Sandeep Loha | Banaras Hindu University, Varanasi (original) (raw)

Papers by Sandeep Loha

Anesthesia & Analgesia, 2013

Address e-mail to stefan.lakemeier@med. uni-goettingen.de.

Journal of Clinical and Diagnostic Research, 2022

Journal of Anesthesiology and Reanimation Specialists' Society

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Trends in Anaesthesia and Critical Care

Indian Journal of Clinical and Experimental Ophthalmology, 2020

To compare the incidence of oculocardiac reflex(OCR) between hang-back and conventional method of... more To compare the incidence of oculocardiac reflex(OCR) between hang-back and conventional method of rectus muscle recession in horizontal strabismus.In this prospective, randomized, double blind study, 40 consecutive patients of horizontal strabismus were evaluated. The patients were randomized into two groups based on the type of surgical recession technique employed for squint correction. Twenty patients were operated by Hang-back technique (group-1) and 20 by conventional rectus muscle recession where the muscle tendon was sutured directly to the globe (group-2). All patients underwent pre-operative evaluation which included refraction, keratometry and assessment of angle of deviation etc. ECG was monitored before surgery. During surgery heart rate (HR) was recorded as heart rate baseline (HRB), after 5 minutes of intubation (HR5), during muscle traction (HRT), Minimum heart rate during traction of muscle (HRMin), Maximum increase in heart rate (HRMax). OCR was defined as > 20% ...

Introduction: Laparoscopic cholecystectomy is now the gold standard for treatment of symptomatic ... more Introduction: Laparoscopic cholecystectomy is now the gold standard for treatment of symptomatic gallstones. After this surgery patients suffer visceral and shoulder pain secondary to peritoneal insufflation. Use of intraperitoneal and port site instillation of local anesthetics has been used to reduce postoperative pain and decreases the need for intravenous opioids. Studies regarding comparison of intraperitoneal use of ropivacaine and bupivacaine to reduce postoperative pain are few. This study compared the efficacy of ropivacaine and bupivacaine in reducing postoperative pain after laparoscopic cholecystectomy. Methodology: After ethical committee’s clearance and informed consent 100 patients with symptomatic cholelithiasis, aged 20-70 years, of either gender, ASA status I to III and within ± 20% of ideal body weight, scheduled for laparoscopic cholecystectomy were included. . Patients were randomized into two groups with 50 patients in each group. Group-B: Patients received 0.5...

Objective: Acute heart failure frequently happens in critically ill patients due to myocardial in... more Objective: Acute heart failure frequently happens in critically ill patients due to myocardial injury, cardiac dysfunction, arrhythmias, and inflammatory mediators. Till now, the outcomes of studies comparing levosimendan with dobutamine for patients requiring inotropic support remain controversial and ambiguous. The present study was aimed to compare the effects of levosimendan and dobutamine in the management of critically ill patients in ICU and establish preference of one over the other drug. Methodology: In this study 100 critically ill patients with clinical diagnosis of heart failure or impending heart failure due to any cause of age between 21 years to 80 years (left ventricular ejection fraction < 35%) in ICU were included and randomly divided into 2 groups; Group-1 (n=50) received inj levosimendan and Group-2 (n=50) which received inj dobutamine. The parameters recorded during study were: heart rate (beats/min), systolic blood pressure (mmHg), stroke volume (ml), cardia...

Interscalene block is a commonly done regional anesthesiatechnique for shoulder and upper arm sur... more Interscalene block is a commonly done regional anesthesiatechnique for shoulder and upper arm surgery. It has been used regularly as it is simple and achieves good and satisfactory block, but still it is not completely devoid of complications. In our case we have given interscalene block to a 45 year old male patient of ASA grade-I. Immediately after injecting the local anesthetic drug the patient became unconscious and unresponsive due to total spinal blockade. The patient was resuscitated and shifted to ICU where the he regained his consciousness after few hours and shifted to the ward without any neurological deficit.

