Target-Controlled Inhalational Anesthesia-Isoflurane Consumption with Adequacy of Anesthesia Monitoring in Conventional and Multimodal Analgesia - A Comparative Study.

Background: In a time of increased concern over the environmental impact of chlorofluorocarbons, there is an impetus to minimize inhalational anesthetic consumption. It is possible with multimodal analgesia (MMA) and the use of end-tidal controlled anesthesia (EtCA) which is a low-flow anesthesia technique with adequacy of anesthesia (AoA) monitoring. In MMA, all four elements of pain processing namely transduction, transmission, modulation, and perception are targeted with drugs having a different mechanism of action.

The Effect of Multimodal Analgesia on Intraoperative Morphine Requirement in Lumbar Spine Surgeries.

Background: Lumbar spine surgery demands intense analgesia. Preemptive multimodal analgesia (MMA) is a novel approach to attenuate the stress response to surgical stimulus.

Aims: The aim of the study was to assess the intraoperative morphine consumption in patients undergoing lumbar spine surgery.

Hemodynamic Responses at Intubation, Change of Position, and Skin Incision: A Comparison of Multimodal Analgesia with Conventional Analgesic Regime.

Background: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes.

Aim: To assess the relative effectiveness of preemptive MMA compared with the conventional analgesic regime in suppressing the hemodynamic response to endotracheal intubation, prone positioning, and skin incision.

The effect of multimodal analgesia on minimum alveolar concentration of isoflurane for skin incision at constant bispectral index.

Background: Multimodal analgesia (MMA) by synergy with volatile anesthetics minimizes their use thus decreasing operation theater pollution and greenhouse gas emission.

Aims: To estimate minimum alveolar concentration (MAC) requirement of isoflurane (ISO) for skin incision with use of MMA in the study group versus conventional regime in the control group for a constant bispectral index (BIS). To observe the side effects of analgesic drugs administered in the study.

A modified submental orotracheal intubation.

In patients with concomitant occurrence of maxillofacial and basilar skull fractures, open reduction and internal fixation is the treatment. It requires intermittent intra operative dental occlusion which precludes oral or nasal intubation. In such cases submental intubation (SMI) is a recognized technique in practice.