Efficacy and Safety of Obturator Nerve Block in Transurethral Resection of Bladder Tumors: A Comprehensive Review.

Transurethral resection of bladder tumors (TURBT) is a pivotal procedure in the management of bladder cancer, essential for both diagnosis and treatment. Effective anesthesia is crucial in TURBT to ensure a stable and pain-free operative field, facilitate precise tumor resection, and minimize complications such as the obturator reflex, which can lead to involuntary leg movement and bladder injury. The obturator nerve block (ONB) is a regional anesthesia technique designed to prevent the obturator reflex by blocking the obturator nerve, which innervates the adductor muscles of the thigh.

Sugammadex vs Neostigmine, a Comparison in Reversing Neuromuscular Blockade: A Narrative Review.

The use of neuromuscular blocking agents (NMBA) has grown due to the development of laparoscopic and minimally invasive procedures. Respiratory insufficiency, an elevated risk of aspiration, postoperative pulmonary complications, and subsequent reintubation are among the risks linked to the residual block. The normal clinical practice calls for the pharmacologic "reversal" of these agents with either sugammadex or neostigmine prior to extubation.

Comparative Analysis of the Modified Aldrete Score and Fast-Track Criteria for Post-general Anaesthesia Recovery: A Narrative Review.

There are two commonly used scoring systems to evaluate recovery from general anaesthesia (GA): the Modified Aldrete Score (MAS) and the Fast-Track Criteria (FTC). Recently, concerns have been expressed about the safety and effectiveness of the Aldrete scoring system due to its exclusion of an assessment for pain or nausea, which can exacerbate recovery from surgery and anaesthesia and cause many patients to experience these side effects. FTC was created to evaluate post-operative nausea vomiting, and pain in order to assess recovery from GA.

Assessment of the Efficacy of Nalbuphine as an Adjuvant to Intrathecal Bupivacaine in Endoscopic Urological Surgeries for the Prolongation of Postoperative Analgesia.

Background In anaesthesiology, intrathecal drugs play pivotal roles in spinal anaesthesia. Despite their ability to induce a high sensory block, bupivacaine alone may not be adequate for postoperative analgesia. It often requires a substantial dose of postoperative rescue analgesia to manage pain effectively.

Evaluating Sedation Strategies for Magnetic Resonance Imaging: A Comprehensive Review of Intravenous Fentanyl, Butorphanol, and Midazolam in Adult and Pediatric Populations.

Magnetic resonance imaging (MRI) is a critical diagnostic tool that often requires patient sedation to ensure optimal image quality and patient comfort, particularly in those with anxiety or an inability to remain still. This comprehensive review examines the efficacy, safety, and practical considerations of three commonly used intravenous sedatives, namely, fentanyl, butorphanol, and midazolam, in adult populations undergoing MRI procedures. This review highlights the pharmacological profiles, advantages, and limitations associated with each sedative agent through a detailed analysis of current literature, clinical guidelines, and practice-based evidence.

Magnesium Sulfate and Its Versatility in Anesthesia: A Comprehensive Review.

In the field of general anesthesia, magnesium sulfate (MgSO4) has become a valuable adjunct because it provides a range of benefits that enhance and optimize conventional aesthetic procedures. This review highlights the various intra-anesthetic benefits of MgSO4 while examining its complex function in the treatment using anesthesia. Magnesium inhibits the release of acetylcholine at the motor endplate and blocks calcium channels at presynaptic nerve terminals.

A Comprehensive Review of Extra Corporeal Membrane Oxygenation: The Lifeline in Critical Moments.

Extracorporeal membrane oxygenation (ECMO) has evolved into a pivotal intervention in critical care, offering a lifeline for patients facing severe respiratory or cardiac failure. This review provides a comprehensive exploration of ECMO, spanning its definition and historical background to its contemporary advancements and ongoing impact in critical care. The versatility of ECMO in addressing diverse critical conditions, careful patient selection criteria, and the nuanced management of complications are discussed.

Intubation in a Case of Ectodermal Dysplasia During Surgery: A Case Report.

Ectodermal dysplasia, a heterogeneous group of rare genetic disorders, is characterized by the aberrant development of ectodermal structures, leading to various clinical anomalies. This case report presents a unique and challenging case of a 33-year-old male with ectodermal dysplasia who underwent Le Fort III advancement and implant rehabilitation surgery to address severe craniofacial and dental deficiencies. This case, characterized by facial dysmorphism, craniofacial anomalies, and the absence of a nasal bone, highlights the complexity of surgical planning required to address these diverse clinical features.

Anesthetic Challenges in an Infant With Tetralogy of Fallot Posted for Non-cardiac Surgery: A Case Report and Literature Review.

