Stuti Bhamri - Academia.edu (original) (raw)

Papers by Stuti Bhamri

Research paper thumbnail of Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Cureus, Nov 8, 2022

Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative den... more Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative dental injuries include difficult intubation, use of transesophageal echocardiography (TEE) probe, motor-evoked potential (MEP) monitoring, poor dental hygiene, etc. Our patient was a case of a thalamic cavernoma who underwent craniotomy in a sitting position with the neck flexed along with MEP and TEE monitoring. At the end of the surgery, the lower three incisors were found to be subluxated. The subluxated teeth were stabilized using a 2-0 Ethilon suture in the operation room. Immediate dental consultation was sought postoperatively. Sitting position surgeries with associated neck flexion, simultaneous, advanced monitoring techniques like TEE and MEP, poor dental condition, and the use of hard bite blocks can predispose patients to dental injury. Preoperative dental evaluation and explanation of neuromonitoring-associated injuries can be beneficial.

Research paper thumbnail of A Rare Case of Bradycardia and Hypotension Following Administration of Ondansetron to a Patient During Spinal Fixation Surgery

Cureus, 2023

Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperativ... more Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperative nausea and vomiting (PONV). It is a 5-hydroxytryptamine 3 (5-HT 3) receptor antagonist. Although relatively safe, few cases of ondansetron-induced bradycardia are described in the literature. Here, we present the case of a 41-year-old female with a burst fracture of the lumbar (L2) vertebrae following a fall from height. The patient underwent spinal fixation in the prone position. The intra-operative period was otherwise uneventful, except for an unprecedented incidence of bradycardia and hypotension following administration of intravenous (IV) ondansetron, at the time of closure of the surgical wound site. It was managed with IV atropine and fluid bolus. The patient was shifted to a intensive care unit (ICU) postoperatively. The postoperative period was uneventful, and the patient was discharged in good health on postoperative day three.

Research paper thumbnail of A peripheral nerve stimulator guided popliteal sciatic nerve block combined with adductor canal block in lower leg surgery- A sole anesthetic technique

Indian Journal of Clinical Anaesthesia, Mar 15, 2023

In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD ... more In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD surgeries choice of anesthesia is usually regional anesthesia. When these patients are associated with co-morbid cardio-respiratory problems then it will become challenge for anesthesiologist to maintain homeostasis with good surgical anesthesia. Ayukut urfalioglu suggested another alternative technique in the form of Adductor canal block plus Lateral approach popliteal sciatic block as good alternative for these surgeries with better Intra-operative Haemodynamic Stability, additional post-operative pain relief and less requirement of systemic analgesia post-operatively. Materials and Methods: In this prospective randomised controlled trial, we aim to explore the efficacy of Adductor canal block plus Popliteal Sciatic Block for Lower leg surgeries. Sixty patients (ASA I, II, III) undergoing lower limb surgeries were randomly allocated in 2 groups (30 patients in each group). In Group P patients received PNS guided Adductor canal block combined with popliteal sciatic block and in group S patients received unilateral spinal anesthesia. Objectives: The primary objectives were to evaluate duration of sensory and motor block and postoperative pain relief. Secondary objectives included intra operative requirements of additional anesthesia and intraoperative haemodynamic stability. Results: There was significant intraoperative haemodynamic stability and post-operative pain relief attributable to Group P. Time for first requirement of rescue analgesia post-operatively was significantly higher in Group P compared to Group S (Group P Mean SD15.9±5.26 vs 6.05±1.23 in Group S with p= < 0.0001). Conclusion: Combined adductor canal block and popliteal sciatic block can be an alternative technique with advantage of prolonged post-operative analgesia and haemodynamic stability. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Research paper thumbnail of Comparison of McGrath videolaryngoscope with conventional Macintosh laryngoscope for tracheal intubation in pediatric patients with normal airway

The Indian Anaesthetists Forum

Research paper thumbnail of A peripheral nerve stimulator guided popliteal sciatic nerve block combined with adductor canal block in lower leg surgery- A sole anesthetic technique

Indian Journal of Clinical Anaesthesia

In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD ... more In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD surgeries choice of anesthesia is usually regional anesthesia. When these patients are associated with co-morbid cardio-respiratory problems then it will become challenge for anesthesiologist to maintain homeostasis with good surgical anesthesia. Ayukut urfalioglu suggested another alternative technique in the form of Adductor canal block plus Lateral approach popliteal sciatic block as good alternative for these surgeries with better Intra-operative Haemodynamic Stability, additional post-operative pain relief and less requirement of systemic analgesia post-operatively.In this prospective randomised controlled trial, we aim to explore the efficacy of Adductor canal block plus Popliteal Sciatic Block for Lower leg surgeries. Sixty patients (ASA I, II, III) undergoing lower limb surgeries were randomly allocated in 2 groups (30 patients in each group). In Group P patients received PNS gui...

