The point prevalence of PAH was 4.2% in our cohort of patients with SLE. Most of the PAH cases were found to be of mild severity (<40 mmHg). The significant association of LAC and presence of APS in PAH cases suggests that thrombosis may play an important role in PAH with SLE. This is important, as it is treatable.
Background: Ultrasonography is a newer tool for identification of nerves in the practice of regional anaesthesia. Visualization of target structures and spread of drugs under direct vision and thus avoiding complications like pneumothorax, accidental intravascular injections are potential benefit of ultrasonography technique. Aim of the study was to examine the usefulness of ultrasound guided brachial plexus block and compare it with paresthesia technique with the believe that ultrasound guidance can shorten the onset as well as increase the duration of blockade..Methods: Eighty patients of either sex, 18-60 years, posted for upper limb surgery were divided into 2 groups according to the technique used to give block, group US (ultrasound technique) and group PA (paresthesia technique). Both the groups received 0.5 % bupivacaine 20 ml with 8 mg of dexamethasone.Results: There was notable difference between the patient groups with regard to initiation of motor blockade (10 min group US vs 11.1 min group PA, p <0.0156) and sensory blockade (5.16 min group US vs 6.96 min group PA, p <0.0001) also duration of motor blockade (1272.88 min in group US vs 899.25 min in group PA, p <0.0001) and sensory blockade (1343.88 min in group US vs 996.75 min in group PA, p<0.0001).Conclusions: Ultrasound guided supraclavicular brachial plexus blocks result in a higher success rate with respect to onset and duration of blockade with less incidence of complications compared to paresthesia technique.
<p class="abstract"><span lang="EN-US">Perioperative cardiac arrests represent the most serious complication of anesthesia and surgery. It is believed that the incidence and mortality of cardiac arrest has declined because of advanced and increased surgical acuity and patients with extremes of age. We described a case of 31 year old male who had deterioration of cardiorespiratory and hemodynamic status in half an hour period after giving spinal anesthesia for hydrocoele operation. After half an hour of giving spinal anesthesia, patient developed supraventricular tachycardia followed by ventricular tachycardia progressed to cardiorespiratory arrest in a fraction of 2 to 3 minutes. He was unconscious and convulsing. Fortunately, this patient was successfully resuscitated with timely and appropriate measures in form of endotracheal intubation, cardiac defibrillation, antiarrythmic and inotropic cardiac medications and anticonvulsant drugs. Patient was shifted to ICU with ionotropic support and anticonvulsant infusion. Patient had apparently no previous cardiorespiratory or neurological complaints. Post-operative MRI report showed right cerebello-pontine angle cistern lesion suggestive of epidermoid cyst.</span></p>
<p class="abstract"><span lang="EN-US">High morbidity and mortality occur in patients with pulmonary hypertension (PH) undergoing non-cardiac surgery under any type of </span>anaesthesia<span lang="EN-US"> technique. Right heart failure occurs due to increased pressure in pulmonary artery secondary to pain, stress and ventilation. It is important to maintain preload, ventricular contractility, pulmonary vascular resistance and right ventricular afterload. It is also necessary to avoid hypoxia, hypercarbia, hypothermia and pain. A 45 year old male patient, known case of chronic obstructive pulmonary disease (COPD) with severe PH was posted for ileostomy closure. General </span>anaesthesia<span lang="EN-US"> (GA) with epidural catheter for analgesia was given.</span></p>
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