Anand Sardesai - Academia.edu (original) (raw)
Papers by Anand Sardesai
Regional Anesthesia & Pain Medicine, 2020
British Journal of Radiology, 2005
... Another potential clinical use of brachial plexus spatial mapping using 3D ultrasound is in r... more ... Another potential clinical use of brachial plexus spatial mapping using 3D ultrasound is in radiotherapy planning. ... With the advent of 3D conformal radiotherapy and intensity-modulated radiotherapy (IMRT) [24], a spatial map of the brachial plexus could be imported into ...
Anesthesiology, Jul 1, 2006
Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry ... more Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry into the spinal canal. The purpose of this study was to identify the angles and depths of needle insertion that increase the likelihood of such an event, using the traditional classic interscalene approach and two more proximal entry points. Magnetic resonance images of the neck from 10 healthy volunteers were used to obtain the three-dimensional spatial coordinates of three skin markers and the right-sided cervical nerves at the exiting neural foramina. The distance of the intervertebral foramina from the skin markers and the angles of the needle vector and the foramina were calculated. The distance from the skin to the intervertebral foramen may be as short as 2.5 cm with the classic approach. A caudal angulation greater than 50 degrees seemed to eliminate the risk of needle entry through the foramen. With the classic approach to the interscalene block, there is a greater possibility of the needle passing through the intervertebral foramen if the needle is advanced too deeply. More proximal entry points and techniques that use a more steeply angled needle may reduce the risk of entry into the spinal space.
Fundamentals of Anaesthesia, 2009
Journal of perioperative practice, 2010
Use of a tourniquet for performing surgery in order to create a bloodless surgical field and redu... more Use of a tourniquet for performing surgery in order to create a bloodless surgical field and reduce blood loss has been in use for many years. Tourniquets may fail perioperatively for various reasons, leading to ongoing bleeding. An important cause of tourniquet failure is calcification of the underlying artery. A patient undergoing total knee replacement surgery in whom the tourniquet failed, secondary to femoral artery calcification is reported. The implications of tourniquet use in patients with arterial calcification, including acute distal ischaemia, aneurysm formation and vessel fracture will be discussed. Recommendations include: thorough vascular assessment of all patients preoperatively, awareness of the possibility of tourniquet failure particularly in vasculopaths, and the provision of an alternative perioperative management plan such as use of a cell saver device, should the tourniquet fail.
Current Anaesthesia & Critical Care, 2009
... View Record in Scopus | Cited By in Scopus (139). 14 GJI Van Geffen, HC Rettig, T. Koornwinde... more ... View Record in Scopus | Cited By in Scopus (139). 14 GJI Van Geffen, HC Rettig, T. Koornwinder, S. Renes and MJM Gielen, Ultrasound-guided training in the performance of brachial plexus block by the posterior approach: an observational study, Anaesthesia 62 (2007), pp. ...
Before continuing, try to answer the following questions (single best answer). The answers can be... more Before continuing, try to answer the following questions (single best answer). The answers can be found at the end of the article, together with an explanation.
Regional Anesthesia and Pain Medicine, 2004
We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic... more We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic infusion administered at home. This case highlights the need for patient education and postoperative communication. report A 52-year-old male patient presented for a rotator cuff repair. He was a chronic tobacco abuser with a history of occasional chest pain of unexplained cause. An interscalene catheter was placed preoperatively and surgery was performed under a combination of an interscalene block and a general anesthetic. An infusion of 0.2% ropivacaine was started via the interscalene catheter postoperatively and continued at home following his discharge from the hospital on the third postoperative day. Within 24 hours of discharge, he was readmitted to the hospital after complaining of chest pain and dyspnea. The patient was seen in the emergency department by nonanesthesiologists who were not familiar with the potential for interscalene blocks to cause diaphragmatic paresis. Good communication must be maintained with the patient at all times. Doctors from other specialties may be unaware of the potential complications of an interscalene block.
