Gaurav Sindwani

Saviour of stylet injuries: 'Ryle's tube'

How to cite this article: Kaushal A, Bindra A, Singh S, Saeed Z. Modification of intravenous cannula for arterial line insertion: Simple yet effective technique. Indian J Anaesth 2018;62:397-9.

Quadratus lumborum block failure: “A must know complication”

1016 Indian Journal of Anaesthesia | Volume 61 | Issue 12 | December 2017 the supplementary advantage of lower rates of infection. Prevention of leak from anastomosis site is essential, as post‐transplant patients on immunosuppressants are at high risk of a leak. Protection of anastomosis can be assured by making a temporary diversion stoma. If the patient is on cyclosporine, it predisposes them to deep vein thrombosis.[2] Hence, prophylaxis in the form of unfractionated heparin or dose‐adjusted low molecular weight heparin is advised.[5]

Facial skin injury caused by acrylate-based adhesive tapes in a post-menopausal patient: A preventable cause

1. Paediatric Epidural and Caudal Analgesia and Anaesthesia in Children. NYSORA; 2014. Available from: http://www. anes-som.ucsd.edu/Intranet/Peds_Resources/Regional/. [Last cited on 2015 Oct 24]. 2. Pinciroli R, Fumagalli R. The unexpected epidural: A case report. BMC Anesthesiol 2015;15:83. 3. Joselyn A, Bhalla T, Schloss B, Martin D, Tobias J. A case report of a retained and knotted caudal catheter. Saudi J Anaesth 2014;8:424-7. 4. Huang J, Lawrence J, Sposato M. Another case of knotting of an epidural catheter. AANA J 2010;78:93-4. 5. Browne RA, Politi VL. Knotting of an epidural catheter: A case report. Can Anaesth Soc J 1979;26:142-4. 6. Pant D, Jain P, Kanthed P, Sood J. Epidural catheter breakage: A dilemma. Indian J Anaesth 2007;51:434-7. Available from: http://www.ijaweb.org/text.asp?2007/51/5/434/61178. [Last cited on 2015 Oct 01]. 7. Lenox WC, Kost-Byerly S, Shipley R, Yaster M. Pediatric caudal epidural catheter sequestration: An unusual complication. Anesthesiology 1995;83:1112-4. 8. Mitra R, Fleischmann K. Management of the sheared epidural catheter: Is surgical extraction really necessary? J Clin Anesth 2007;19:310-4.

Anesthetic management of a patient with Yamaguchi syndrome for laparoscopic radical nephroureterectomy

© 2017 Annals of Cardiac Anaesthesia | Published by Wolters Kluwer Medknow The Editor, A 64‐year‐old female diagnosed as a case of transitional cell carcinoma of the ureter. During preanesthetic checkup, we found hypertensive and electrocardiogram (ECG) showed high‐voltage QRS complexes with deep T‐wave inversion in the chest leads V1‐6 and ST segment depression in leads V5‐6 [Figure 1a]. ECG and echocardiography, showing apical hypertrophy of left ventricle with Grade‐1 diastolic dysfunction without any regional wall motion abnormality, were diagnosed as a case of apical variant of hypertrophic cardiomyopathy (HCM). The gradient across left ventricle was normal without systolic anterior motion of mitral leaflet and no left ventricular outlet obstruction [Figure 1b]. Holter monitoring to rule out any arrhythmia was normal. She was scheduled for laparoscopic radical nephroureterectomy with bladder cuff incision in right lateral kidney position under general anesthesia (GA) with epidural analgesia. She was premeditated with tablet alprazolam 0.25 mg night before surgery. Monitoring was initiated with ECG, noninvasive blood pressure, SpO2 and bispectral index (for depth of anesthesia monitoring). A large bore 16 G IV cannula and FloTrac (FloTrac System, Edward Life Sciences, USA) were used to monitor cardiac output, stroke volume variation, systemic vascular resistance throw 20 G arterial line under local anesthesia.

Anesthetic management of a patient with dilated cardiomyopathy and end-stage renal disease for emergency strangulated hernia repair surgery

Dilated cardiomyopathy (DCMP) is a myocardial disease associated with dilatation of one or both the ventricles, impaired myocardial contractility, decreased cardiac output, and increased ventricular filling pressures. Patients with end-stage renal disease are dependent on renal replacement therapy to survive and often manifest with a variety of pathological organ dysfunction. We present a case of DCMP and chronic kidney disease posted for emergency reduction of strangulated umbilical hernia under general plus epidural anesthesia.