One-lung ventilation (OLV) is a challenging task in infants and children as few techniques are possible because of narrow anatomy. The aim of this study is to evaluate and experience lung isolation with Fogarty catheters as a bronchial blocker placed by rigid bronchoscope for OLV in infants and children with lung pathologies requiring surgical management in an industrial hospital. This study is a prospective study carried out in J.L.N. Hospital and Research Centre, Bhilai (CG), from January 2011 to December 2014. The study was designed to place Fogarty catheter for achieving OLV using rigid bronchoscope in children. The patient and anaesthesia characteristics, placement and positioning of Fogarty catheters, intraoperative course, complications and recovery of the patient were studied. The data were then compared with the relevant and available literature. Over the study period of 4 years, 27 cases were included, out of which 22 (81.48 %) cases had suppurative lung disease, three cases (11.11 %) had hydatid cyst of the lung, whereas one case (3.7 %) each of congenital lobar emphysema and congenital cystic adenomatoid malformation of the lung, respectively. In all cases general anaesthesia was provided using single lumen endotracheal tube and one lung ventilation achieved by parallel placement of Fogarty catheter as a bronchial blocker with rigid bronchoscope. The surgical management included thoracotomy with decortication in 21 cases, thoracotomy with excision of hydatid cyst in 3 cases, video-assisted thoracoscopic surgery, thoracotomy with left upper lobectomy and thoracotomy with left lower lobectomy in one case each, respectively. There were no major intraoperative and postoperative complications. There was no mortality in our study. We conclude that rigid bronchoscope can be safely and effectively used to place Fogarty catheter in main bronchus in infants and children for achieving OLV.

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Purpose:Our objective was to study the pressor response to endotracheal intubation through laryngeal mask airway C-Trach and compare it to the hemodynamic response to intubation with direct laryngoscopy (DL).Materials and Methods:After obtained approval from institutional ethical committee, 100 patients of American Society of Anesthesiologists physical Status I, aged 14-65 years, posted for elective surgery were enrolled in the trial. They were randomly divided into two groups of each 50 patients. Anesthesia technique was standardized and patients of Group I were intubated using DL, while patients of Group II were intubated with the help of C-Trach assembly. Hemodynamic parameters, systemic blood pressure (systolic and diastolic) and heart rate were recorded before and after induction of anesthesia and every minute up to 5 min after intubation.Results:Patients of Group II recorded a minimal rise in peak systolic blood pressure (SBP) (1.8%) and diastolic blood pressure (10.6%). In comparison patients of Group I recorded a significant sustained rise in peak SBP (20.3%) and diastolic blood pressure (21.4%). However heart rate changes recorded in the two groups were of equal measure (peak rise of 22.9% in Group I vs. 22.4% in Group II).Conclusion:We conclude that intubation through C-Trach generates a lower pressor response to intubation in comparison to intubation using DL.

Maxillofacial trauma patients present with airway problems. Submandibular intubation is an effective means of intubation to avoid tracheostomy for operative procedures. Airway is secured with oral endotracheal intubation in paralyzed patient and tube is then transplaced in sub mental or submandibular region. However there may be instances when paralyzing such trauma patients is not safe and short term tracheostomy is the only airway channel available for conduction of anesthesia. We report a case of submandibular intubation in awake patient of maxillofacial trauma with anticipated intubation problems.

Background:  Venous thromboembolic (VTE), deep vein thrombosis (DVT) and pulmonary embolism (PE), cause significant morbidity, mortality and healthcare costs. Direct oral anticoagulant which has been demonstrated in clinical trials, anaesthetists need to be careful of how to minimize the risks of bleeding complications when treating patients who are taking an anticoagulant. Rivaroxaban, non-vitamin K antagonist direct oral anticoagulants (DOACs), was shown to be more effective regimens for the prevention of VTE after orthopaedic surgery. Aims and objectives: To look for the influence of timing of the first thromboprophylactic dose and clinical outcomes in patients undergoing orthopaedic surgery Method: Patients aged ≥18 years, with planned orthopaedic surgery or fracture-related orthopaedic surgery and in whom thromboprophylaxis has been indicated. Out of 324 patients selected for the study 164 received rivaroxaban 10 mg once daily and 160 received standard-of-care (SOC) pharmacological prophylaxis. Incidences of symptomatic thromboembolic events and bleeding events were analysed. Bleeding events and thromboembolic events recorded and calculated for the rivaroxaban and SOC groups.  Results: Overall major bleeding events observed in rivaroxaban group was  9 (5.49%) was much lower than the SOC group which was 13 (8.13%).The percentage of patients using mechanical methods alongside pharmacological thromboprophylaxis was slightly higher in   the rivaroxaban as compared to  SOC groups ( 64% and 55%). Overall thromboembolic effect was lower in rivaroxaban as compared to SOC group. Conclusion: Comparison of rivaroxaban & SOC shows the effectiveness and safety of rivaroxaban in patients undergoing major orthopedic surgery in clinical practice. Major bleeding events & thromboembolic with rivaroxaban were less as compared to SOC group.