Percutaneous nephrolithotomy (PCNL), a minimally invasive method for removal of renal calculi, was initially started in the 1950s but gained popularity about two decades later and has now become standard practice for management. There has been an immense improvement in technique and various guidelines have been established for treatment of renal stones. However, it has its own share of complications which can be attributed to surgical technique as well as anesthesia related complications. PubMed and Google search yielded more than 30 articles describing the different complications seen in this procedure, out of which 15 major articles were selected for writing this review. The aim of this review article is to describe the implications of the complications associated with PCNL related to the anesthesiologist. The anesthesiologist is as much responsible for the management of the patient perioperatively as the surgeon. Therefore, it is mandatory to be familiar with the various complications, some of which may be life threatening and he should be able to manage them efficiently. The paper also analyses the advantages and drawbacks of the available options in anesthesia, that is, general and regional, both of which are employed for PCNL.

The teaching curriculum in anesthesia involves traditional teaching methods like topic-based didactic lectures, seminars, and journal clubs; intraoperative apprenticeship; and problem-based learning (PBL) and simulation. The advantages of incorporating PBL in anesthesia teaching include development of skills like clinical reasoning, critical thinking, and self-directed learning; in addition it also helps in developing a broader perspective of case scenarios. The present paper discusses the characteristics, key elements, and goals of PBL; various PBL methods available; lacunae in the existing knowledge of PBL research; its current status and future perspectives in anesthesia teaching.

Traumatic diaphragmatic hernia (TDH) is generally a consequence of thoraco-abdominal trauma. Anaesthetic problems arise due to herniation of abdominal contents into the thoracic cavity causing diaphragmatic dysfunction, lung collapse, mediastinal shift and haemodynamic instability. Diagnosis depends on history, clinical signs and radiological investigations. Sometimes, it may be misdiagnosed as hydropneumothorax due to the presence of air and fluid in the viscera lying in the pleural cavity. We report a case of TDH mimicking hydropneumothorax on radiological investigations and subsequent surgical management, which led to serious complications.

Minimal mandatory monitoring in the perioperative period recommended by Association of Anesthetists of Great Britain and Ireland and American Society of Anesthesiologists are universally acknowledged and has become an integral part of the anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, transesophageal echocardiography, advanced neurological monitoring, improved alarm system and technological advancement in objective pain assessment. Various factors that need to be considered with the use of improved monitoring techniques are their validation data, patient outcome, safety profile, cost-effectiveness, awareness of the possible adverse events, knowledge of technical principle and ability of the convenient routine handling. In this review, we will discuss the new monitoring techniques in anesthesia, their advantages, deficiencies, limitations, their comparison to the conventional methods and their effect on patient outcome, if any.