Anesthetic Consideration for Modified Electroconvulsive Therapy in an Adolescent With Uncorrected Atrial Septal Defect: A Case Report.

Catatonia is a serious neuropsychiatric syndrome of motor and behavioral dysfunction where electroconvulsive therapy (ECT) is a well-proven treatment modality. ECT is also preferred as it is a low-risk procedure compared to chronic medications having significant side effects. However, the cardiovascular events that occur during ECT are a major cause of morbidity and mortality in patients with an abnormal cardiovascular pathophysiology.

Orotracheal Intubation Challenges in an Anticipated Difficult Mask Ventilation, Preoxygenation, Tricky Laryngoscopy, and Supraglottic Airway Device Insertion: A Case Report.

With the advancement of technology, equipment, and airway management knowledge, anticipated difficult airway (DA) management has come a long way towards excellence. Usually, anticipated difficulties are related to bag-mask ventilation (BMV), laryngoscopy, intubation, or supraglottic airway placement; all in a single patient pose exceptionally challenging airway management. We may electively plan a surgical airway, but the option may not be available, especially when the patient provides tracheostomy permission only for emergency airway management, not for an elective.

Enhanced perioperative communication elevates patients' understanding, perception, and satisfaction for anesthesia services: Insights from a survey study.

Background And Aims: Anesthesiologists' services extend to many critical areas of any healthcare setup. However, there needs to be more understanding among the public regarding their crucial role. Preanesthesia evaluation (PAE) visits can disseminate information about anesthesiologists and services.

The Relation of Preoperative HbA1c Level With Intraoperative and Postoperative Complications in Type-2 Diabetic Patients: An Observational Study.

Background Perioperative dysglycemia increases morbidity and mortality, particularly among those with diabetes mellitus (DM), and elevated HbA1c levels, reflecting long-term blood glucose, are linked to poor healing and higher infection rates. This study investigates the link between preoperative HbA1c levels and perioperative outcomes in type-2 DM patients. Methodology This prospective observational study was conducted in India between January 2021 and April 2022.

Effect of real-time oxygen consumption versus fixed flow-based low flow anesthesia on oxygenation and perfusion: a randomized, single-blind study.

Although low-flow anesthesia is widely used due to its various advantages, there are concerns about potential and relative hypoxia. Furthermore, oxygen is also a drug with benefits and adverse effects. We aimed to evaluate and compare the effect of real-time oxygen consumption versus fixed flow-based low flow anesthesia on oxygenation and perfusion and to compare the economic benefits.

A Comparison of Analgesic and Recovery Profiles of Ketamine, Lignocaine, and Dexmedetomidine (KeLiDex) Versus Fentanyl-Based Anesthesia in Laparoscopic Nephrectomies: A Randomized, Single-Blind, Pilot Study.

Background: In the search for opioid-free anesthesia, notable numbers of drugs, singly or in combinations, have been tested with variable results. However, most of the drugs used are not as strong as opioids. Even if some non-opioid drugs are potent enough, they cause significant untoward effects, necessitating the use of lower effective dosages of multiple drugs as a substitute.

Deep Machine Learning Might Aid in Combating Intensive Care Unit-Acquired Weakness.

Secondary muscle weakness in critically ill patients like intensive care unit (ICU)-associated weakness is frequently noted in patients with prolonged mechanical ventilation and ICU stay. It can be a result of critical illness, myopathy, or neuropathy. Although ICU-acquired weakness (ICU-AW) has been known for a while, there is still no effective treatment for it.

The Efficacy and Safety of Spinal Anesthesia With Hyperbaric Ropivacaine 0.75% and Bupivacaine 0.5% in Patients Undergoing Infra-Umbilical Surgeries: A Randomized, Double-Blind Study.

Background: Spinal anesthesia utilizing hyperbaric 0.75% ropivacaine has been gaining clinical acceptance recently. It is a pure S-enantiomer of bupivacaine, which is expected to have a better clinical profile, but the studies for the same are yet limited.

Steroid Premedication Might Protect From Postoperative Erythema Nodosum Leprosum in Leprosy: A Case Report.

