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Research paper thumbnail of Comparison of neuromuscular blockade effects of a combination of atracurium and vecuronium with vecuronium or atracurium used alone

Pravara Medical Review, 2011

Muscle relaxants are necessary for intubation of patients during anesthesia. Many such agents are... more Muscle relaxants are necessary for intubation of patients during anesthesia. Many such agents are available with various degrees of efficacy regarding intubation conditions, onset of actions and complications. In this study, effects of atracurium and vecuronium were analysed both singly and in various combinations. Eighty adult patients of ASA Grade I and II posted for elective surgery were randomly divided in 4 groups. Group A patients received intubating dose of injection Atracurium (0.5 mg/kg body weight), Group B received intubating dose of injection Vecuronium (0.1 mg/kg body weight), Group C received combination of half of the intubating dose of both injection Atracurium (0.25 mg/kg body weight) and injection Vecuronium (0.05mg/kg body weight) and Group D received combination of ¾ th of the intubating dose of both the injection Atracurium (0.375 mg/kg body weight) and injection Vecuronium (0.075 mg/kg body weight). It was concluded that ¾ combination of atracurium and vecuroni...

Research paper thumbnail of Role of Oxygen-Ozone (O 2-O 3 ) Injection in Discogenic Pain

Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applic... more Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applications. Ozone chemonucleolysis by injecting mixture of oxygen-ozone is a minimally invasive technique to treat discogenic pain. Considering invasiveness and possible morbidity with surgery for discogenic pain, minimal invasive techniques are preferred. Ozone chemonucleolysis is currently available such technique which has shown promising result in recent years. It involves injection of ozone gas into the intervertebral disc under fluoroscopic guidance. This article deals with mechanism of action, indications, procedure and side effects of this technique in detail.

Research paper thumbnail of Case Report Anesthesia management of patient with achondroplasia for abdominal hysterectomy

Achondroplasia is the commonest form of dwarfism. These patients present several problems for bot... more Achondroplasia is the commonest form of dwarfism. These patients present several problems for both general and regional anesthesia. There are reports describing regional anesthesia in such patients but there are scarce reports of general anesthesia. The aim of this report is to discuss anesthetic considerations in such patients and to emphasize the difficulties encountered. A 34 year old patient with achondroplasia underwent abdominal hysterectomy under general anesthesia supplemented with regional analgesia. Since preoperative assessment suggested difficult airway, regional anesthesia was planned which was not successful due to spinal abnormality. Subsequently general anesthesia was established with Laryngeal Mask Airway (LMA) with controlled ventilation without any complication.

Research paper thumbnail of LETTER TO EDITOR: Role of Oxygen-Ozone (O2-O3) Injection in Discogenic Pain

LETTER TO EDITOR: Role of Oxygen-Ozone (O2-O3) Injection in Discogenic Pain

Journal of Krishna Institute of Medical Sciences University, 2012

Medical ozone is a mixture of oxygen-ozone (O2-O3) which can be used for several medical applicat... more Medical ozone is a mixture of oxygen-ozone (O2-O3) which can be used for several medical applications. Ozone chemonucleolysis by injecting mixture of oxygen-ozone is a minimally invasive technique to treat discogenic pain. Considering invasiveness and possible morbidity with surgery for discogenic pain, minimal invasive techniques are preferred. Ozone chemonucleolysis is currently available such technique which has shown promising result in recent years. It involves injection of ozone gas into the intervertebral disc under fluoroscopic guidance. This article deals with mechanism of action, indications, procedure and side effects of this technique in detail.