Indian Journal of Clinical Anaesthesia, 2017

Introduction: Supraglottic devices are in regular practice in India for laparoscopic cholecystect... more Introduction: Supraglottic devices are in regular practice in India for laparoscopic cholecystectomy. Repeated use of supraglottic devices lead to risk of malfunction (herniation of cuff, inadequate seal) and transmissible infection. Proseal LMA is commonly used after cleaning many times due to economical factor. We plan this study to compare the leak fraction and incidence of gastric regurgitation after C-LMA with nasogastric tube and P-LMA in patients undergoing laparoscopic cholecystectomy. Materials and Method: Sixty adult patients of American Society of Anaesthesiologist I, II (ASA I, II) undergoing laparoscopic cholecystectomy under general anaesthesia were allocated randomly into two equal group to receive C-LMA with nasogastric tube or P-LMA. Patients who had any contraindication for using supraglottic devices were excluded. The leak fraction, airway pressure, ease to insertion, incidence of gastric regurgitation, postoperative sore throat were compared. Results: All patient...

Background: Advancement in labour analgesia includes newer local anaesthetics with more selective... more Background: Advancement in labour analgesia includes newer local anaesthetics with more selective sensory blockade which permit ambulation of parturient, various technological improvement and newer adjutant which facilitate reduced requirement of local anaesthetics and hence side effect. Objective: The objective of this study was to evaluate the efficacy butorphenol 0.5mg and fentanyl 25 mcg mixed with 0.1% ropivacaine for epidural labour analgesia. Material and Method: After Institutional Ethical approval and written informed consent, 60 full term parturient with spontaneous onset of labour randomly assigned to two equal groups of 30 each, to receive an epidural injection of 12 ml ropivacaine 0.1% with butorphenol 0.5ml (500 mcg) in group B1 and 12 ml of ropivacaine 0.1% with fentanyl 0.5ml (25 mcg) in group L2 as initial bolus dose. Further Top-up of 0.1% ropivacaine was given on patients demand. Duration of analgesia, sedation, hemodynamic parameters, oxygen saturation, Respirato...

Despite the decrease in the incidence of goiter throughout the world, there are still cases repor... more Despite the decrease in the incidence of goiter throughout the world, there are still cases reported having large thyroid masses presenting for surgery. These cases impose difficulty for definite airway management while providing anaesthesia to these patients. Recent advances in airway management and its widespread availability such as fibreoptic bronchoscope has decreased the rate of various complications.

These cases represented significant challenges in the areas of intensive care, obstetrics, and et... more These cases represented significant challenges in the areas of intensive care, obstetrics, and ethics.A previously healthy 30-year-old elderly primigravidae, G1P0, presented at 28 weeks’ gestation with road traffic accident. The patient was transferred by ambulance to our institution for management. On admission, the patient was afebrile with stable vital signs. The patient suffered mild head injury with GCS (Glasgow coma scale) of 13/15 with one episode of vomiting on the way to hospital.

Sri Lankan Journal of Anaesthesiology, Feb 6, 2019

Background: Successful and effective ventilation using a face mask is very basic, important and c... more Background: Successful and effective ventilation using a face mask is very basic, important and critical step in emergency resuscitation as well as in the operating room for preoxygenation of anesthetized apnoeic patients. Mask ventilation requires a good seal and a patent airway. Techniques for face mask ventilation include one-handed techniques and twohanded techniques. One-handed technique can be either classical C-E technique or glass holding technique. We aim to compare two one-handed techniques of mask holding in terms of delivered ventilation, mask leak and ease of performing. Method: All patients fulfilling inclusion and exclusion criteria were included after approval of the institutional ethics committee. After induction of general anaesthesia and confirming apnoea, patients with an odd serial number were first started with one-handed C-E technique then crossed over with glass holding technique while patients having even serial numbers were ventilated first with glass holding technique followed by the one-handed C-E technique. Expiratory tidal volume (VTe) and peak inspiratory pressure (PIP) and ease of ventilation for each breath in one minute were recorded. Results: VTe (mean ± SD) ml, Leak (mean ± SD) ml, PIP (mean ± SD) cmH2O was 94.94±25.22, 21.36±7.97, 18.05±2.99 and 101.78±28.18, 19.78±15.68, 16.52±1.95 for CE and Glass holding technique respectively. There is no significant difference between both the techniques in terms of analysed variables. (p-value > 0.05) Conclusion: Statistical analysis does not support that Glass holding technique is better than C-E technique in respect to studied variables. Still as results were comparable for both the groups, the Glass holding technique is a good alternative to C-E and other techniques of mask ventilation. Glass holding technique is very promising in view of ease of ventilation, decreasing procedural fatigue and reducing incidence and severity of tissue trauma, but further studies are required.

