Should pipeline nitrous oxide be discontinued in secondary care: A cost-benefit analysis.

Background: Nitrous oxide (NO) has seen a marked decline in its usage in recent years due to its adverse clinical effects. We audited the practice in our department to evaluate the NO consumption and cost-effectiveness of its supply.

Methodology: Electronic anesthesia records of all patients anesthetized in our main operating rooms in a typical month were reviewed retrospectively, and utilization of NO was noted in addition to the patient demographics, surgical procedure, and specialty.

Tonsillar Trauma During Video Laryngoscopy: A Case Report.

Potentially difficult airways warrant the use of airway adjuncts, which, if not used with caution, can cause trauma to the oral cavity. Although most operators are familiar with modern airway adjuncts, as they are not routinely used, adverse events can occur. Since its introduction, a video laryngoscope (VL) has been lauded as a necessary instrument for airway management in and out of the operating room.

Anesthesia management of living donor liver transplantation in a patient with scimitar syndrome.

Scimitar syndrome is a rare congenital anomaly with a hallmark of an abnormal drainage of pulmonary veins into inferior vena cava instead of the left atrium; this creates a curvilinear radiological pattern resembling a sword (scimitar) on a chest radiograph, thus attracting the name. This case report highlights the challenges during liver transplantation, and perioperative anesthetic management of a patient with an uncorrected Scimitar Syndrome.

Magnetic resonance imaging of cerebrospinal fluid spread in the epidural space and postdural puncture headache in obstetrics: A proof-of-concept study.

Background: Currently, performing an epidural blood patch (EBP) for postdural puncture headache (PDPH) remains a subjective clinical decision. An evidence-based protocol may be of value in identifying women at high risk of developing a severe PDPH.

Objective: To investigate a potential correlation between the extent of CSF spread in the epidural space, as noted on Magnetic Resonance Imaging (MRI), and the likelihood of development of severe PDPH in obstetric patients.

Cost drain of anesthesia emergency drugs in a quaternary care hospital.

Background: Anesthesiologists draw up a selection of drugs for emergency use at the start of their list; unused drugs are discarded at the end of the list, to prevent contamination and spread of infections. We audited the practice in our department to evaluate the scale and cost impact of anesthesia emergency drugs wastage.

Subjects And Methods: A questionnaire was randomly given to anesthesiologists in our department, working in some of the operating rooms in our main floor, every morning over 7 working days.

Ultrasound-guided continuous spinal anesthesia for cesarean section in a parturient with scoliosis corrected with Harrington's rod surgery.

With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique.

Above Elbow Amputation Under Brachial Plexus Block at Supraclavicular and Interscalene Levels.

Introduction: The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It is performed for analgesia as well as anesthesia for upper limb procedures. It has been used for amputation and replantation surgeries of the upper limb.

The safe and responsible disposal of unused controlled drugs.

There are well-defined legal requirements for the safe storage, handling and disposal of controlled drugs (CDs): The Misuse of Drugs Act 1971, and Safer Management of Controlled Drugs (Department of Health, 2007). Clinical staff involved in the prescription and administration of CDs to patients are responsible and accountable for the appropriate disposal of these drugs because of the risk of substance abuse. A review of current practice, as followed by staff involved in the use and disposal of CDs, has been evaluated in a multi-centre audit.