Research paper thumbnail of Cancellation of Elective Operations on the Day of Surgery : Three Years Study

Journal of Evidence Based Medicine and Healthcare, 2015

There are several studies suggesting decreased operating room efficiency caused by cancellations ... more There are several studies suggesting decreased operating room efficiency caused by cancellations of the surgical procedures. It also affects patient satisfaction. This study was to analyse the reasons for cancellation of elective operations so that in future necessary actions can be taken to minimize number of unnecessary cancellations. METHODS: This was a retrospective study conducted in teaching hospital for 3 years from April 1, 2012 to March 31, 2015. The data was collected from postponement register and medical record department. The reasons for cancellations were classified as (1) structural factors (e.g., no hospital bed); (2) patient factors (e.g., patient unwell); and (3) process factors (e.g., scheduling error). RESULTS: During the study period, 11,208 patients were posted for elective procedures. 9.8 % patients were cancelled on the day of surgery. The frequency of cancellations was more in process related issues (47.9%). Cancellations due to structural factors and patient factors were 26.4% and 25.7% respectively. CONCLUSION: Although cancellations were only 9.8% of total elective operations, this can be reduced by anticipating and taking necessary steps that have been suggested. More thorough and detailed documentation is needed to achieve this.

Research paper thumbnail of Neuromusular Blockade of Inj. Atracurium and Inj. Vecuronium

Journal of Evidence Based Medicine and Healthcare, 2015

Rapid onset of action, short duration of action and no cardiovascular side effects are the proper... more Rapid onset of action, short duration of action and no cardiovascular side effects are the properties of ideal neuromuscular blocking agents. Both inj. Atracurium and Vecuronium are used for facilitating endotracheal intubation. It has been shown that synergism exists between them. In this study we evaluated the pharmacodynamic interaction of combination of injection atracurium and injection vecuronium. Our objective was to study quality of neuromuscular block. Sixty patients belonging to ASA-I category received either intubating dose of injection Atracurium (0.5mg/kg ) or intubating dose of injection Vecuronium ( 0.1mg/kg) or combination of 1/2 of the intubating dose of both drugs. Endotracheal intubation was attempted after injection of relaxant. We analyzed intubating condition, onset of action, duration of action, quality of muscle relaxation and complications if any. Pulse rate and blood pressure were monitored during endotracheal intubation and during maintenance. The combination of atracurium and vecuronium provided shorter onset time (3.6±2.11). There was excellent intubation condition in 90% patients. There was excellent muscle relaxation but with moderate prolongation of duration of action (44.25±12.00). There was good hemodynamic stability and no side effects. Combination of two drugs was synergistic and more potent favoring either drug alone.

Research paper thumbnail of Causes of cancellation for elective orthopedic procedures on the day of surgery

International Journal of Scientific Reports, 2015

Background: A retrospective observational study was conducted to find out the reasons for cancell... more Background: A retrospective observational study was conducted to find out the reasons for cancellation of elective orthopedic surgical inpatients on the day of surgery and to plan for future suggestive actions to decrease unnecessary cancellations. Methods: This was a retrospective observational study conducted at medical teaching hospital for 3 years from January 1, 2012 to December 31, 2014. The data was collected from postponement register. The files of cases that were cancelled were reviewed for the reasons of cancellations. The reasons were classified as anaesthetist related, administrative issues, surgeon related and patient related issues. Results: During the study period, 7673patients were posted for elective orthopedic procedures. 6.49 % patients were cancelled on the day of surgery. The frequency of cancellations was more in anesthetist related issues (38.9%). Cancellations due to administrative issues, patient related issues and surgeon related were 30%, 27.7% & 3.4% respectively. Conclusions: Although cancellations were only 6.49% of total elective operations, this can be reduced by implementing and following the recommendations that have been proposed. More thorough and detailed documentation is needed to achieve this.

