Sumesh T. Rao

Ludwig's angina and airway considerations: a case report

IntroductionPatients with deep neck infections present challenging airways for an anesthesiologist. Patients with Ludwigs angina may die as a result of the inability to effectively manage the airway.Case presentationHere we discuss the anesthetic management with fiberoptic intubation of a 45-year-old man with Ludwigs angina scheduled for emergency drainage.ConclusionAwake fiberoptic intubation under topical anesthesia may be the ideal method to secure the airway in advanced cases of Ludwigs angina. When fiberoptic bronchoscopy is not feasible, not available or has failed, an awake tracheostomy may be the preferred option.

Comparative Study of Anti – Emetic Efficacy of Palonosetron with Ondansetron And Metoclopramide

Aim: This study was designed to assess the safety and efficacy of palonosetron in comparison with ondansetron and metoclopramide administered intravenously before general anesthesia for prevention of post operative nausea and vomiting. Patients and methods: A randomized prospective study was carried out in 60 patients aged 18-65 yrs of ASA grade I, II and III. They were categorized into 3 groups. Group P (n = 20) received Inj: palonosetron 0.25mg, Group O (n = 20) Inj: ondansetron 4 mg and Group M (n = 29) Inj: metoclopramide 10 mg. Results: Statistically, no significant difference was found in the anti-nausea efficacy of palonosetron compared to ondansetron and metoclopramide. Comparing overall incidence of vomiting showed that the antiemetic efficacy of palonosetron is the same as ondansetron and metoclopramide for post-operative emesis.

A comparative study of induction and recovery characteristics with Propofol and Halothane or Sevoflurane in Adult Day Case Surgeries

Introduction : For day case surgery to be effective, morbidity must be minimized. The choice of anaesthetic agent and technique is critical. Sevoflurane or propofol may be ideal agents owing to smooth, rapid induction and emergence and less PONV. This study aimed to compare these properties and adverse effects of sevoflurane and propofol. Material and Method Prospective study on 100 patients of ASA I or II, aged 18 to 70 years, scheduled for elective day case surgeries under general anaesthe- sia. Patients assigned randomly to one of two study groups: Group P/H, i.v. propofol (with lidocaine) induction and halothane/nitrous oxide maintenance; and Group S, sevoflurane/nitrous oxide induction and maintenance. Results Sevoflurane was associated with higher PONV than propofol/halothane, more adverse events during induction and agitation and distress in recovery.

Comparison of Post-Operative Analgesic Effects of Pre-Operative Pregabalin with Diclofenac in Head and Neck Surgery

Background: Study conducted to compare effects of pre-emptive pregabalin with diclofenac on post-opera- tive after head and neck surgery. Side effects assessed, and hemodynamics for 24 hrs post-operatively observed. Methods: Prospective, randomized, placebo-controlled clinical study on 66 ASA 1 and 2 patients between 18-60 yrs posted for elec- tive head and neck procedures. Patients were randomized in two groups. Pre-emptive analgesia was given 1 hr before surgery with • 75 mg diclofenac orally • 150 mg pregabalin orally Primary outcomes were severity of postoperative pain, and postoperative analgesic requirement (IM diclofenac 75mg). Secondary outcomes were incidence and severity of side-effects. Results: Patients in the pregabalin group: had less post-operative pain in the 12 - 24 hour period, were sedated more during the first 8 hrs, and less of them needed postoperative rescue analgesic, in lower doses. Conclusion: Oral pregabalin 150 mg administered pre-operatively was more effective in reducing postoperative pain and rescue an- algesic requirement in patients undergoing elective Head and Neck Surgeries compared to diclofenac.