Notes

Pancreatic Acinar Mobile Planning regarding O2 Ingestion and also Lactate Generation Evaluation.
The process of laryngoscopy and endotracheal intubation is associated with intense sympathetic activity, which may precipitate intra-operative complications. Taking the advantage of dexmedetomidine's good bioavailability and rapid absorption through nasal mucosa; we contemplated this study to evaluate the effects of nebulised dexmedetomidine as a premedication in blunting the haemodynamic response to laryngoscopy and tracheal intubation.

This prospective, randomised, comparative study was conducted in 100 American Society of Anesthesiologists (ASA) I, II patients. The primary outcome was to evaluate the effects of dexmedetomidine nebulisation in blunting the stress response to laryngoscopy and intubation. The secondary outcome was to study its adverse effects. The study population was divided randomly into two groups. Control group C (
= 50) received nebulisation with 5 ml of normal saline and group D (
= 50) received 1 μg/kg dexmedetomidine 5 ml 10 min before induction in sitting position.

Demographics were comparable. Following laryngoscopy and intubation, systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP), response entropy (RE) and state entropy (SE) were markedly increased in the control group whereas in group D there was a fall in SBP (at 1 min-126.64 ± 26.37;
0.01, 5 min-109.50 ± 16.83;
0.02, 10 min-106.94 ± 17.01;
0.03), DBP (at 1 min-83.18 ± 17.89;
0.001, 5 min-66.40 ± 13.88;
0.001, 10 min- 62.56 ± 14.91;
0.01) and MAP (at 1 min-99.68 ± 19.22;
0.001, 5 min- 84.08 ± 13.66;
0.003, 10 min- 81.74 ± 14.79;
0.008), RE and SE which was statistically significant (
0.002). There was a dose sparing effect of propofol in group D; sedation score was comparable.

Nebulised dexmedetomidine effectively blunts the stress response to laryngoscopy and intubation with no adverse effects.
Nebulised dexmedetomidine effectively blunts the stress response to laryngoscopy and intubation with no adverse effects.
Lumbar spinal fusions have post-operative pain levels that can be difficult to treat. The objective of this study was to determine if using bilateral quadratus lumborum (QL) nerve block catheters for lumbar fusions changes the patient's post-operative recovery experience by reducing opioid consumption, thereby limiting potential risks and side effects and reducing recovery time.

There were a total of 52 surgical lumbar fusion patients in this single-center, retrospective cohort review. In control Group A, there were 26 patients who received opioid regimens. In control Group B, there were 26 patients who received bilateral QL block catheters with breakthrough opioid regimens. Forty-eight hour post-operative opioid use in oral morphine milligram equivalents (MME) and length of stay (LOS) from the post-anaesthesia care unit to hospital discharge were examined.

Group A had a mean MME of 307.62 ± 305.37 mg. Group B had a statistically significant lower mean total MME of 133.78 ± 152.66 mg (
= 0.012, α = 0.05). On an average, Group A required 2.3 times the MMEs than Group B. Group A had a mean LOS of 2.34 ± 1.87 days, whereas Group B had a lower mean LOS of 1.98 ± 0.51 days. This difference of 0.36 days was not statistically significant (
= 0.522, α = 0.05).

Surgical lumbar fusion patients who received the QL block catheter had a lower opioid requirement compared to standard opioid regimens. The study was underpowered to detect a difference in LOS.
Surgical lumbar fusion patients who received the QL block catheter had a lower opioid requirement compared to standard opioid regimens. The study was underpowered to detect a difference in LOS.
Endotracheal intubation is the predominant cause of airway mucosal injury, resulting in post-operative sore throat (POST), with an incidence of 20-74%, which brings immense anguish to patients. This study was conducted to evaluate and compare the efficacy of nebulised dexmedetomidine and ketamine in decreasing POST in patients undergoing thyroidectomy.

Patients were randomly allocated into two groups of 50 each; Group 1 received ketamine 50mg (1mL) with 4mL saline nebulisation, while Group 2 received dexmedetomidine 50μg (1mL) with 4mL saline nebulisation for 15 min. GA was administered 15 min after completing nebulisation. POST monitoring was done at 0,2,4,6,12 and 24h after extubation. POST was graded on a four-point scale (0-3). The statistical analysis were performed using Statistical Package for Social Sciences (SPSS) software version 17.0. Fisher Exact-t-test, Chi square test, Student t-test, Paired t test and repeated measure analysis of variance (ANOVA) were used for analysis.

The overall incidence of POST in this study was 17% POST was experienced by seven patients (14.3%) in ketamine and 10 patients (20.4%) in dexmedetomidine group (
= 0.424). There was no statistically significant difference in the incidence of POST between the two groups at 0,2,4,6,12 and 24h post-operatively. Severity of sore throat was also significantly lower in both groups at all time points. A statistically significant increase in heart rate, systolic and diastolic blood pressure was noted in ketamine group, post nebulisation.

Pre-operative dexmedetomidine nebulisation can be utilised as a safe and ideal alternative to ketamine nebulisation in attenuating POST, with less haemodynamic derangement.
Pre-operative dexmedetomidine nebulisation can be utilised as a safe and ideal alternative to ketamine nebulisation in attenuating POST, with less haemodynamic derangement.
A number of videolaryngoscopes (VLs) have flooded the Indian market. As per All India Difficult Airway Association 2016 guidelines, all anaesthesiologists should have access to a VL and must be trained to use it. We conducted an electronic survey to know the perception of Indian anaesthesiologists, who are members of the Indian Society of Anaesthesiologists (Karnataka State Chapter) towards the role of VL in the management of difficult airway (DA) and factors governing their use.

An electronic survey was sent to 2580 ISA members to know the availability, use and attitude towards VLs in the management of DA in adults. The survey was open for a period of 2 months and responses analysed.

The response rate was 25.8% (666 out of 2580). Zongertinib cost A total of 280 (42%) respondents had access to VL. The respondents rated VL as 4
preference for anticipated DA and 1
for unanticipated DA (if available). The most widely used VLs were C-MAC, Airtraq, and Kingvision. As per 133 respondents (20%), access to VL in institutes was restricted only to consultants and the main reason being cost.
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