Research paper thumbnail of Anesthesia management of patient with achondroplasia for abdominal hysterectomy

International Journal of Scientific Reports, 2015

Research paper thumbnail of Ayurvedic medicine and anaesthesia

Indian Journal of Anaesthesia, 2012

Research paper thumbnail of Intradiscal injection of oxygen-ozone and intraforaminal steroid for the treatment of prolapsed intervertebral disc: 4 years follow up

International Journal of Research in Medical Sciences, 2015

There are number of studies which have shown prevalence rate of low back pain (LBP) to be approxi... more There are number of studies which have shown prevalence rate of low back pain (LBP) to be approximately 22% to 65% in one year and lifetime prevalence to be in the range of 29% to 70%. In 60% to 75% patients suffering from LBP, causative factors are muscle pain or ligament injuries. In 5% to 15% of patients LBP is associated with degenerative joints and disc disease. The short term success rate after surgery for disc herniation is approximately 95-98% which decreases to 88% in long term. 2 These findings have led to research

Research paper thumbnail of Journal of Krishna Institute of Medical Sciences Universityª LETTER TO EDITOR Role of Oxygen-Ozone (O 2-O 3

Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applic... more Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applications. Ozone chemonucleolysis by injecting mixture of oxygen-ozone is a minimally invasive technique to treat discogenic pain. Considering invasiveness and possible morbidity with surgery for discogenic pain, minimal invasive techniques are preferred. Ozone chemonucleolysis is currently available such technique which has shown promising result in recent years. It involves injection of ozone gas into the intervertebral disc under fluoroscopic guidance. This article deals with mechanism of action, indications, procedure and side effects of this technique in detail.

Research paper thumbnail of KEYWORDS: Elective surgical procedures, Operation room, Efficiency

KEYWORDS: Elective surgical procedures, Operation room, Efficiency

Research paper thumbnail of KEYWORDS: Neuromuscular Blockade, Atracurium, Vecuronium, Relaxant Combination

KEYWORDS: Neuromuscular Blockade, Atracurium, Vecuronium, Relaxant Combination

Research paper thumbnail of Comparison of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach for their analgesic efficacy after lower abdominal surgery

Comparison of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach for their analgesic efficacy after lower abdominal surgery

MedPulse International Journal of Anesthesiology

Research paper thumbnail of Comparison of neuromuscular blockade effects of a combination of atracurium and vecuronium with vecuronium or atracurium used alone

Pravara Medical Review, 2011

Muscle relaxants are necessary for intubation of patients during anesthesia. Many such agents are... more Muscle relaxants are necessary for intubation of patients during anesthesia. Many such agents are available with various degrees of efficacy regarding intubation conditions, onset of actions and complications. In this study, effects of atracurium and vecuronium were analysed both singly and in various combinations. Eighty adult patients of ASA Grade I and II posted for elective surgery were randomly divided in 4 groups. Group A patients received intubating dose of injection Atracurium (0.5 mg/kg body weight), Group B received intubating dose of injection Vecuronium (0.1 mg/kg body weight), Group C received combination of half of the intubating dose of both injection Atracurium (0.25 mg/kg body weight) and injection Vecuronium (0.05mg/kg body weight) and Group D received combination of ¾ th of the intubating dose of both the injection Atracurium (0.375 mg/kg body weight) and injection Vecuronium (0.075 mg/kg body weight). It was concluded that ¾ combination of atracurium and vecuroni...

Research paper thumbnail of Role of Oxygen-Ozone (O 2-O 3 ) Injection in Discogenic Pain

Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applic... more Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applications. Ozone chemonucleolysis by injecting mixture of oxygen-ozone is a minimally invasive technique to treat discogenic pain. Considering invasiveness and possible morbidity with surgery for discogenic pain, minimal invasive techniques are preferred. Ozone chemonucleolysis is currently available such technique which has shown promising result in recent years. It involves injection of ozone gas into the intervertebral disc under fluoroscopic guidance. This article deals with mechanism of action, indications, procedure and side effects of this technique in detail.

