Publications by authors named "Sivasenthil Arumugam"

Article Synopsis
  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used medications for managing diabetes and aiding weight loss but can delay gastric emptying, increasing aspiration risk during surgery.
  • Current guidelines suggest pausing these medications before surgery based on expert consensus rather than clear evidence.
  • A case series demonstrates how gastric point of care ultrasound (POCUS) assessed gastric contents in three patients, allowing for tailored and safer anesthetic plans based on individual needs and urgency.
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Background: Total hip arthroplasty (THA) is one of the most common operative procedures performed. Controlling postoperative pain following THA remains a challenge due to the complex innervation of the hip joint and the recent desire to preserve motor function following nerve blockade. Several nerve block techniques have been used for THA in the past, but the quadratus lumborum (QL) block and the blockade of the pericapsular nerve group (PENG) have emerged as opiate-sparing regional anesthesia techniques that preserve motor function.

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Purpose Of Review: Application of ultrasound in clinical anesthesia practice extends beyond regional anesthesia. In this review, we have discussed other point of care applications of ultrasound in perioperative care and anesthetic management with special emphasis on ambulatory practice.

Recent Findings: Point of care ultrasound (POCUS) for anesthesiologists has gained widespread interest and popularity.

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Article Synopsis
  • Spinal anesthesia for total hip arthroplasty (THA) is becoming more popular due to fewer complications, but the choice of local anesthetic can affect recovery time.
  • Bupivacaine is commonly used but has a long-acting effect, while ropivacaine may be a better option because of its shorter duration.
  • A study involving 503 patients found that those receiving ropivacaine had better ambulation times, quicker transitions from the post-anesthesia care unit, and similar complication rates compared to those receiving bupivacaine, making ropivacaine preferable for faster recovery.
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Introduction Dexamethasone is commonly administered intraoperatively to control postoperative nausea and vomiting (PONV) and pain. There is limited evidence of the ideal dosage of dexamethasone during surgery. Dexamethasone administration may increase blood glucose levels, posing unique challenges in maintaining acceptable blood glucose levels in patients with diabetes.

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In a retrospective analysis, we evaluated the safety and efficacy of peripheral nerve blocks (PNB) compared to epidural anesthesia in 221 consecutive patients undergoing same-day bilateral total knee arthroplasty (TKA). Primary outcome measures included: hypotension requiring physician intervention, number of blood transfusions, perioperative hespan and crystalloid consumption, incidences of respiratory desaturation, pruritis, urinary retention, and nausea/vomiting. The incidences of hypotension, urinary retention, and pruritis were all higher in the epidural group, compared to PNB.

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Background: We studied the efficacy of local infiltration analgesia in surgical wounds with 0.2% ropivacaine (50 mL), ketorolac (15 mg), and adrenaline (0.5 mg) compared with that of local infiltration analgesia combined with continuous infusion of 0.

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Background: Sciatic nerve block when combined with femoral nerve block for total knee arthroplasty may provide superior analgesia but can produce footdrop, which may mask surgically induced peroneal nerve injury. In this prospective, randomized, observer-blinded study, we evaluated whether performing a selective tibial nerve block in the popliteal fossa would avoid complete peroneal motor block.

Methods: Eighty patients scheduled for primary total knee arthroplasty were randomized to receive either a tibial nerve block in the popliteal fossa or a sciatic nerve block proximal to its bifurcation in combination with femoral nerve block as part of a multimodal analgesia regimen.

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