Changes in central venous oxygen saturation, lactates, and ST segment changes in a V lead ECG with changes in hemoglobin in neurosurgical patients undergoing craniotomy and tumor excision: A prospective observational study.

Background And Aims: The aim of the study was to observe the trends in central venous oxygen saturation (ScvO), lactate, and ST segment changes with change in hemoglobin in patients undergoing acute blood loss during surgery and to assess their role as blood transfusion trigger.

Material And Methods: Seventy-seven consecutive patients undergoing craniotomy at a tertiary care institution were recruited for this study after obtaining written, informed consent. After establishing standard monitoring, anesthesia was induced with standard anesthetic protocol.

A comparison of the recovery profiles of desflurane and isoflurane anesthesia in patients undergoing elective supratentorial craniotomy: A randomized controlled trial.

Context: Few studies have compared recovery profiles of desflurane and isoflurane for patients undergoing elective supratentorial craniotomy. It is not known if the choice of inhalational agent can affect the duration of transient postoperative neurological deficits in these patients.

Aims: To compare the effect of desflurane and isoflurane on time-to-emergence and time-to-recovery of transient postoperative neurological deficits in patients undergoing supratentorial craniotomy.

Intra-Operative Fluid Management in Adult Neurosurgical Patients Undergoing Intracranial Tumour Surgery: Randomised Control Trial Comparing Pulse Pressure Variance (PPV) and Central Venous Pressure (CVP).

Introduction: Fluid management in neurosurgery presents specific challenges to the anaesthesiologist. Dynamic para-meters like Pulse Pressure Variation (PPV) have been used successfully to guide fluid management.

Aim: To compare PPV against Central Venous Pressure (CVP) in neurosurgical patients to assess hemodynamic stability and perfusion status.

A Randomized Controlled Trial Studying the Role of Dexamethasone in Scalp Nerve Blocks for Supratentorial Craniotomy.

Background: The aim of this double-blinded randomized control study was to examine the role of the steroid dexamethasone as an adjuvant to lignocaine and ropivacaine in scalp nerve blocks in adults undergoing supratentorial craniotomy under general anesthesia. We compared the intraoperative anesthetic and postoperative analgesic requirement with and without the addition of dexamethasone to the local anesthetics.

Methods: The consented 90 patients were randomized into 2 groups: one group received 8 mg (2 mL) of dexamethasone, whereas the other received 2 mL of normal saline along with the local anesthetics in the scalp nerve block administered soon after induction of general anesthesia.

Comparison of the effect of lignocaine instilled through the endotracheal tube and intravenous lignocaine on the extubation response in patients undergoing craniotomy with skull pins: A randomized double blind clinical trial.

Background: A desirable combination of smooth extubation and an awake patient after neurosurgical procedures is difficult to achieve in patients with skull pins. Lignocaine instilled into endotracheal tube has been reported to suppress cough by a local mucosal anesthetizing effect. We aimed to evaluate if this effect will last till extubation, if given before pin removal.

Preoperative fasting in children: An audit and its implications in a tertiary care hospital.

Background: Prolonged preoperative fasting in children is a common problem, especially in highvolume centers. All international professional society guidelines for preoperative fasting recommend 2 h for clear fluids, 4 h for breast milk and 6 h for solids, nonhuman and formula milk in children. These guidelines are rarely adhered to in practice.

Awake craniotomy and electrophysiological mapping for eloquent area tumours.

Objective: An awake craniotomy facilitates radical excision of eloquent area gliomas and ensures neural integrity during the excision. The study describes our experience with 67 consecutive awake craniotomies for the excision of such tumours.

Methods: Sixty-seven patients with gliomas in or adjacent to eloquent areas were included in this study.

Oxidative stress-associated hypertension in surgically induced brain injury patients: effects of β-blocker and angiotensin-converting enzyme inhibitor.

Background: Postoperative hypertension is a common problem in patients undergoing surgical procedures, and the modification of this response could result in improved surgical outcome. Although it is recognized that the incidence of postoperative hypertension is higher in neurosurgical procedures, mechanisms behind this are not well understood. Oxidative stress is an important component of brain injury, and free radicals can influence blood pressure by a number of mechanisms.

Anaesthetic management of a patient with hypokalemic periodic paralysis- a case report.

We report the anaesthetic management of a patient with hypokalemic periodic paralysis who underwent hepaticojejunostomy for stricture of the common bile duct. Patients with this disorder, who are apparently normal, can develop sudden paralysis as they are exposed to many of the predisposing factors, perioperatively. The complications due to this rare genetic disorder, the factors that can precipitate these problems and preventive measures are discussed.

A comparative study between the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous lignocaine on coughing and hemodynamics during extubation in neurosurgical patients: a randomized controlled double-blind trial.

A prospective, randomized double-blind trial was performed to compare the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous (IV) lignocaine on coughing and hemodynamics during extubation in patients undergoing elective craniotomies in supine position. Forty-one patients received 4% lignocaine into the endotracheal tube cuff after intubation (ETT group) and 41 patients received IV lignocaine at 1.

CT-guided lung biopsies in children: anesthesia management and complications.

We describe the anesthetic management of three children who underwent CT-guided lung biopsies and the complications associated with the procedure. We discuss the likely causes and recommend steps that would help decrease the risk of these complications during such a procedure.

A simple glucose insulin regimen for perioperative blood glucose control: the Vellore regimen.

In this study, we sought a simple, easily implemented method of intraoperative control of blood glucose in diabetic patients in a large multispecialty teaching hospital. The Vellore regimen, which offers the advantages of a combined glucose insulin and variable rate infusion was evaluated. For every 1 to 50-mg/dL increase in blood glucose concentration more than 100 mg/dL, 1 U of insulin was added to the injection port of a 100-mL measured volume set containing 5% dextrose in water.

Unsuspected pheochromocytoma: von Hippel-Lindau disease.

The authors report a case of cerebellar hemangioma excision in a 13-year-old girl with unsuspected pheochromocytoma. This patient had an uneventful attempt at embolization of her tumor under general anesthesia but manifested hypertensive crisis during the intracranial surgery. The intra- and postoperative course of events and management are described.

Anaesthetic management of a patient with achondroplasia.

A 12-year-old girl diagnosed with achondroplasia was admitted for bilateral ear surgery and adenotonsillectomy. She had classical symptoms and signs of upper airway obstruction, which is often seen in patients with achondroplasia. We describe the anaesthetic management of this patient, emphasizing the airway difficulties encountered and their anaesthetic implications.

Acute coronary vasospasm during thoracic spine surgery.

Cardiac ischemia is a well-known and serious complication during surgery. The authors describe a case of acute coronary vasospasm in a young patient undergoing thoracic laminectomy with biopsy of intramedullary tumor. The possible role of the autonomic nervous system in the causation of acute coronary vasospasm is discussed, and this is highlighted as an unusual cause of myocardial ischemia during thoracic spine surgery.