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Byline: Archna. Koul, Deepanjali. Pant, Sneha. Nathany Sir, Transhiatal gastric pull-up surgery, indicated in long gap oesophageal atresia, has a number of postoperative complications. We observed an unusual occurrence of [...]

An artery may be entered on the dorsum of the hand with the mistaken belief that it is a vein. Intraarterial injection of drugs is one of the dreadful consequences of accidental intraarterial cannulation. In this case of a 3-month-old infant, we emphasize the fact that careful observation can prevent unintentional intraarterial drug injection via an 'assumed intravenous' cannula and prevent the associated morbidity. When there is a suspicion of an intraarterial placement of venous cannula, it is of paramount significance to confirm before the injection of medications. Aberrant arterial anatomy should be kept in mind, particularly in children on the dorsum of the hand, where placement of an intravenous cannula is usually considered safe. [ABSTRACT FROM AUTHOR]

Byline: Archna. Koul, Jayashree. Sood Introduction Primary tracheal tumours are rare, contributing to 0.1-0.4% [sup][1] of all malignancies. Reports of tracheal leiomyoma are even less common and account for approximately [...]

Quadratus lumborum block is an efective truncal block for postoperative analgesia in patients undergoing abdominal surgeries. We aimed to compare the analgesic efficacy of caudal block versus ultrasonography-guided quadratus lumborum block in pediatric patients undergoing open pyeloplasty. Fifty patients weighing ) 16 kg (age ) 4 years) with ASA physical status I-II scheduled for elective open pyeloplasty under general anesthesia were randomized into caudal block or transmuscular quadratus lumborum block groups. Fifty patients were included in the analysis. The mean duration of postoperative analgesia in the caudal group was 6.85 ± 1.99 hr, and for the quadratus lumborum block group it was 11.27 ± 3.74 hr (P < .001). There was no significant diference between the groups in terms of perioperative fentanyl requirement. However, there was a significant diference in postoperative paracetamol requirement between the groups (P = .005). There was a significant diference in postoperative pain score between the groups at 30 min, 1 hr, 1.5 hr, 2 hr, 8 hr, and 24 hr (P < .05). Mean heart rate and mean arterial pressure were comparable. No complications were recorded. Quadratus lumborum block was more efective than caudal block in terms of duration of postoperative analgesia and postoperative analgesic consumption. [ABSTRACT FROM AUTHOR]

Byline: Archna. Koul, Rashmi. Jain, Jayashree. Sood Although propofol is one of the most commonly used drugs for induction of anaesthesia, it is not devoid of anaphylactic potential. Early detection [...]

Byline: Archna. Koul, Deepanjali. Pant, Jayshree. Sood We evaluated the analgesic efficacy, hemodynamic and respiratory safety of Clonidine when added to bupivacaine for caudal block. Forty children undergoing inguinal hernia [...]

Background: The ProSeal™ laryngeal mask (PLMA) is increasingly being used as an airway device for laparoscopic surgery. Its silicone cuff allows diffusion of nitrous oxide, carbon dioxide and other gases with resultant rise in its intracuff pressure during anesthesia. The present study was designed to investigate the intracuff pressure changes during anesthesia with and without nitrous oxide in patients undergoing laparoscopic surgery lasting up to two hours. Materials and Methods: One hundred patients, American Society of Anesthesiologists physical status 2 and 3, undergoing general anesthesia with muscle paralysis, were randomized into two groups of 50 patients each to receive an anesthetic gas mixture containing either oxygen and nitrous oxide (group N) or oxygen and air (group A). Following insertion of an appropriate size PLMA, its cuff was inflated with air to an intracuff pressure of 45 mm Hg. The cuff pressure was measured every 10 minutes for the entire course of anesthesia. The position of the device was also assessed fiberoptically and postoperative airway complications were recorded. Results: The maximum intracuff pressure recorded in group N was 103 ± 4.7 mm Hg vs. 45.5 ± 1.5 mm Hg in group A. The percentage rise in cuff pressure every 10 minutes was also highly significant (P < 0.001) being maximum in first 10 min in group N. The incidence of postoperative airway complications was comparable between the two groups. Conclusion: The results of this study demonstrate that the intracuff pressure of the PLMA increases progressively over time when the breathing gas mixture contains nitrous oxide. [ABSTRACT FROM AUTHOR]