The goal of this article is to provide an up-to-date and comprehensive review of the current perioperative anesthetic management of pediatric patients with congenital heart disease (CHD) undergoing non-cardiac surgery. This report discusses a case of a nine-month-old female with Tetralogy of Fallot who was scheduled for non-cardiac surgery for anorectal malformation stage 1 and stage 2 repair. This case study discusses how to adjust perioperative anesthesia care in cases of left-to-right shunt, right-to-left shunt, and complex cardiac disease.

Comparison of Dexamethasone Versus Methylprednisolone With Bupivacaine in Transversus Abdominis Plane Block for Attenuation of Chronic Postoperative Abdominal Pain.

Background  Opioids, which have well-known adverse effects such as drowsiness paralytic ileus and respiratory depression, were mostly utilised to treat postoperative pain in the past. The increased incidence of side effects has led to a rise in interest in pain management techniques that spare opioids. Persistent abdominal pain following surgery has a major detrimental effect on patients' quality of life.

Anesthetic and Airway Management in a Case of Surgical Excision of Recurrent Buccal Hemangioma.

Difficult airway is one of the challenges trained anesthesiologists face in their life. Induction of general anesthesia in a patient with a compromised airway has always caused a dilemma for anesthesiologists. Challenges were more in this case of buccal hemangioma as its bleeding tendency makes it a challenging job.

Challenges in Anaesthetic Management in a Case of Facial Plexiform Neurofibromatosis Posted for Debulking Surgery.

A patient diagnosed with facial plexiform neurofibromatosis type 1 who is 18 years old and is scheduled for tumour resection and debulking surgery of his face is the subject of this study. The purpose of this paper is to describe the anaesthetic treatment that was administered to this patient. In addition, we analyze the relevant literature, with a particular emphasis on the implications of modifying neurofibromatosis to achieve anaesthesia.

Acute Bilateral Swelling of the Parotid Gland After General Anesthesia in Lateral Decubitus Position.

A rare but well-known anesthetic side effect is acute parotid gland enlargement after general anesthesia, sometimes known as anesthesia mumps or acute post-operative sialadenitis. Acute dehydration, obstruction of glandular excretory ducts caused by the position of the patient, and/or medications such as atropine that increase saliva viscosity have all been proposed as potential causes, while the specific cause is still unknown. We present a case of a 41-year-old patient who underwent a right open anatrophic pyelolithotomy for a staghorn calculus in the left lateral decubitus position and had swelling in the right and left preauricular and postauricular regions, which had progressed to the angle of the mandible post-operatively.

Continuous Spinal Anesthesia Technique After Accidental Dural Puncture.

Continuous spinal anesthesia (CSA) is a mode of anesthesia and analgesia that has various therapeutic advantages. CSA allows the anesthesiologist to titrate tiny doses of a local anesthetic to achieve the desired degree of spinal anesthesia. The duration can be extended to accommodate the demands of the protracted operation.

Advancement in Current Therapeutic Modalities in Postpartum Cardiomyopathy.

Pregnancy is considered one of the most delicate conditions for the woman and her fetus, rendering physiological stress on her body. Sometimes, this leads to unwelcomed incidences of certain systemic disorders which further complicate the course of pregnancy. Cardiovascular conditions associated with pregnancy have major morbidity amongst the general population.

Perioperative impact of body mass index on upper urinary tract and renal robot-assisted surgery: a single high-volume centre experience.

To assess the impact of body mass index (BMI) on peri-operative outcomes of kidney and upper tract robot-assisted surgery. Medical audit of patients who underwent robot-assisted kidney and upper tract cancer surgery at a single institution between 2017 and 2019, categorized on BMI into obese patients with a BMI ≥ 30 kg/m and a control group with BMI < 25 kg/m. Patient and tumour characteristics, surgery time, intraoperative blood loss, intraoperative adverse events (AE) according to the European Association of Urology Intraoperative Adverse Incidents Classification (EAUiaiC), conversion- to-open/radical rate as well as 30-day postoperative AE according to Clavien-Dindo (CD) and length of inpatient stay were analyzed.

Particle current on flexible surfaces excited by harmonic waves.

In this paper, a study on the directed particle current on flexible surfaces excited by a harmonic wave is reported. The proposed theory considers three different models for the kinematics of the surface, namely the Euler-Bernoulli, Timoshenko, and Rayleigh surface wave models. The particle-surface interaction terms in the theory incorporate Coulomb friction and inelastic collision between the particle and the surface.

Retrospective study of descending cervical mediastinitis.

Objective: Descending cervical mediastinitis can occur as a complication of oropharyhgeal and cervical space that spread to the mediastinum vis cervical space. Descending mediastinitis represent a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce high morality associated with the disease. Surgical management and a particularly optimal form of mediastinal drainage remain controversial.