Our Experience of Conscious Sedation as an Anaesthetic Technique in patients undergoing Automatic Implantable Cardioverter Defibrillator.

Ten patients with life threatening ventricular arrhythmias who underwent placement of automatic cardioverter defibrillator ( AICD) under conscious sedation are reported. Our clinical experience, patient,s satisfaction, recovery profile and complications of the technique of conscious sedation is presented and discussed.

Congenital Absence of Pericardium: A Rare Case Associated with Severe Mitral Stenosis with Pulmonary Hypertension.

We report a rare case of congenital absence of pericardium in a 35 year old middle-aged man, who underwent closed mitral commissurotomy done for severe mitral restenosis developed after Percutaneous Transluminal Mitral Commissurotomy (PTMC) six months back. Operation was done under General Anaesthesia through left anterolateral thoracotomy. Pericardial defect was discovered intraoperatively. There was no clinical symptom that could be clearly related to the defect of the pericardial sac pre-operatively. The recovery of the patient was satisfactory and uneventful.

Cervical Epidural Anesthesia for Carotid Endarterectomy.

The successful anaesthetic management using a cervical epidural technique is reported in patients undergoing carotid artery surgery. Adequate analgesia is obtained and the adequacy of cerebral blood flow is easily judged by the patient’s state of consciousness. Cervical epidural anaesthesia could be a safe and reasonable technique for the management of patients who need carotid artery surgery.1 A 54 years old man of A.S.A (American Society of Anesthesiologists) grade- II underwent carotid endarterectomy under Cervical Epidural Anaesthesia (CEA) at C7 – T1 level using a mixture of 0.5% Lidocaine, 0.25% Bupivacaine and Fentanyl citrate. Standard peroperative monitoring including invasive arterial blood pressure and arterial blood gas analysis was done.