A comparative study of intrathecal bupivacaine and levobupivacaine for patients undergoing caesarean section

Background: The present study was conducted to compare the effects of 0.5% isobaric levobupivacaine and 0.5% hyperbaric bupivacaine in pregnant females undergoing caesarean section.Methods: Study was conducted on 100 pregnant females undergoing caesarean section. They were randomly divided into two groups B and L receiving 2 ml of 0.5% hyperbaric bupivacaine and 0.5% levobupivacaine respectively. Two groups were compared with regard to sensory block, motor block, haemodynamic stability and complications if any.Results: Time to achieve sensory blockade till T6 dermatome was prolonged in group B (162.52±80.55 sec) as compared to group L (139.40±49.79 seconds) (p value= 0.087). Prolonged duration of motor blockade was observed in group B (160.76±6.56 minutes) as compared to group L (131.48±14.42 minutes) (p<0.001). Less haemodynamic stability was seen in patients of group B with more incidence of hypotension and bradycardia.as compared to group L.Conclusions: Levobupivacaine is nearly equally effective to bupivacaine to produce sensory and motor blockade with comparable onset time and better haemodynamic stability with lesser side effects.

Retrograde Intubation An Alternative Way For Endotracheal Intubation Using Epidural Catheter As A Guide – A Case Report

Patients having restricted mouth opening and limited movement of tempro-mandibular joint present as difficult airway scenario. Fibre-optic assistance is a gold standard technique for anticipated difficult intubation, but it’s availability and expertise still is a challenge at most of places worldwide especially in developing countries.The retrograde intubation technique can be an alternative and less invasive than other emergency surgical airway options for such cases. We present a case of difficult intubation, successfully managed with the help of retrograde intubation.

Anaesthetic Management of an Infant with Myocarditis for Non-Cardiac Surgery

We report a case of two months old infant diagnosed with acute myocarditis, with a ventricular septal defect (VSD) of 0.9 mm size, admitted to our hospital with gangrene of left foot. A below knee amputation was planned under general anaesthesia with caudal block. Digoxin and diuretics were continued. Induction was done with fentanyl and sevoflurane and supraglottic device was used to secure the airway. Caudal block with bupivacaine was administered.The recovery was satisfactory and postoperative stay was uneventful.

Anesthetic Management of Sacrococcygeal Teratoma- A Case Report

Sacrococcygeal teratoma is a tumour of new born which is derived from germ cells. It is mostly found in female child and has good prognosis if complete resection of the tumour along with coccyx done early. Recurrence or turning into malignant form is uncommon if careful resection is done early. Here we describe anesthetic management of a suspected case of sacrococcygeal teratoma in a new born baby.

Ludwig’s Angina: A Challenge for Anaesthesiologist

Ludwig’s angina is an aggressive, rapidly spreading cellulitis of the floor of mouth and neck. It is less frequently seen in children as compared to adults. Successful management of Ludwig’s angina requires proper understanding of the anatomy, appropriate antibiotic therapy and surgical drainage whenever needed. Airway management is of prime concern and should be done with prior planning and cooperation of surgeon and anaesthesiologist. We hereby describe the successful management of Ludwig’s angina in a 3 year old child.