RESUMEN
Patients with intraoral mass may present to anesthesiologists for various diagnostic or definitive procedures. These patients may be challenging not only due to inherent airway problems associated with tumour mass but also due to comorbid conditions. Pedunculated lipoma arising from the buccal mucosa is rare. We report the anticipated airway difficulty encountered in a 55-year-old male patient with an intraoral pedunculated lipoma made easy by the patient by facilitating the mass out of the oral cavity manually
RESUMEN
Our knowledge about thyroid function during pregnancy has made rapid strides in the recent past. However, there are not much published reports in anesthesia literature regarding these newer developments. Even though an anesthesiologist is not the primary care physician, he/she may occasionally encounter pregnant patients with thyroid dysfunction in routine practice of anesthesia. This article aims to update anesthesiologists about recent developments in understanding of thyroid physiology during pregnancy, effects of thyroid dysfunction on mother and fetus, interpretation of thyroid function tests as well as treatment and anesthetic considerations
RESUMEN
Background and Aims: Brachial plexus block is a useful alternative to general anaesthesia. Postoperative analgesia is an added advantage. Midazolam, a water soluble benzodiazepine has been used by various routes to prolong analgesia
The present study was undertaken to assess the analgesic efficacy of midazolam with bupivacaine in brachial plexus block
Methods : A prospective, randomized, double blind study was done at Karnataka Institute of Medical Sciences [KIMS], Hubli [India], from 01 March 2008 to 01 March 2009, on 50 adult patients of ASA1 and 2, aged between 18-65 years and scheduled for various upper limb surgeries. Patients were divided into two groups of 25 each. Group B received 30ml of inj. bupivacaine 0.5% +2ml normal saline and group BM received 30ml of inj. bupivacaine 0.5% + inj. midazolam [preservative free] 0.05mg/kg. Patients were observed for sedation, respiratory depression, pulse rate, SBP, DBP, duration of motor block, duration of pain relief and occurrence of any complications
Resutls: Post operative analgesia was significantly longer [805.04 175.75 min] in group BM, as compared to group B [502.24 52.68 min] with p value <0.001. Pain score was significantly low in group BM [mean 1.6], compared togroup B [mean 4.92] at 12 hours postoperatively. Onset of sensory block was 8.36 3.58 min and 8.52 4.18 min in group B and groupBMrespectively with p value >0.05. Hence there was no statistically significant difference. Onset of motor block in group B was 9.96 5.69 min and in group BM 7.92 5.68 min. and p value was >0.05 min. Hence there was not statistically significant difference Mild respiratory depression and sedation occurred intraoperatively in groupBMwhich required no active intervention
Addition of midazolam 50mcg/kg to 30ml of bupivacaine 0.5% for supraclavicular brachial plexus block prolonged sensory blockade and post-operative analgesia without increasing the risk of adverse effects