Regional Anesthesia and Pain Medicine, 2004
Single-injection block needles are manufactured in many different lengths, diameters, and tip des... more Single-injection block needles are manufactured in many different lengths, diameters, and tip designs, but the literature contains no reports of methods to assess clinical characteristics of regional-block needles. A novel animal model for the assessment of the characteristics of single-injection regional anesthesia needles is described. Nine different needles designed for peripheral nerve blocks that were fitted with identical hubs were used. Pork bellies were used as the biologic model. The bellies were mounted such that the needles passed from inside to outside. The last layer to be penetrated was the skin. Ten experienced and blinded anesthesiologists scored the feel, resistance, and usability of the 9 needles during their passage through similarly prepared pork bellies. Two identical (index) needles were included in the study to assess the internal validity of the study. The overall scoring was acceptably consistent and repeatable and showed statistically significant differences between the needles tested. The needles that were judged the most usable were those with a moderate resistance to passage through the tissue and a high degree of feel, which was defined as the ability to appreciate the passage of the needle through the tissue planes. Needles with very high or very low resistances and those with poor feel scored poorly on the usability scale. Differences in individuals' assessment of the index needles suggested some within-subject variability during the study. This type of biologic model can be used for the quantifiable and repeatable assessment of different needle tip designs. Needles with moderate resistance and high feel were preferred.
Anesthesiology, 2006
Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry ... more Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry into the spinal canal. The purpose of this study was to identify the angles and depths of needle insertion that increase the likelihood of such an event, using the traditional classic interscalene approach and two more proximal entry points. Magnetic resonance images of the neck from 10 healthy volunteers were used to obtain the three-dimensional spatial coordinates of three skin markers and the right-sided cervical nerves at the exiting neural foramina. The distance of the intervertebral foramina from the skin markers and the angles of the needle vector and the foramina were calculated. The distance from the skin to the intervertebral foramen may be as short as 2.5 cm with the classic approach. A caudal angulation greater than 50 degrees seemed to eliminate the risk of needle entry through the foramen. With the classic approach to the interscalene block, there is a greater possibility of the needle passing through the intervertebral foramen if the needle is advanced too deeply. More proximal entry points and techniques that use a more steeply angled needle may reduce the risk of entry into the spinal space.
Anaesthesia & Intensive Care Medicine, 2005
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2012
Regional Anesthesia & Pain Medicine, 2020
British Journal of Radiology, 2005
... Another potential clinical use of brachial plexus spatial mapping using 3D ultrasound is in r... more ... Another potential clinical use of brachial plexus spatial mapping using 3D ultrasound is in radiotherapy planning. ... With the advent of 3D conformal radiotherapy and intensity-modulated radiotherapy (IMRT) [24], a spatial map of the brachial plexus could be imported into ...
Anesthesiology, Jul 1, 2006
Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry ... more Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry into the spinal canal. The purpose of this study was to identify the angles and depths of needle insertion that increase the likelihood of such an event, using the traditional classic interscalene approach and two more proximal entry points. Magnetic resonance images of the neck from 10 healthy volunteers were used to obtain the three-dimensional spatial coordinates of three skin markers and the right-sided cervical nerves at the exiting neural foramina. The distance of the intervertebral foramina from the skin markers and the angles of the needle vector and the foramina were calculated. The distance from the skin to the intervertebral foramen may be as short as 2.5 cm with the classic approach. A caudal angulation greater than 50 degrees seemed to eliminate the risk of needle entry through the foramen. With the classic approach to the interscalene block, there is a greater possibility of the needle passing through the intervertebral foramen if the needle is advanced too deeply. More proximal entry points and techniques that use a more steeply angled needle may reduce the risk of entry into the spinal space.
Fundamentals of Anaesthesia, 2009
Journal of perioperative practice, 2010
Use of a tourniquet for performing surgery in order to create a bloodless surgical field and redu... more Use of a tourniquet for performing surgery in order to create a bloodless surgical field and reduce blood loss has been in use for many years. Tourniquets may fail perioperatively for various reasons, leading to ongoing bleeding. An important cause of tourniquet failure is calcification of the underlying artery. A patient undergoing total knee replacement surgery in whom the tourniquet failed, secondary to femoral artery calcification is reported. The implications of tourniquet use in patients with arterial calcification, including acute distal ischaemia, aneurysm formation and vessel fracture will be discussed. Recommendations include: thorough vascular assessment of all patients preoperatively, awareness of the possibility of tourniquet failure particularly in vasculopaths, and the provision of an alternative perioperative management plan such as use of a cell saver device, should the tourniquet fail.
