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(1.5% of Lignocaine (15MG/ML) + 5 g/ml of Adrenaline) Adrenaline: Adrenaline 1 ampoule contains 1mg/ml Dilute to 10 ml = Each ml contains 100 g Take one ml of this and dilute to 5 ml. Then each ml contains 20 g/ml Lignocaine: To 3 ml of 2% Lignocaine (60 mg) add 1 ml of above solution (20 g/ml of Adrenaline) Total 4ml with 1.5% Lignocaine (60 mg/4=15mg/ml) plus 5 g/ml Adrenaline.
Over the past 25 years a variety of alternatives to conventional manual CPR have been developed in an effort to enhance perfusion during attempted resuscitation from cardiac arrest and to improve survival. Compared with conventional CPR, these techniques and devices typically require more personnel, training, and equipment, or they apply to a specific setting.
For Adults: Women: Typically, a 7.0-8.0 mm internal diameter (ID) tube is used. Men: Usually, an 8.0-8.5 mm internal diameter tube is appropriate. For Children: Neonates (birth to 1 month): 3.0-3.5 mm ID. Infants (1 month to 1 year): 3.5-4.0 mm ID. Toddlers (1-3 years): 4.0-5.0 mm ID. Preschoolers (3-5 years): 5.0-6.0 mm ID. School-age children (6-12 years): 6.0-7.0 mm ID.
Introduction Hip fracture is the commonest reason for a frail older person to need an anaesthetic and operation. However, the immediate physiological stress experienced by these patients is the pain and blood loss associated with the fracture. High quality anaesthetic care is crucial to the effective management of both stresses. Association of Anaesthetists of Great Britain and Ireland in 2012 issued guideline on The Management of Proximal Femoral Fracture.
Death or permanent disability from anaphylaxis in anaesthesia may be avoidable if the reaction is recognised early and managed optimally. Recognition of anaphylaxis during anaesthesia is usually delayed because key features such as hypotension and bronchospasm more commonly have a different cause. If anaphylaxis is suspected during anaesthesia, it is the anaesthetists responsibility to ensure the patient is referred for investigation.
Retired anesthesiologists can contribute in various roles beyond traditional clinical practice, including mentoring younger colleagues, serving as consultants, or engaging in research and education. Some may also choose to continue working part-time or in different capacities, like administration or specialized clinical settings. Distribution of anaesthetists by age and country.
Until now, awake fibreoptic intubation (FOI) was the most widely recommended technique for the management of the anticipated difficult airway. However, awake FOI is becoming more and more obsolete and used only by a few airway enthusiasts. Recent evaluations of the awake videolaryngoscope guided intubation (VLI) strongly suggest that this technique is not only a suitable alternative to awake FOI but should now be the 1st choice technique for managing anticipated difficult airway.
INTRODUCTION: Peripartum cardiomyopathy is a form of acute and sometimes severe cardiac degeneration that leads to clinical heart failure during pregnancy or in the early postpartum period. The disorder is generally defined as maternal heart failure with systolic dysfunction (left ventricular ejection fraction, <45%) that develops in the last month of pregnancy or in the first 5 months after delivery, in the absence of known preexisting cardiac dysfunction.
Introduction: The acute pain is defined as pain that is present in a surgical patient after a procedure. Such pain may be the result of trauma from the procedure or procedure-related complications. Pain management in the perioperative setting refers to actions before, during, and after a procedure that are intended to reduce or eliminate postoperative pain before discharge.
Throughout the perioperative period, the goals of anesthetic management for left-to-right shunts are to decrease the shunt flow and maintain cardiovascular and respiratory stability to provide adequate tissue perfusion and oxygenation. Effects of Ketamine versus propofol in children with cardiac shunting: the principal hemodynamic effect of propofol is a decrease in systemic vascular resistance (SVR).
There is an assumption that anaesthesia started in the 1840s when nitrous oxide and ether were administered in a few affluent countries for the first time. Japanese historians have shown that a very effective herbal based oral anaesthetic agent was perfected some 40 years before this by Seishu Hanoaka. But even this is not the start of anaesthesia. While the use of opium poppy and other herbal remedies as anesthetics date back to early civilization.
