Continuous Erector Spinae Plane Block in Paediatric VATS: A Case Series.

Decortication and stripping of infected pleura by video-assisted thoracoscopic surgery or thoracotomy is the treatment of choice in cases of empyema. The stripping is associated with intense post-operative pain. Erector spinae block is an excellent and safe alternative to thoracic epidural block.

Perfusion index as a predictor of working pediatric caudal block under general anesthesia- A prospective observational study.

Background And Aims: Advances in pulse oximeter technology have enabled us to measure parameters such as perfusion index (PI). We aimed to ascertain the utility of PI in the lower limb for evaluating the onset and adequacy of the pediatric caudal block under general anesthesia. The primary objective was to monitor PI trends after caudal block.

A novel use of ultrasound for the extraction of a fractured umbilical arterial catheter.

A 7-day-old 600 grams baby with a post-conceptual age of 29 weeks presented with features suggestive of hollow viscous perforation, and was posted for an emergency laparotomy. In addition, she had a fractured indwelling umbilical arterial catheter which was planned for extraction in the same sitting. Radiological imaging showed that the catheter extended into the stump of the umbilical cord.

Effect of preoperative education on anxiety in children undergoing day-care surgery.

Background And Aims: There have been various methods tested for reducing preoperative anxiety in children, but very limited literature is available in the Indian scenario. Our aim was to analyse the effect of an informative video about the anaesthetic technique on preoperative anxiety in children.

Methods: In all, 94 children were randomly allotted into two groups.

Correlation between bispectral index, end-tidal anaesthetic gas concentration and difference in inspired-end-tidal oxygen concentration as measures of anaesthetic depth in paediatric patients posted for short surgical procedures.

Background And Aims: Measurement of end-tidal anaesthetic gas concentrations (ETAG) is currently a pragmatic indicator for monitoring anaesthetic depth. We aimed to assess the performance of ETAG for sevoflurane (ETAG-sevo) with bispectral index (BIS) and difference between inspired and end-tidal oxygen concentration (Fi-Et)O% in measuring anaesthetic depth in toddlers and preschool children. Primary outcome was to correlate BIS with ETAG-sevo.

Accuracy of skin temperature over carotid artery in estimation of core temperature in infants and young children during general anaesthesia.

Background And Aims: Core temperature monitoring is essential in children under general anaesthesia as they are more susceptible to hypothermia. We aimed to use skin temperature over the carotid artery (T-carotid) with correction factors (Cf) to estimate core temperature. Primary outcome measure was to assess the sensitivity of T-carotid with Cf for detecting hypothermia.

[Comparison of endotracheal tube cuff pressure changes using air versus nitrous oxide in anesthetic gases during laparoscopic abdominal surgeries].

Background And Objectives: The purpose of this study was to compare the endotracheal tube cuff pressure changes during laparoscopic surgeries using air versus nitrous-oxide in anesthetic gas mixture; and to observe the incidences of postoperative sore throat, hoarseness and dysphagia.

Methods: Total 100 patients scheduled for elective laparoscopic abdominal surgery were allocated into two groups. Group A ( = 50) received air while Group N ( = 50) received nitrous-oxide in anesthetic gas mixture.

Local anaesthetic systemic toxicity following oral ingestion in a child: Revisiting dibucaine.

Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block.

Randomized comparative study of intravenous infusion of three different fixed doses of milrinone in pediatric patients with pulmonary hypertension undergoing open heart surgery.

Background: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone.

A randomised comparative study of Miller laryngoscope blade versus Oxiport Miller laryngoscope blade for neonatal and infant intubations.

Background And Aims: Neonates and infants are prone to oxygen desaturation during the induction of general anaesthesia. Pharyngeal oxygen insufflation has been shown to delay the onset of desaturation and hypoxaemia during apnoea. We tested the hypothesis that deep laryngeal oxygenation with Oxiport Miller blade would delay the onset of desaturation compared to laryngoscopy without supplemental oxygen (Miller blade).

Disinfection of laryngoscopes: A survey of practice.

Background And Aims: The laryngoscope is a common piece of equipment used by anaesthesiologists. It has been identified as a potential source of cross infection. Although guidelines exist regarding appropriate disinfection practices, recent reviews suggest ineffectiveness of current methods of disinfection and poor compliance with the established protocols.

Role of pre-operative multimedia video information in allaying anxiety related to spinal anaesthesia: A randomised controlled trial.

Background And Aims: A high incidence of anxiety has been reported in patients in the operation theatre set up. We developed a short visual clip of 206 s duration depicting the procedure of spinal anaesthesia (SAB) and aimed to compare the effect of this video on perioperative anxiety in patients undergoing procedures under SAB.

Methods: A prospective randomised study of 200 patients undergoing surgery under SAB was conducted.

Critical incidents in paediatric anaesthesia: A prospective analysis over a 1 year period.

Background And Aims: Critical incident reporting helps to identify errors and formulate preventive strategies. Many countries have existing national reporting systems. Such a system is yet to be established in India.

A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery.

Background And Aims: The complications of central venous catheterisation can be minimized by ensuring catheter tip placement just above the superior vena cava-right atrium junction. We aimed to compare two methods, using an electrocardiogram (ECG) or landmark as guides, for assessing correct depth of central venous catheter (CVC) placement.

Methods: In a prospective randomised study of sixty patients of <12 years of age, thirty patients each were allotted randomly to two groups (ECG and landmark).