Transoesophageal echocardiography (TOE) is regularly used in cardiac and also increasingly in non-cardiac surgeries. It has a leading role in the perioperative management of renal cell carcinoma with tumour extension into inferior vena cava. We report two cases in which TOE was of immense help for patient management. This report highlights the two cases where intraoperative TOE was of immense help to establish diagnosis, to modify surgical plan, to guide the surgeon during clamp placement, to monitor cardiac function, to rule out tumour embolism and to confirm the complete removal of tumour thrombus.

Introduction: Music is a non-invasive, inexpensive and non-pharmacological nursing intervention that has no side effects and can be effective when provided alongside the routine care in cardiothoracic and vascular surgery (CTVS) ward and intensive care unit (ICU). The objective of the study was to assess the effect of music on pain, anxiety and physiological parameters among the post-operative sternotomy patients from CTVS ward and ICU in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Methods: A randomized controlled trial research design was used to conduct the study among 70 post-operative sternotomy patients. The pain score, and anxiety level were recorded using Numerical Pain Rating Scale (NPRS) and post-operative anxiety scale, with the physiological parameters recorded for both groups before the music intervention, after the first post-operative day, and after the intervention on seventh post-operative day. Data were analyzed by SPSS software version 23. Results: There was a marked reduction in the mean score of pain, anxiety, systolic and diastolic blood pressure (SBP & DBP), heart rate and respiratory rate in the study group as compared to the control group. There was a significant difference between the mean score of pain, anxiety, SBP, DBP, heart rate, respiratory rate and oxygen saturation in both groups after the intervention. Conclusion: Music was found to be effective on pain, anxiety, diastolic blood pressure, heart rate and oxygen saturation among post-operative sternotomy patients. Thus, it is essential to include music as a tool in post-operative care.

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