Introduction: Caudal epidural block is one of the most popular, reliable, and safetechniques in p... more Introduction: Caudal epidural block is one of the most popular, reliable, and safetechniques in pediatric patients that can provide analgesia for a variety of supra- andinfra-umblical surgical procedures. This study aimed to compare the efficacy ofdexmedetomidine–bupivacaine, fentanyl-bupivacaine mixture and bupivacaine alone onduration of postoperative analgesia, sedation, emergence agitation, duration of sensoryand motor block, hemodynamic stability and side effects.Methodology: After approval from ethical committee 90 pediatric patients of age 2-7 ywere enrolled. The children were randomly allocated to three equal groups of 30 eachusing a computer generated randomization list.Caudal block was given after induction of general anesthesia for urogenital surgery.General anesthesia was maintained with sevoflurane at a concentration adjusted tomaintain BIS between 40-60. Hemodynamic parameters, Pediatric AnaesthesiaEmergence Delirium (PAED) score, Richmond agitation sedation scale (RAS...

The Journal of Medical Research

19th Annual Conference of the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC)

Methodology/Description: A 7-year-old female patient had a history of continuous left partial sei... more Methodology/Description: A 7-year-old female patient had a history of continuous left partial seizures since 1 year of age. She remained refractory to antiepileptics and was diagnosed as epilepsia partialis continua. She was posted for a functional right hemispherotomy. Her developmental age was of 3 years and 4 months with an IQ of 52 (moderate mental retardation). On the day of surgery, her antiepileptics were continued. Intravenous induction was done with propofol, followed by vecuronium as relaxant. Patient was intubated using flexometallic tube. Invasive BP monitoring was done and two large-bore IV lines were secured. Anesthesia was maintained with isoflurane and fentanyl. Injection mannitol and dexamethasone were given to decrease ICP. Temperature was maintained with air warming blankets. Blood loss around 250 mL was replaced with packed RBCs. Patient was extubated on table. Intravenous levetiracetam was given before extubation. Postoperatively patient remained seizure-free, alert, and oriented for 24 hours after which she became sleepy but arousable for next 5 days. She had fever on postoperative day 5 which subsided the next day with steroids and was discharged on the seventh day. Conclusion: Pediatric patients present challenges to neurosurgeons as well as anesthesiologists. The intraoperative concerns include possibility of sudden massive blood loss, longer duration of surgery, and interaction of muscle relaxants with antiepileptic drugs, hypothermia, and delayed recovery. Increased sleepiness after 48 hours due to contralateral edema of the cerebrum or obstructive hydrocephalus increases postoperative ICU stay. A noninfectious fever mostly on day 4 or 5 is caused by chemical ventriculitis, and usually responds to steroids. Thus, a team approach including neurosurgeon, neurophysician, anesthesiologist and intensivist helps in making pediatric hemispherotomy a successful and safe surgery for intractable epilepsy

Journal of Anesthesia & Clinical Research, 2016

Anesthesia: Essays and Researches, 2016

Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with su... more Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others. The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin. Prospective, randomized, double-blind trial. Forty patients with chronic discogenic low back pain were randomized to receive CRF plus intradiscal triamcinolone 40 mg (Group 1) or to receive PRF plus intradiscal triamcinolone 40 mg (Group 2). Outcome measured includes immediate as well as long-term pain relief using visual analog scale, the Oswestry Disability Index and straight leg raising test. The continuous variables were compared by one-way analysis of variance test. Discrete variables were compared by Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test/Chi-square test/Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test, whichever appropriate. The value of P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 was considered statistically significant. There was a significant decrease in pain score after CRF without any added side effect. Pain relief after PRF was insignificant. CRF with steroid seems to be better for treatment of chronic discogenic low back pain than PRF with steroid.