Transthoracic echocardiography is a potent and appealing diagnostic tool by virtue of rapidity, noninvasiveness, and repeatability. Focus-assessed transthoracic echocardiography (FATE) forms quick guidance to interpret the echocardiographic information and relates it to the clinical context. It can be applied in the perioperative period, intensive care units (ICUs), and emergency situations, in trauma and as resuscitation aids. FATE intents to assess cardiac function including contractility, chamber size and hypertrophy, valvular dysfunction, cardiac tamponade, and pericardial and pleural effusions. Thence, FATE has become a quintessential scanning tool perioperatively and in ICUs.

Introduction Conventional strategy in the postoperative ventilation was a long-established practice in former times but now fast tracking is an acknowledged technique. This study was embarked to assess the impact of ultrafast tracking on patient recovery and length of stay in intensive care unit (ICU) compared with conventional methods in off-pump coronary artery bypass (OPCAB) patients. Methods Fifty patients were enrolled in each group. Exclusion criteria were patients with ejection fraction > 30%, hemodynamically unstable, on intra-aortic balloon pump, associated valvular heart disease, and intraoperative conversion to on-pump coronary artery bypass grafting. Ultrafast tracking of anesthesia (UFTA) protocol included induction with low dose fentanyl, propofol, and vecuronium. Maintenance of anesthesia was done with sevoflurane, fentanyl, and atracurium whereas analgesia was done with tramadol and paracetamol. Results Statistical analysis was done with SPSS 21.0 program. Fischer’s test, chi-square test, independent t-test/Mann–Whitney U tests were used for calculations. Extubation time was statistically significant (p = 0.0001). Shift to ward was 3.96 ± 0.73 days in UFTA group and 4.34 ± 0.66 days in conventional group which proved statistically significant (p = 0.0073). No patients in both groups had postoperative myocardial infarction, stroke, low cardiac output, or mediastinitis. Renal failure and mortality were 2% in conventional group. Hypothermia, pacemaker dependency, blood transfusion, inotrope score, atrial fibrillation, re-exploration, and reintubation were monitored. No reintubation occurred in UFTA group. Conclusion UFTA appears to be safe and effective in OPCAB patients with early shift from ICU without any major complications.

Stroke culminates into 6.2 million deaths annually and is thereby a leading cause of disability and death worldwide. In patients undergoing noncardiac, nonneurological surgery, perioperative stroke can eventuate into a catastropic aftermath with almost eight-fold rise in mortality. In cardiac, neurological, and carotid surgery, stroke rate accounts to be high (2.2%–5.2%) and is a significant instigator of morbidity and mortality as well. These facts kindle interest to review the predictive parameters, preventive measures, and all the possibilities in the management and protection against perioperative stroke.

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Background and Aims:Magnesium, a physiological antagonist of calcium and N-methyl-d-aspartate, has a role in the prevention of pain in patients undergoing surgery for peripheral vascular diseases with cardiac comorbidities such as ischaemic heart disease and coronary artery disease. The objective of our study was assessment of effects of epidural magnesium in cardiac patients undergoing vascular surgery.Methods:Sixty patients of either sex American Society of Anesthesiologists physical status III undergoing surgeries for peripheral vascular diseases were enrolled. The control group had 30 patients who received levobupivacaine 0.25% 10 ml with fentanyl 50 μg while 30 patients in study group received levobupivacaine 0.25% 10 ml with fentanyl 50 μg and magnesium 100 mg. The primary outcome was duration of analgesia. Sedation score, pain assessment using visual analogue scale (VAS), systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR) and fentanyl consumption were also recorded. Statistical analyses were performed using Minitab 15 statistical software.Results:Both groups were similar demographically and with respect to baseline HR, SBP, DBP and RR. In the study group, compared to the control group, duration of analgesia was 4.17 ± 1.07 h versus 1.55 ± 0.47 h (P < 0.01), sedation score were\ better (P = 0.003) and the VAS scores was lower (P < 0.01).Conclusion:Epidural magnesium, added to levobupivacaine and fentanyl as a single bolus dose effectively prolongs the duration of analgesia in high-risk cardiac patients undergoing peripheral vascular surgery.