FACTORS THAT INFLUENCE THE MECHANICS OF ARTIFICIAL VENTILATION: The forces that impede ventilation include non-elastic or respiratory system resistance, which occurs when gas flows within the airway circuit, and elastic resistance, which occurs in the absence of gas flow in the circuit. Examples of non-elastic resistance include frictional resistance to gas flow, viscoelastic resistance from the deformation of thoracic tissues, and finally, the inertia of gas flow and tissue movement.
I am not arguing that a static CVP value should be used to predict a patient’s volume status, or volume responsiveness? Absolutely not. However, there is tremendous meaning in the CVP as the starting point for a basic lesson in hemodynamics. The CVP is the fulcrum of cardiovascular physiology at the bedside; understanding the genesis of the CVP lays the foundation for interpretation of hemodynamic intervention in the ICU as well as interpretation of bedside echocardiography.
INTRODUCTION: The importance of functional right ventricular failure and resultant splanchnic venous congestion has long been under-appreciated and is difficult to assess by traditional physical examination and standard diagnostic imaging. The recent development of the venous excess ultrasound score (VExUS) and growth of point-of-care ultrasound in the last decade has made for a potentially very useful clinical tool.
1. CONGENITAL HEART DISEASE (CHD) Atrial septal / ventricular septal defects in pregnancy are often well tolerated during pregnancy. When anaesthetizing patients with CHD, using either a regional technique or general anaesthesia, the following factors must be kept in mind; prevention of accidental intravenous infusion of air bubbles, when planning epidural anaesthesia, loss of resistance to saline rather than air should be used to identify the epidural space , a slow onset of epidural analgesia
2. VALVULAR HEART DISEASE i) MITRAL STENOSIS: Anaesthetic considerations are to maintain a slow heart rate, venous return and SVR, avoid aorto-caval compression, treat atrial fibrillation (AF) aggressively, try and maintain sinus rhythm, prevent pain, hypoxaemia, hypercarbia and acidosis as these can increase PVR. Both general anaesthesia and regional techniques have been used.
iii) AORTIC STENOSIS: Anaesthetic management in AS is to avoid tachycardia, and bradycardia, maintain intravascular volume and venous return, avoid aortocaval compression, and myocardial depression, maintain a normal heart rate as a slow heart rate decreases cardiac output (CO). Tachycardia may decrease time for coronary perfusion of the hypertrophied LV.
3. PRIMARY PULMONARY HYPERTENSION: Anaesthetic management is similar to that of the Eisenmenger syndrome. Elective caesarean section is the preferred method of delivery. Both regional and general anaesthesia can be used for caesarean delivery. For regional anaesthetic technique using a slow induction epidural anaesthesia is advised. Vasopressors are only used if absolutely necessary, as they increase pulmonary artery pressure.
5. MATERNAL ARRHYTHMIAS DURING PREGNANCY: Management of arrhythmias during pregnancy is similar to that in the non-pregnant patient. Congenital heart block and bradyarythmias If congenital heart block is recognized in a pregnant woman, cardiac consultation should be taken, to determine whether there is need of a pacemaker. A pacemaker is indicated in patients with symptoms, when Q-T interval is prolonged or there is left atrial enlargement.
ANESTHESIA FOR CESAREAN DELIVERY FOR CARDIAC PATIENTS: • Patients with mWHO class I or II cardiac disease typically tolerate a traditional intrathecal dose of local anesthesia (eg, hyperbaric bupivacaine 10–15 mg) for cesarean delivery. Depending on the cardiovascular lesion, patients with mWHO class III or IV lesions may benefit from a more gradual-onset sympathectomy. • Neuraxial anesthesia for most patients with cardiac disease undergoing caesarean delivery should be considered.
1. Immediately communicate to the surgery team and the operating room (OR) staff that the patient’s status may be compromised. 2. Ensure adequate oxygenation; increase the fraction of inspired oxygen (FiO2) to 100% to improve oxygen saturation as measured by pulse oximetry (SpO2) 3. Decrease anesthetic depth 4. Expand monitoring to include 12-lead ECG, or order it immediately if in the pre- or postoperative area 5.
INTRODUCTION: Perioperative ARF (Acute Renal Failure) accounts for 20–25% of cases of hospital-acquired renal failure. It is also associated with a high risk of infection, prolonged intensive care unit (ICU) and hospital stay, progression to chronic renal failure (CRF), and dialysis-dependent end-stage renal disease (ESRD). The chance of full recovery from an episode of ARF in the surgical setting is only 15%—many patients progress to develop varying degrees of chronic renal dysfunction.
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