Research paper thumbnail of Case Report Anesthesia management of patient with achondroplasia for abdominal hysterectomy

Achondroplasia is the commonest form of dwarfism. These patients present several problems for bot... more Achondroplasia is the commonest form of dwarfism. These patients present several problems for both general and regional anesthesia. There are reports describing regional anesthesia in such patients but there are scarce reports of general anesthesia. The aim of this report is to discuss anesthetic considerations in such patients and to emphasize the difficulties encountered. A 34 year old patient with achondroplasia underwent abdominal hysterectomy under general anesthesia supplemented with regional analgesia. Since preoperative assessment suggested difficult airway, regional anesthesia was planned which was not successful due to spinal abnormality. Subsequently general anesthesia was established with Laryngeal Mask Airway (LMA) with controlled ventilation without any complication.

Research paper thumbnail of LETTER TO EDITOR: Role of Oxygen-Ozone (O2-O3) Injection in Discogenic Pain

LETTER TO EDITOR: Role of Oxygen-Ozone (O2-O3) Injection in Discogenic Pain

Journal of Krishna Institute of Medical Sciences University, 2012

Medical ozone is a mixture of oxygen-ozone (O2-O3) which can be used for several medical applicat... more Medical ozone is a mixture of oxygen-ozone (O2-O3) which can be used for several medical applications. Ozone chemonucleolysis by injecting mixture of oxygen-ozone is a minimally invasive technique to treat discogenic pain. Considering invasiveness and possible morbidity with surgery for discogenic pain, minimal invasive techniques are preferred. Ozone chemonucleolysis is currently available such technique which has shown promising result in recent years. It involves injection of ozone gas into the intervertebral disc under fluoroscopic guidance. This article deals with mechanism of action, indications, procedure and side effects of this technique in detail.

Research paper thumbnail of Cancellation of Elective Operations on the Day of Surgery : Three Years Study

Journal of Evidence Based Medicine and Healthcare, 2015

There are several studies suggesting decreased operating room efficiency caused by cancellations ... more There are several studies suggesting decreased operating room efficiency caused by cancellations of the surgical procedures. It also affects patient satisfaction. This study was to analyse the reasons for cancellation of elective operations so that in future necessary actions can be taken to minimize number of unnecessary cancellations. METHODS: This was a retrospective study conducted in teaching hospital for 3 years from April 1, 2012 to March 31, 2015. The data was collected from postponement register and medical record department. The reasons for cancellations were classified as (1) structural factors (e.g., no hospital bed); (2) patient factors (e.g., patient unwell); and (3) process factors (e.g., scheduling error). RESULTS: During the study period, 11,208 patients were posted for elective procedures. 9.8 % patients were cancelled on the day of surgery. The frequency of cancellations was more in process related issues (47.9%). Cancellations due to structural factors and patient factors were 26.4% and 25.7% respectively. CONCLUSION: Although cancellations were only 9.8% of total elective operations, this can be reduced by anticipating and taking necessary steps that have been suggested. More thorough and detailed documentation is needed to achieve this.

Research paper thumbnail of Neuromusular Blockade of Inj. Atracurium and Inj. Vecuronium

Journal of Evidence Based Medicine and Healthcare, 2015

Rapid onset of action, short duration of action and no cardiovascular side effects are the proper... more Rapid onset of action, short duration of action and no cardiovascular side effects are the properties of ideal neuromuscular blocking agents. Both inj. Atracurium and Vecuronium are used for facilitating endotracheal intubation. It has been shown that synergism exists between them. In this study we evaluated the pharmacodynamic interaction of combination of injection atracurium and injection vecuronium. Our objective was to study quality of neuromuscular block. Sixty patients belonging to ASA-I category received either intubating dose of injection Atracurium (0.5mg/kg ) or intubating dose of injection Vecuronium ( 0.1mg/kg) or combination of 1/2 of the intubating dose of both drugs. Endotracheal intubation was attempted after injection of relaxant. We analyzed intubating condition, onset of action, duration of action, quality of muscle relaxation and complications if any. Pulse rate and blood pressure were monitored during endotracheal intubation and during maintenance. The combination of atracurium and vecuronium provided shorter onset time (3.6±2.11). There was excellent intubation condition in 90% patients. There was excellent muscle relaxation but with moderate prolongation of duration of action (44.25±12.00). There was good hemodynamic stability and no side effects. Combination of two drugs was synergistic and more potent favoring either drug alone.