Leprosy is known for its diverse pathophysiologic involvement and resulting multisystemic manifestation and morbidities. Despite global efforts to eliminate this public health illness, it is still prevalent in some Asian and European countries. Perioperative management of a leprosy patient is challenging owing to the indirect and direct involvement of the airway, respiratory, and cardiac systems; treatment-related side-effects involving the hepato-renal systems affecting the anesthesia techniques and drugs pharmacokinetic and pharmacodynamics.

Effect of Sevoflurane, Isoflurane, and Desflurane on the Random Blood Glucose Levels in Non-diabetic Patients Undergoing General Anesthesia: A Randomized, Single-Blind Study.

Background: Volatile anesthetic agents like sevoflurane, isoflurane, and desflurane are widely used for maintaining general anesthesia (GA). Their effect on the autonomic system is different and can impact the blood sugar homeostasis. This study compares the intraoperative blood glucose levels in non-diabetic patients undergoing non-cardiac surgery under GA with the three volatile agents.

The diagnostic accuracy of preoperative perfusion index as a predictor of postspinal anesthesia hypotension in parturients undergoing cesarean delivery: A prospective non-blinded observational study.

Background And Objectives: Spinal anesthesia is the technique of choice for elective cesarean section with a prominent side effect of postspinal anesthesia hypotension (PSH). This needs an early prediction to avoid feto-maternal complication. This study aimed to assess the diagnostic accuracy of perfusion index (PI) and inferior vena cava collapsibility index (IVCCI) in the prediction of PSH.

Inventory Control Mechanism of the Pharmacy Store of a Recently Established National Institute in Eastern India: A Cross-Sectional, Investigative Analysis.

Background New establishments frequently face challenges. Pharmacy is integral to healthcare delivery institutes, and inventory management is crucial. The present study investigated the problems faced by the pharmacy of a newly established health institute and proposed relevant solutions to identify drugs needing stringent management control.

Preintubation Machine-Delivered Pressure Support Ventilation With Positive End-Expiratory Pressure Versus Manual Bag-Mask Ventilation for Oxygenation in Overweight and Obese Patients: A Randomized, Pilot Study.

Background: Noninvasive positive pressure ventilation (NIPPV) maintains mean airway pressures well, and its usability for preoxygenation is well described. Anesthesia machine-delivered NIPPV-based preoxygenation has recently been evaluated against the traditional manual bag-mask ventilation (BMV). The efficiency of such a technique over the traditional one is yet to be established well.

The Uneventful Use of Modern-Day Anesthetic Drugs in Post-polio Paralytic Patients: A Report of Three Cases.

The Western world has been polio-free for decades; however, many are affected by the stigmata of polio in several countries, including India. While general anesthesia (GA) and subarachnoid block (SAB) have been used successfully and widely, all those cases were mostly done with relatively older drugs and without additives. Therefore, further literature is needed to note the effect of newer anesthetic agents on post-polio paralytic patients for both GA, viz.

Anesthesia Services in Low- and Middle-Income Countries: The Fragile Point for Safe Surgery and Patient Safety.

The Safe Surgery Saves Life campaign of the World Health Organization advocates patient safety best practices during surgical procedures. Anesthesia service is indivisible from the patient safety best practices. Although anesthesia services are safer than ever before, safe delivery of anesthesia service and patient safety depends significantly on the availability of qualified anesthesiologists, the knowledge and competency of anesthesiologists, the work environment, and the availability of essential equipment and monitoring facilities.

Ischemic Stroke as the Presenting Feature for Non-acute Promyelocytic Leukemia Variant of Acute Myeloid Leukemia: A Case Report.

Acute myeloid leukemia (AML) patients encounter complications mainly due to their underlying disease or chemotherapy. Although they are at high risk for both hemorrhagic and thrombotic complications, thrombotic vascular complication as an initial manifestation is less common and rarely reported, especially in non-acute promyelocytic leukemia (non-APML). A 58-year-old female with no co-morbidity presented with fever, decreased appetite, headache, and weakness in her left upper and lower limbs.

Atracurium Versus Cis-Atracurium for Laryngeal Relaxation and Hemodynamic Stability in Pediatric Patients: A Randomized, Double-Blind Study.

Background and aim Equipotent dose of atracurium and cis-atracurium has failed to show clinically equi-effective muscle relaxation actions required for laryngoscopy and endotracheal intubation (LETI) in adults. There needs to be more data on children. We aimed to compare the efficacy of equipotent atracurium and cis-atracurium for producing optimal LETI.