Publications by authors named "Subramaniam Rajeshwari"

Objectives: LMA Gastro Airway (LGA) is an advanced airway device that allows simultaneous endoscopy through separate conduits and ventilation during endoscopic retrograde cholangiopancreatography (ERCP). It can be an alternative to an endotracheal tube (ETT) and potentially hasten recovery from general anesthesia(GA) by avoiding muscle relaxants. We aimed to compare LGA with ETT regarding recovery from anesthesia and adverse respiratory events.

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Introduction: Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al . Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre.

Patients And Methods: A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively.

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Background: Hospitalized patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are at risk of further clinical deterioration and poor outcome. In this study, clinical risk factors of the requirement of mechanical ventilation within the first 24 h of hospital admission in coronavirus disease 2019 pneumonia patients have been evaluated.

Methods: In this retrospective study, admission characteristics of SARS-CoV-2-infected patients and risk factors for requiring mechanical ventilation and death within 24 h of admission have been evaluated.

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Unlabelled: During face mask ventilation, invariably, some air enters the esophagus rather than the airways; this results in gastric insufflation while the esophagus is intact or loss of tidal volume in patients with a cervical esophagostomy (Cx-esophagostomy).

Objective: The objective of the study was to report the indigenous use of an electrocardiography (ECG) electrode in successfully occluding the Cx-esophagostomy to prevent inadvertent loss of tidal volume.

Materials And Methods: Twenty-nine observations were recorded on 27 patients (mean age: 10.

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Article Synopsis
  • * Results showed that the LMA blockbuster had a significantly higher success rate (91.4%) for blind intubation compared to the Air-Q ILA (55.7%).
  • * Despite similar numbers of attempts and insertion times for both devices, the LMA blockbuster proved to be more effective, particularly when enhanced with specialized tubes and techniques.
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Background: Insulin resistance is often implicated as a risk factor of cell-mediated immune dysfunction in sepsis patients and results in poor clinical outcome. However, it is unclear whether early insulin resistance is contributory to T-cell dysfunction and poor clinical outcome in coronavirus disease 2019 (COVID-19) patients.

Methods: Adult patients with moderate-to-severe or critically ill COVID-19 infection were included in this study.

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Background And Aims: Parental separation, fear, and exposure to the operating room environment lead to stress and anxiety in pediatric patients. This study aims to identify the research gaps in the effect of video distraction on pediatric patients of Indian origin. We hypothesized that video distraction along with parental presence would reduce preoperative anxiety in pediatric patients undergoing ophthalmic procedures under general anesthesia compared with parental presence alone.

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Background And Aims: Comparison of analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block (QL-3) and erector spinae block (ESP) in children undergoing open pyeloplasty was done in this study.

Material And Methods: This was a randomized, double-blinded, controlled study conducted in a tertiary care center, operating rooms, post-anesthesia care unit (PACU), and paediatric surgical ward. Sixty children of age 1-6 years, with American Society of Anesthesiologists (ASA) status I or II, undergoing elective open pyeloplasty were included in the study.

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Background: Morphine is commonly used in pediatric caudal blocks. We compared the analgesic efficacy and effect on cortisol levels of intrathecal morphine and bupivacaine with caudal morphine and bupivacaine in children undergoing lower abdominal surgeries.

Methods: Forty children undergoing lower abdominal surgeries were randomized to receive 4 μg/kg of intrathecal morphine and 0.

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Background: The costoclavicular space serves as an alternative approach to the infraclavicular brachial plexus block, and numerous studies in adults have demonstrated promising outcomes for distal upper limb surgery. Blocking the brachial plexus at this level is potentially advantageous because the cords are relatively superficial, located in close proximity to each other and easily identified using ultrasound.

Aims: This study aimed to assess the success rate and feasibility of costoclavicular block in children undergoing unilateral below elbow upper limb surgery.

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Postoperative pulmonary complications (PPC) has a significant negative impact and are associated with increased length of hospital stay and cost of care. Emergency surgery is a well-established risk factor for PPC. Previous studies reported that personalized positive end-expiratory pressure (PEEP) might reduce postoperative atelectasis and postoperative pulmonary complications.

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 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus-associated pneumonia and acute respiratory distress syndrome (ARDS) were often associated with hyperinflammation and elevation of several serum inflammatory markers but usually less than what is observed in non-coronavirus disease (COVID) ARDS. Elevated inflammatory markers such as C-reactive protein, interleukin (IL)-6, etc., are associated with severe infection.

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Objective: Postspinal hypotension occurs in nearly 50% of women undergoing cesarean section (CS). Although phenylephrine (PE) is currently the vasopressor of choice, severe maternal bradycardia may adversely affect the fetal status due to the reduction in the maternal cardiac output. Norepinephrine (NE) is not associated with bradycardia and is now being evaluated for the treatment of post-spinal hypotension in obstetric patients.

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Background:  Lung protective ventilation during the intraoperative period is now well established. However, the additional role of positive end-expiratory pressure (PEEP) during the intraoperative period remains uncertain in major laparoscopic gynecological surgery. The authors hypothesized that compliance-based optimum PEEP titration reduces postoperative lung atelectasis and improves outcomes.

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Background: Ambu AuraGain has proven to be better compared with other supraglottic airway devices in terms of higher first-attempt insertion success rate, time and ease of insertion, high oropharyngeal leak pressure, and fewer complications in children. The performance of the BlockBuster laryngeal mask has not been evaluated in children.

Aims: The primary objective of this study was to compare the oropharyngeal leak pressure of the BlockBuster laryngeal mask with those of the Ambu AuraGain during controlled ventilation in children.

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Introduction: Bile duct injury (BDI) continues to occur despite technological advances and improvements in surgical training over the past 2 decades. This study was conducted to audit our data on laparoscopic cholecystectomies performed over the past 2 decades to determine the role of Critical View of Safety (CVS) and proctored preceptorship in preventing BDI and postoperative complications.

Materials And Methods: All patients undergoing elective laparoscopic cholecystectomy were analyzed retrospectively.

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Background And Aims: Transversus abdominis plane (TAP) block has been used to provide analgesia in renal transplant surgery with varying results. This study was designed to assess if the addition of clonidine in TAP block would decrease 24-h postoperative morphine consumption in adult renal transplant recipients.

Materials And Methods: Forty adult patients undergoing renal transplantation under general anesthesia in a tertiary care hospital were randomized into either group RC (TAP block with 20 mL of 0.

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Gastrointestinal endoscopies are often done in the prone position and anesthesiologists are needed to provide sedation. Airway access is limited in the prone position and may make timely airway management difficult in case of airway obstruction during sedation. Specialized laryngeal mask airway devices customized for endoscopy procedures like LMA Gastro™ can be inserted in the prone position and may help anesthesiologists tide over such crisis situations while simultaneously allowing the endoscopy procedures through the dedicated conduit available for inserting the endoscopes.

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