Research paper thumbnail of Causes of cancellation for elective orthopedic procedures on the day of surgery

International Journal of Scientific Reports, 2015

Background: A retrospective observational study was conducted to find out the reasons for cancell... more Background: A retrospective observational study was conducted to find out the reasons for cancellation of elective orthopedic surgical inpatients on the day of surgery and to plan for future suggestive actions to decrease unnecessary cancellations. Methods: This was a retrospective observational study conducted at medical teaching hospital for 3 years from January 1, 2012 to December 31, 2014. The data was collected from postponement register. The files of cases that were cancelled were reviewed for the reasons of cancellations. The reasons were classified as anaesthetist related, administrative issues, surgeon related and patient related issues. Results: During the study period, 7673patients were posted for elective orthopedic procedures. 6.49 % patients were cancelled on the day of surgery. The frequency of cancellations was more in anesthetist related issues (38.9%). Cancellations due to administrative issues, patient related issues and surgeon related were 30%, 27.7% & 3.4% respectively. Conclusions: Although cancellations were only 6.49% of total elective operations, this can be reduced by implementing and following the recommendations that have been proposed. More thorough and detailed documentation is needed to achieve this.

Research paper thumbnail of Anesthesia management of patient with achondroplasia for abdominal hysterectomy

International Journal of Scientific Reports, 2015

Research paper thumbnail of Ayurvedic medicine and anaesthesia

Indian Journal of Anaesthesia, 2012

Research paper thumbnail of Intradiscal injection of oxygen-ozone and intraforaminal steroid for the treatment of prolapsed intervertebral disc: 4 years follow up

International Journal of Research in Medical Sciences, 2015

There are number of studies which have shown prevalence rate of low back pain (LBP) to be approxi... more There are number of studies which have shown prevalence rate of low back pain (LBP) to be approximately 22% to 65% in one year and lifetime prevalence to be in the range of 29% to 70%. In 60% to 75% patients suffering from LBP, causative factors are muscle pain or ligament injuries. In 5% to 15% of patients LBP is associated with degenerative joints and disc disease. The short term success rate after surgery for disc herniation is approximately 95-98% which decreases to 88% in long term. 2 These findings have led to research

Research paper thumbnail of Journal of Krishna Institute of Medical Sciences Universityª LETTER TO EDITOR Role of Oxygen-Ozone (O 2-O 3

Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applic... more Medical ozone is a mixture of oxygen-ozone (O 2-O 3) which can be used for several medical applications. Ozone chemonucleolysis by injecting mixture of oxygen-ozone is a minimally invasive technique to treat discogenic pain. Considering invasiveness and possible morbidity with surgery for discogenic pain, minimal invasive techniques are preferred. Ozone chemonucleolysis is currently available such technique which has shown promising result in recent years. It involves injection of ozone gas into the intervertebral disc under fluoroscopic guidance. This article deals with mechanism of action, indications, procedure and side effects of this technique in detail.

Research paper thumbnail of KEYWORDS: Elective surgical procedures, Operation room, Efficiency

KEYWORDS: Elective surgical procedures, Operation room, Efficiency

Research paper thumbnail of KEYWORDS: Neuromuscular Blockade, Atracurium, Vecuronium, Relaxant Combination

KEYWORDS: Neuromuscular Blockade, Atracurium, Vecuronium, Relaxant Combination

Research paper thumbnail of Comparison of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach for their analgesic efficacy after lower abdominal surgery

Comparison of ultrasound guided transversus abdominis plane (TAP) block by posterior and lateral approach for their analgesic efficacy after lower abdominal surgery

MedPulse International Journal of Anesthesiology