Indian Journal of Anesthesia and Analgesia

Anesthesia for patient with pituitary adenoma posted for non-neurosurgical surgeries is a challenge to the anesthesiologist with the risk of sudden change in intracranial dynamics during administration of spinal anesthesia or during stress response of general anesthesia. We reported a case of intracapsular neck of femur fracture with pituitary macroadenoma managed with epidural anesthesia.

Acute low back pain is a common cause of pain in the majority of the adult population. Facet joints are a potential source of pain in low back pain (LBP) and its prevalence increases with age. Our case report is about a 34-year-old male patient who came with chief complaints of chronic low back ache, more on the left side, insidious in onset, non-radiating not associated with tingling or numbness. Pain aggravates on walking, sitting to standing posture, and left side movements. His Numerical rating scale (NRS) was 7 and the Verbal rating scale (VRS) was moderate. On palpation patient had left para median tenderness more at L5-S1 area. The Lasegue straight leg raising test and flexion, abduction, external rotation (FABER) were also negative. We decided to proceed with diagnostic block of left L5-S1 facet joint with 1ml 0f 1% lignocaine and our patient had significant pain relief of about 80%.

   Rett syndrome (RS) is a progressive neurological disorder that almost exclusively affects females. It is characterized by severe mental retardation following a period of normal development during childhood. Classical features include autism, stereotypical hand movements, seizures, microcephaly and abnormal respiratory control. Anesthetic challenges in patients with RS include difficult airway, seizure management, positioning, increased sensitivity to sedatives, autonomic dysfunction, anesthesia-triggered episodes of apnoea, hypoxemia and sudden death. Here, we describe the successful anesthetic management of a 13-year-old patient with RS exhibiting most of these features who underwent laparoscopic SOS open ovarian cystectomy and hysterectomy.

Objective: Level of plasma cholinesterase and its association with clinical manifestations.

Methods: This is a prospective study and observation study of 50 cases of organo phosphorus poisoning compound admitted in casualty and intensive care department. In present study we were evaluated plasma cholinesterase levels and correlate with clinical symptomatology in organo phosphorus poisoning, also included patient requiring ventilator support in respiratory failure patients. Prior approval for the study and the protocol was obtained from the institution ethical committee. In present study, serum cholinesterase estimation was repeated on after 6 hours, 12 hours, 24 hours, 48 hours, 96 hours and 7th day of stay in intensive care unit. The serum cholinesterase activity was measured by Genx cholinesterase butyryl thiocholinemethod (quantitative determination of cholinesterase in human serum).

Conclusion: In present study 50 cases of organophosphorus compound poisoning admitted to our tertiary care centre. Commonest age group 21 to 30 years and 31 to 40 years. Serum cholinesterase is a useful marker for predicting clinical outcome in op poisoning as marked reductions are associated with increased need for ventilator support, atropine requirement, duration of hospital stay and outcome. Serum cholinesterase levels correlated well with clinical manifestation, severity of poisoning, ventilator support required or not and outcome.

Aims and objective: To compare heamodynamic parameters, complication, recovery time and time of early extubation with sevoflurane and desflurane.

Materials and methods: This was prospective study conducted from January to December 2020 using sampling technique total 60 adult patient of American society of Anesthesiologist (ASA) Grade I, II, III. Age between 18–60 years of either male or female who were posted for Laproscopic appendicectomy under general anesthesia were selected for study after informed consent. All the patient were randomly allocated into one of two group using computer generated random number table. Group ‘S’ received induction with sevofluraneamd Group ‘D’ received induction with desflurane.

Result: Both group did not differ significantly in age, weight, sex, ASA grade. Heart rate was significantly higher in the sevoflurane group than in the desflurane group after intubation. Systolic blood pressure was significantly higher in the sevoflurane group. The Sevoflurane group showed higher time in spontaneous respiration, verbal commands following, ET removal time.

Conclusion: Desflurane provides faster recovery from anesthesia and better hemodynamic
stability introperative and post operative.