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Context: Post-dural headache puncture (PDPH) is a frequent consequence after lumbar puncture. PDPH usually has frontal/occipital, postural headaches that are worse while they are standing and better when they are resting. Symptoms associated with stiff neck, loss of hearing, tinnitus, photophobia and nausea. The prevalence of PDPH in pregnant women is greater. This research seeks to examine the latest update on the prevention of post-dural headache puncture for pregnant women in the caesarean section. Methods: The search in MEDLINE, Embase, Pubmed and CINAHL Plus was conducted in the same periodical with the following mediacl terms: "post-dural; cramp; headache; caesarean section," encompassing articles 2000-2020, 2012; Articles other than English are excluded from the review. Results and findings: Headache treatment after accidental hard puncture varies. This diversity extends to the literature with various PDPHA definitions and epidural blood patch indications. More importantly, the absence of follow-up of the patients following accidental dural puncture was a survey addressed to members of the Society for Obstetric Anesthesia and Perinatology. Due to contradictory facts and views, a documented procedure is essential and all departmental members have to be followed.

Many patient undergoing neurosurgical procedures have disease affecting the cervical spine or they may have a trauma including the cervical spine , and these patient must be treated as far as we can so not causing more damage to the cord. The anesthesiologist must have a logical approach to evaluate and manage the cervical spine as regard ; Anatomy of the cervical spine including typical and atypical vertebrae. Congenital anomalies in relation to cervical spine. Infectious, neoplastic lesions and inflammatory arthropathies which affect the cervical spine. Uncommon accentuation looking into exchange from claiming trauma of the cervical spine for examining the vitality for securing the aviation route instantly At there will be hindrance or over apnic tolerant. The preoperative assessment of the tolerant What's more examination of the aviation route thus that those anesthesiologist might suspect those challenges Furthermore place the want for management. Cautious pre- Also intraoperative positioning of the tolerant Furthermore adjustment so as should keep further neurosurgical harm. The utilization about suitableness incitement agenize as stated by the desperation of the circumstance. The have from claiming neurosurgical observing and the utilization of those intraoperative (wake up test) so as on evaluate the neurological harm of the tolerant. Postoperative need for mechanical ventilation Also postoperative ache control.

This is a forthcoming randomized control clinical trial.We pointed tocompare between intrathecal hyperbaric bupivacaine alone versusintrathecal hyperbaric bupivacainein formation with one or the other fentanyl; or nalbuphinein 3 distinct portions (0.2 mg, 0.4mg, 0.8 mg).The study was done on 100 grown-up patients planned for elective lower stomach medical procedures under spinal sedation were randomlyallocated to 1 of the accompanying five gatherings to get intrathecally: 15 mg bupivacaine 0.5% alone (control);bupivacaine 15 mg joined with either 25 μg fentanyl; or nalbuphine 0.2,0.4 and 0.8 mg. Segment information, ASA characterization, length of medical procedure, kind of medical procedure, intra-employable Hemodynamic boundaries as the circulatory strain, the pulse and respiratory misery (respiratory rate, oxygen immersion), results as shuddering, sickness and regurgitating, and pruritis, beginning of engine and tactile square, most elevated level of tangible square, span of engine and tangible square, likewise postoperative pulse, non-intrusive pulse, oxygen immersion, torment score visual simple scale, results, term of viable absense of pain, all out number of salvage analgesics in first 24 hours were recorded. The outcome indicated that Both intrathecal nalbuphine and fentayl were viable in giving intra-employable and post-usable hemodynamic solidness, improving the time of postoperative complete and compelling absense of pain yet fentanyl was in a way that is better than nalbuphine in spreading beginning of tactile square, However, nalbuphine 0.8 mg is the best in expanding the time of postoperative complete and successful absense of pain, reducing the need of postoperative salvage pain relieving drugs and has better highlights, for example, hostile to pruritic, lesser shuddering, sickness and retching. Our decision is that nalbuphine 0.8 milligram is protected, significant and the best among the gatherings.

Acute pain is one of the most common adverse stimuli experienced by pediatric population as a result of surgery. Children continue to experience moderate to severe unrelieved pain postoperatively despite the evidence to guide practice being readily available. Although the spectrum of options for effective perioperative pain management in children ranges from simple oral medication to invasive epidural, it is sad to observe that there is a wide incongruity between available technology and clinical practice. Pain is a complex phenomenon that is not well understood. There are several misconceptions relating to the physiology of pain in children. Pain should be assessed regularly to detect for the presence of pain and to evaluate the effectiveness of treatments. There need aid An number from claiming non-drug systems that might a chance to be used to mitigate children‘s torment. Social insurance professionals, need on assess their ache oversaw economy hones Concerning illustration a few investigations bring suggester non-drug routines would not routinely utilized. In this audit article we will examine the postoperative ache clinched alongside pediatric, routines about evaluation from claiming agony for pediatric and assess those part of ultrasonography done administration of torment.

Obesity is a multi-system chronic pro-inflammatory disorder with increase morbidity and mortality. Adipocytes are far more than storage vessels for lipids, they secrete a large number of physiologically active substances called adipokines that lead to inflammation, vascular, cardiac remodeling, airway inflammation and altered microvascular flow patterns. to study the anaesthetic consideration in patients undergoing bariatric surgery in the pre-operative, intraoperative and postoperative phases of surgery. All patients presenting for bariatric surgery should be evaluated pre-operatively in an anesthesia pre-surgical screening clinic. This will allow an assessment of the patients’ airway as well as vascular access issues that may present due to the presence of excess adipose tissue. In addition, co-morbidities such as hypertension and diabetes must be addressed prior to surgery. For instance, in the morbidly obese patient intravenous access may be difficult at best. These patients may benefit from a PIC line, or a central line, inserted on the day of surgery.

Carotid artery disease is the result of atherosclerosis, if the obstruction of common carotid and the bifurcation of the common carotid artery or internal carotid artery occurred. The embolic phenomenon is the main cause of this obstruction. The role of collateral blood flow (circle of Willis and exracranial anastomosis channels) is very important. During endoarterctomy, the degree of ischemia and postoperative complications depends on the degree of the dependency of cerebral circulation on the ipsi lateral internal carotid artery, and the efficiency of the collateral circulation. There is five folds increase in the incidence of perioperative stroke, with the presence of good cerebral blood flow during the surgery. The aim of this study is to review the anesthetic choices between general anesthesia and regional anesthesia displaying the merits of local anesthetic methods in achieving a reduced hospital stay, patient satisfaction, and fewer complications. Carotid artery disease is defined by the narrowing or lockage of the artery due to laque build-up. The process hat blocks these arteries (atherosclerosis) are basically the same as that which causes coronary artery disease and peripheral artery disease (PAD). The slow build-up of plaque (which is a deposit of cholesterol, calcium, and other cells in the artery wall) is caused by high blood pressure, diabetes, tobacco use, high blood cholesterol and other modifiable risk factors. Carotid endarterectomy is surgery to remove fatty deposits (plaque) that are narrowing the arteries in neck. These are called the carotid arteries.