Congenital lobar emphysema (CLE) or congenital lobar over inflation is a rare pulmonary anomaly that causes respiratory distress in neonates. CLE presents significant challenges in diagnosis and management. We reported a case of two-month old infant with respiratory distress and pneumonia related to CLE affecting the left upper lobe. Lobectomy was performed under general anaesthesia with spontaneous and controlled lung Ventilation. The case was challenging, as it involved careful and planned anaesthetic management of lung separation as well as prevention of hyperventilation of the un-involved lung.
Awake craniotomy for eloquent area surgery can be managed with different anaesthetic techniques ranging from local anaesthetic with or without intravenous sedation to intermittent general anaesthesia with or without instrumentation of the airway, known as awake—awake—awake, asleep—awake—awake and asleep—awake—asleep craniotomy. We present a case of 34 year old male who was diagnosed to have Right frontal low grade glioma. Tumor resection was planned and decided to perform craniotomy with the patient being awake during the procedure, to allow intraoperative cortical mapping in order to preserve the language and motor functions.
Objectives: A comparative study to evaluate effect of pre-operative administration of oral aspirin and precurarization (with pancuronium) in prevention of suxamethonium induced myalgia.
Methodology Design and setting: Tertiary care teaching hospital. Subjects: The present study was carried out on 75 patients in age group of 16-65 years belonging to ASA grade I or II. The cases undergoing surgery under general anaesthesia where endotracheal intubation was considered desirable and in whom aspirin was not contraindicated.
Results: In entire case series of 75 patients, 52 (69.3%) had fasciculation. Out of them Group I patients has least i.e. 24% while group II and Group III had equal i.e 92%of patients having fasciculation.
Conclusion: Preoperative aspirin 600mg orally 1 hr before operation effectively reduces Suxamethonium induced pain and avoid complications associated with pretreatment with non-depolarising agents.
Key words: Oral aspirin, Suxamethonium, Fasciculation.
To evaluate the effect of oral atropine premedication in infants attenuates cardiovascular depression during halothane anaesthesia.
Methodology Design and setting:Tertiary care teaching hospital.Subjects:A double blind study was conducted on 60 patients of paediatric age group of ASA Grade I were divided into Group A(4-9 months) & Group B(10-15 months). Patients of both the groups were randomly placed into premedication subgroups: subgroup I (Placebo), subgroup II (Lo Dose, 0.02mg/kg), subgroup III (Hi Dose, 0.04mg/kg) with 10 patients in each group.
Results:Oral atropine given one hour before the induction of anaesthesia in the doses of 0.02mg/kg and 0.04mg/kg is effective in attenuating cardiovascular depression caused by halothane which is the most commonly used inhalational anaesthetic agent in paediatric patients.
Conclusion:Oral atropine given one hour before the induction of anaesthesia was effective in attenuating cardiovascular depression caused by halothane which was the most commonly used inhalational anaesthetic agent in paediatric patients.
Key words: Oral atropine, Premedication, Halothane Anaesthesia, Cardiovascular depression.
Thyroid swellings rarely present as cystic masses in neck laterally. Mostly cystic neck masses appearing in neck are usually benign. However, they may occasionally have a sinister origin and should be investigated rigrously. Thyroid cysts most often result from cystic degeneration in an adenomatous nodule. ² Brachial Cysts, dermoid cysts and epidermoid cysts are the most common benign neck cysts. Presentation of thyroid tissue as a cystic mass in the lateral side of the neck is rare . We present a rare case of multicystic swelling in left supra-clavicular region of neck with no other thyrotoxic or pressure features . The swelling appeared to be malignant during surgery on gross examination, but turned to be a benign thyroid cyst by histopathological examination.
Keywords: multicystic, thyroid cyst, cystic degeneration