Current Anaesthesia & Critical Care, 2009
... View Record in Scopus | Cited By in Scopus (139). 14 GJI Van Geffen, HC Rettig, T. Koornwinde... more ... View Record in Scopus | Cited By in Scopus (139). 14 GJI Van Geffen, HC Rettig, T. Koornwinder, S. Renes and MJM Gielen, Ultrasound-guided training in the performance of brachial plexus block by the posterior approach: an observational study, Anaesthesia 62 (2007), pp. ...
Before continuing, try to answer the following questions (single best answer). The answers can be... more Before continuing, try to answer the following questions (single best answer). The answers can be found at the end of the article, together with an explanation.
Regional Anesthesia and Pain Medicine, 2004
We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic... more We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic infusion administered at home. This case highlights the need for patient education and postoperative communication. report A 52-year-old male patient presented for a rotator cuff repair. He was a chronic tobacco abuser with a history of occasional chest pain of unexplained cause. An interscalene catheter was placed preoperatively and surgery was performed under a combination of an interscalene block and a general anesthetic. An infusion of 0.2% ropivacaine was started via the interscalene catheter postoperatively and continued at home following his discharge from the hospital on the third postoperative day. Within 24 hours of discharge, he was readmitted to the hospital after complaining of chest pain and dyspnea. The patient was seen in the emergency department by nonanesthesiologists who were not familiar with the potential for interscalene blocks to cause diaphragmatic paresis. Good communication must be maintained with the patient at all times. Doctors from other specialties may be unaware of the potential complications of an interscalene block.
Regional Anesthesia and Pain Medicine, 2004
Single-injection block needles are manufactured in many different lengths, diameters, and tip des... more Single-injection block needles are manufactured in many different lengths, diameters, and tip designs, but the literature contains no reports of methods to assess clinical characteristics of regional-block needles. A novel animal model for the assessment of the characteristics of single-injection regional anesthesia needles is described. Nine different needles designed for peripheral nerve blocks that were fitted with identical hubs were used. Pork bellies were used as the biologic model. The bellies were mounted such that the needles passed from inside to outside. The last layer to be penetrated was the skin. Ten experienced and blinded anesthesiologists scored the feel, resistance, and usability of the 9 needles during their passage through similarly prepared pork bellies. Two identical (index) needles were included in the study to assess the internal validity of the study. The overall scoring was acceptably consistent and repeatable and showed statistically significant differences between the needles tested. The needles that were judged the most usable were those with a moderate resistance to passage through the tissue and a high degree of feel, which was defined as the ability to appreciate the passage of the needle through the tissue planes. Needles with very high or very low resistances and those with poor feel scored poorly on the usability scale. Differences in individuals' assessment of the index needles suggested some within-subject variability during the study. This type of biologic model can be used for the quantifiable and repeatable assessment of different needle tip designs. Needles with moderate resistance and high feel were preferred.
Anesthesiology, 2006
Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry ... more Spinal cord damage during interscalene brachial plexus block has been attributed to needle entry into the spinal canal. The purpose of this study was to identify the angles and depths of needle insertion that increase the likelihood of such an event, using the traditional classic interscalene approach and two more proximal entry points. Magnetic resonance images of the neck from 10 healthy volunteers were used to obtain the three-dimensional spatial coordinates of three skin markers and the right-sided cervical nerves at the exiting neural foramina. The distance of the intervertebral foramina from the skin markers and the angles of the needle vector and the foramina were calculated. The distance from the skin to the intervertebral foramen may be as short as 2.5 cm with the classic approach. A caudal angulation greater than 50 degrees seemed to eliminate the risk of needle entry through the foramen. With the classic approach to the interscalene block, there is a greater possibility of the needle passing through the intervertebral foramen if the needle is advanced too deeply. More proximal entry points and techniques that use a more steeply angled needle may reduce the risk of entry into the spinal space.
Anaesthesia & Intensive Care Medicine, 2005
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2012