Vanitha Rajagopalan | All India Institute of Medical Sciences, New Delhi (original) (raw)

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Papers by Vanitha Rajagopalan

Current neurology and neuroscience reports, 2014

Paroxysmal sympathetic hyperactivity (PSH) is characterized by the rapid onset and paroxysmal cyc... more Paroxysmal sympathetic hyperactivity (PSH) is characterized by the rapid onset and paroxysmal cycling of agitation and dystonia in association with autonomic symptoms. These symptoms may include the following: tachycardia, hypertension, tachypnea, fever, pupil dilation, decreased level of consciousness, diaphoresis, and ventilator dyssynchrony. In a critically ill patient, these are all nonspecific symptoms that may reflect impending sepsis, seizure, or a number of other complications. This can confound and delay the diagnosis and treatment of PSH. While this phenomenon has been frequently observed in the traumatic brain injured population, management is highly variable, prompting this review of the literature. This article aims to outline the evidence base for the management of PSH, as well as to describe an algorithm for management developed at our institution.

Perioperative Neuroscience, 2022

Essentials of Evidence-Based Practice of Neuroanesthesia and Neurocritical Care, 2022

Pharmacology in Clinical Neurosciences, 2020

Journal of Anaesthesiology Clinical Pharmacology, 2014

Saudi Journal of Anaesthesia, 2020

We report a patient who sustained catastrophic pulmonary fat embolism post-induction of general a... more We report a patient who sustained catastrophic pulmonary fat embolism post-induction of general anesthesia during laparotomy for haemoperitoneum. The source being the fractured shaft of fracture femur which was missed during the primary survey in the chaos of a positive focused assessment with sonography for trauma and a transient responding patient. In this case report, we want to emphasize the importance of primary survey in a trauma patient, effective communication and documentation to prevent errors and for better management of patients.

A patient with coronavirus disease-2019 (COVID-19) developed bilateral subcutaneous emphysema inv... more A patient with coronavirus disease-2019 (COVID-19) developed bilateral subcutaneous emphysema involving the neck and upper chest following the institution of noninvasive ventilation (NIV) for worsening hypoxia. We discuss the various causes, differentials and successful management of this patient.

Journal of Neuroanaesthesiology and Critical Care, Mar 1, 2020

Artificial intelligence (AI) already influences almost every sector of our daily life, including ... more Artificial intelligence (AI) already influences almost every sector of our daily life, including the rapidly evolving technologies and datasets of healthcare delivery. The applications in medicine have significantly evolved over the past few decades and have shown promising results. Despite constant efforts to incorporate AI into the field of anesthesiology since its inception, it is still not commonplace. Neuroanesthesiology and neurocritical care is a discipline of medicine that deals with patients having disorders of the nervous system comprising a complex combination of both medical and surgical disease conditions. AI can be used for better monitoring, treatment, and outcome prediction, thereby reducing healthcare costs, minimizing delays in patient management, and avoiding medical errors. In this review, we have discussed the applications of AI and its potential in aiding the clinician's judgment in several aspects of neuroanesthesiology and neurocritical care, some of the barriers to its implementation, and the future trends in improving education in this field, all of which will require further work to understand its exact scope.

Hiccup or hiccough is known by the medical term “singultus,” which is a derivative of the Latin w... more Hiccup or hiccough is known by the medical term “singultus,” which is a derivative of the Latin word “singult,” meaning “a gasp” or “a sob” [1]. Hiccups are characterized by involuntary, intermittent, repetitive, myoclonic, and spasmodic contractions of the diaphragm and the inspiratory intercostal muscles, leading to an abrupt and early closure of the glottis, terminating inspiration and generating the characteristic “hic” sound [2,3]. Both healthy adults and children commonly experience hiccup spells. In the fetus, hiccups play a physiological role by training the respiratory muscles for their breathing function, and as a reflex preventing amniotic fluid aspiration [4,5]. Transient episodes usually do not Hiccups in neurocritical care Vanitha Rajagopalan, MBBS, MD, DNB, DM; Deep Sengupta, MBBS, DNB, DM; Keshav Goyal, MBBS, MD, DM; Surya Kumar Dube, MBBS, MD, DM; Ashish Bindra, MBBS, MD, DM; Shweta Kedia, MBBS, MD, MCh Department of Neuroanaesthesiology and Critical Care, Neuroscie...

Indian Journal of Pain, 2020

Objective: Transcutaneous electrical nerve stimulation (TENS) is a common modality used to treat ... more Objective: Transcutaneous electrical nerve stimulation (TENS) is a common modality used to treat acute and chronic painful conditions. The aim of this study is to find out the effect of immediate preoperative TENS on intraoperative anesthetic drug consumption in patients undergoing lumbar discectomy under general anesthesia. Methods: Sixty patients undergoing lumbar discectomy were randomly divided into two study groups. In TENS group (Group T), TENS was applied for 1 h in the immediate preoperative period with 20 mA current, at 100 Hz frequency, in pulses of 250 μs on either side of the planned incision site. In Sham TENS group (Group S), TENS was applied for 1 h preoperatively to the patients, although with the current intensity set at “zero” mA. The pain intensity during rest as well as movement was recorded before and after TENS, by using the Visual Analog Scale (VAS) scores in both the groups. Intraoperatively, titrated doses of propofol were used to maintain a bispectral index value of 50 ± 5, and IV fentanyl was administered to maintain the heart rate and blood pressure within 20% of baseline values. Postoperatively, fentanyl 0.5 μg/kg IV was administered to achieve VAS of <4. Results: Application of TENS was found to significantly reduce the preoperative VAS score (P < 0.001). Intraoperatively, no difference in propofol and fentanyl consumption was observed in either group (P < 0.6) (P < 0.27). Recovery time and postoperative VAS scores recorded at various time intervals were comparable in both the groups. No difference in fentanyl consumption or rescue analgesia was noted in the postoperative period in both groups. Conclusions: Application of preoperative TENS provided immediate relief from pain, although without any significant decrease in the intraoperative or postoperative analgesic requirement. Furthermore, no difference was noted in the intraoperative anesthetic consumption.

Fundamentals of Pediatric Neuroanesthesia

Bali Journal of Anesthesiology

Journal of Neuroanaesthesiology and Critical Care

β-thalassemia are a group of inherited blood disorders with reduced hemoglobin levels. β-thalasse... more β-thalassemia are a group of inherited blood disorders with reduced hemoglobin levels. β-thalassemia major is the severe form of disease, and the patients often display an array of associated organ dysfunction which thus increase the risk associated with surgery and anesthesia. Patients with β-thalassemia major can have multiple pathological defects that may lead to thromboembolic events. Here, we report such a case who was complicated by occurrence of cerebral sinus thrombosis and presented for decompressive hemicraniectomy under general anesthesia. The anesthetic challenges during in such scenario have been discussed.