CPAP with air and oxygen to non-ventilated lung improves oxygenation during one lung anesthesia

Ten adult patients undergoing one lung ventilation for elective thoracotomy were selected. All these patients failed to maintain oxygen saturation [SaO[2]] > 90% despite administration of 100% oxygen to the non-ventilated lung [NVL]. These patients were studied for the efficacy of continuous positive airway pressure [CPAP] of the NVL using air and oxygen combination [FiO20.5] employing a variable FiO2CPAP system. It was observed that application of CPAP [5-10 cm H2O] with a mixture of air and oxygen to the NVL increased the SaO2 > 90% in all these patients. This could be attributed to nitrogen in air which prevented absorption atelectasis in the NVL. This produced a better ventilation/perfusion ratio and hence the increased oxygen saturation

Clonidine premedication: a useful adjunct in producing induced hypotension with total intravenous anesthesia for middle ear microsurgery

Thirty adult patients were studied to evaluate the role of oral clonidine premedication on the dose requirement of intraoperative labetalol to produce induced hypotension during total intravenous anaesthesia [propofol I fentanyl] for middle ear microsurgery. Also studied was surgeon's satisfaction and quality of recovery. Patients with oral clonidine [4 micro g/kg] premedication [Group-II, n-15] demonstrated insignificant [p>0.05] pressor response to laryngoscopy intubation. Group II patients needed a mean of only 4.2 mg labetalol to keep the intraoperative mean arterial pressure between 60-75 mmHg as compared to 25.0 mg required in the unpremedicated group [Group I, n-15]. Surgeon's satisfaction with the operative field was similar in both the groups. However recovery time was significantly prolonged in patients receiving oral clonidine premedication