Notes

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The study is based on the fact that a lower volume of local anesthetic drugs for ultrasound-guided supraclavicular brachial plexus block is useful for upper limb surgeries lasting for a shorter duration, and result in a lower incidence of complications.

The aim of this study is to compare the effectiveness of 35 mL of 0.5% ropivacaine with 20 mL of 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block for upper limb surgery.

Patients undergoing upper limb surgery in an industry-based government hospital in New Delhi, India. Patients were followed in the operation theater and the recovery room.

The study design involves a prospective, double-blind, randomized controlled trial.

A total of 40 participants were recruited for this study. Twenty participants in each group (referred to as group 20 and 30) received 20 mL and 35 mL of 0.5% ropivacaine, respectively, in ultrasound-guided supraclavicular brachial plexus block.

The statistical analysis was performed using the software SPmparable to 35 mL of 0.5% ropivacaine for supraclavicular brachial plexus block for upper limb surgery. There was a 21% decrease in the duration of analgesia with a decrease in volume of 0.5% ropivacaine from 35 mL to 20 mL.
Both nasal and oral routes can be used for fiberoptic intubation. Often it leads to hemodynamic disturbances, which may have a significant effect in patients with limited cardiopulmonary reserve as well as with cerebrovascular diseases.

The aim of the study was to evaluate whether there is a clinically relevant difference between the circulatory responses to oral and nasal fiberoptic intubation.

This was a prospective, randomized, and comparative study.

In this study, a total of 90 patients with the American Society of Anesthesiologist physical status I and II of either sex in the age group of 18-60 years and having anticipated difficult airway (DA) posted for elective surgery under general anesthesia were randomly allocated into two groups. Patients underwent fiberoptic intubation via either oral or nasal route under sevoflurane anesthesia with bispectral index guidance. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), time taken to intubation, and need of maneuver were measured.

All the analyses were carried out on SPSS 16.0 version (Inc., Chicago, USA). Mean and standard deviation were calculated. The test of analysis between two groups was done by unpaired
-test.

Demographic and DA characteristics were similar in both the groups. Significantly (
< 0.01) lesser alteration in HR, SBP, DBP, and MAP was seen in oral fiberoptic intubation when compared to nasal fiberoptic intubation in the early phase of postintubation. selleck inhibitor Time taken to intubation was also significantly (
< 0.01) lesser in the oral route compared to the nasal route.

Oral fiberoptic intubation causes less hemodynamic alteration and takes less time in comparison to nasal fiberoptic intubation.
Oral fiberoptic intubation causes less hemodynamic alteration and takes less time in comparison to nasal fiberoptic intubation.
With an increase in the duration of general anesthesia, there is a gradual deterioration in pulmonary functions. Intraoperative atelectasis is the major cause of deterioration in pulmonary functions. This study was performed to compare and determine the best ventilatory strategy among conventional ventilation, application of positive end-expiratory pressure (PEEP), and intermittent recruitment maneuver.

Seventy-five patients were divided into three groups each of 25 patients. In the first group (zero positive end-expiratory pressure [ZEEP]), we have applied zero PEEP intraoperatively. In the second group (PEEP), we have applied PEEP of 6 cm of H
O. In the third group (intermittent lung recruitment maneuver [IRM]), we have done intermittent recruitment maneuver intraoperatively. Pulmonary functions were analyzed by partial pressure of oxygen (PaO
)/fraction of inspired oxygen (FiO
) ratio (P/F) and static lung compliance (C
.

While comparing the mean P/F ratio between the groups, a significant decrease in P/F ratio of the ZEEP group was found from 90 min after induction up till the end (i. e. 24 h after extubation) of our observations as compared to both the PEEP and IRM groups. However, it did not differ (
> 0.05) between the PEEP and IRM groups at all time points on statistical analysis. On comparing the mean of C
between the groups, there was a significant decrease in lung compliance of the ZEEP group as compared to both the PEEP and IRM groups at all time points. However, like P/F ratio, compliance was also found to be statistically insignificant between the PEEP and IRM groups.

Pulmonary functions are relatively preserved with application of either PEEP or doing intermittent recruitment maneuver.
Pulmonary functions are relatively preserved with application of either PEEP or doing intermittent recruitment maneuver.
Percutaneous nephrolithotomy (PCNL) is done under general anesthesia (GA) in most of the centers. However, associated complications and cost are higher for GA than for regional anesthesia.

The aim of the study was to compare the efficacy of GA versus subarachnoid block (SAB) with regard to intraoperative blood loss and postoperative drop in hemoglobin (Hb) in patients undergoing PCNL.

This prospective, randomized, comparative clinical trial was carried out at a tertiary care hospital. After obtaining the institute ethical committee clearance (vide no 57/15), patients were randomly allocated into two groups using table of randomization (
= 30 each), Group A - GA, Group B - SAB.

Intraoperative blood loss was assessed by measuring the Hb of irrigated fluid and postoperative drop in Hb concentration. Other parameters such as intraoperative mean arterial pressure and heart rate were also compared in these groups.

The results are presented in frequencies, percentages, and mean ± standard deviation. The Chi-square test was used to compare the categorical variables between the groups. Unpaired
-test was used to compare the continuous variables between the groups.

Hemodynamic parameters were similar in both the groups preoperatively. The Hb drop was significant in Group A (1.28 ± 0.35 g.dl
) as compared to Group B (1.10 ± 0.67 g.dl
). On calculating Hb in irrigated fluid-blood mixture, it was found to be significantly higher in Group A (1.87 ± 0.44 g.L
) as compared to Group B (1.25 ± 0.25 g.L
).

Both GA and SAB are effective and safe in PCNL. However, SAB is associated with less blood loss as estimated by intraoperative blood loss and Hb drop.
Both GA and SAB are effective and safe in PCNL. However, SAB is associated with less blood loss as estimated by intraoperative blood loss and Hb drop.
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