly influenced cardiovascular and respiratory homeostasis; however, measured parameters remained within clinically acceptable range without affecting early function of the transplanted kidney.
- Published
- 2013
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