Research paper thumbnail of Evaluation of efficacy of ketamine nebulization on reduction of incidence and severity of postoperative sore throat due to tracheal intubation- A prospective randomized controlled study

Indian Journal of Clinical Anaesthesia, Nov 15, 2022

Postoperative sore throat (POST) following endotracheal intubation during general anaesthesia (GA... more Postoperative sore throat (POST) following endotracheal intubation during general anaesthesia (GA) is a common complication that leads to patient pain and is estimated to occur in approximately 21-65 percent of patients. The purpose of this study was to determine the efficacy of topical ketamine administration by nebulization in reducing the occurrence and severity of POST. Materials and Methods: After given written informed consent, a total of 134 patients with ASA I-II in the age range of 18-60 years, of either sex, undergoing surgery under GA were selected for this prospective, randomised, placebo-controlled, and double-blind trial. Patients were randomly assigned to one of two groups: group S received 5.0 ml saline nebulisation, while group K got ketamine 50 mg (1.0 ml) in combination with 4.0 ml saline nebulization for 15 minutes. GA was induced 10 minutes after nebulization was completed. After extubating, and at 2, 4, 6, 8, 12, and 24 hours post-operatively, POST monitoring was performed. POST was graded on a scale of 0 to 3. Result: POST occurred in 44.03 percent of patients overall, with 41 patients in group S (61.19 percent) and 18 patients in group K (26.86 percent) experiencing POST throughout the study period. (0.001) (P = 0.001). At 2, 4, 6, 12, and 24 hours postoperatively, the use of ketamine nebulization significantly reduced POST (P 0.05). At 2 h (P=0.04) and 4 h (P = 0.002) postextubation, the severity of sore throat was also greater in the saline group than in the ketamine group. Conclusion: Preoperative nebulized ketamine is helpful at reducing the occurrence and severity of postoperative sore throat without causing any adverse effects. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Research paper thumbnail of Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Cureus

Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative den... more Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative dental injuries include difficult intubation, use of transesophageal echocardiography (TEE) probe, motor-evoked potential (MEP) monitoring, poor dental hygiene, etc. Our patient was a case of a thalamic cavernoma who underwent craniotomy in a sitting position with the neck flexed along with MEP and TEE monitoring. At the end of the surgery, the lower three incisors were found to be subluxated. The subluxated teeth were stabilized using a 2-0 Ethilon suture in the operation room. Immediate dental consultation was sought postoperatively. Sitting position surgeries with associated neck flexion, simultaneous, advanced monitoring techniques like TEE and MEP, poor dental condition, and the use of hard bite blocks can predispose patients to dental injury. Preoperative dental evaluation and explanation of neuromonitoring-associated injuries can be beneficial.

Research paper thumbnail of A Rare Case of Bradycardia and Hypotension Following Administration of Ondansetron to a Patient During Spinal Fixation Surgery

Cureus

Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperativ... more Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperative nausea and vomiting (PONV). It is a 5-hydroxytryptamine 3 (5-HT 3) receptor antagonist. Although relatively safe, few cases of ondansetron-induced bradycardia are described in the literature. Here, we present the case of a 41-year-old female with a burst fracture of the lumbar (L2) vertebrae following a fall from height. The patient underwent spinal fixation in the prone position. The intra-operative period was otherwise uneventful, except for an unprecedented incidence of bradycardia and hypotension following administration of intravenous (IV) ondansetron, at the time of closure of the surgical wound site. It was managed with IV atropine and fluid bolus. The patient was shifted to a intensive care unit (ICU) postoperatively. The postoperative period was uneventful, and the patient was discharged in good health on postoperative day three.

Research paper thumbnail of Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Cureus, Nov 8, 2022

Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative den... more Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative dental injuries include difficult intubation, use of transesophageal echocardiography (TEE) probe, motor-evoked potential (MEP) monitoring, poor dental hygiene, etc. Our patient was a case of a thalamic cavernoma who underwent craniotomy in a sitting position with the neck flexed along with MEP and TEE monitoring. At the end of the surgery, the lower three incisors were found to be subluxated. The subluxated teeth were stabilized using a 2-0 Ethilon suture in the operation room. Immediate dental consultation was sought postoperatively. Sitting position surgeries with associated neck flexion, simultaneous, advanced monitoring techniques like TEE and MEP, poor dental condition, and the use of hard bite blocks can predispose patients to dental injury. Preoperative dental evaluation and explanation of neuromonitoring-associated injuries can be beneficial.

Research paper thumbnail of A Rare Case of Bradycardia and Hypotension Following Administration of Ondansetron to a Patient During Spinal Fixation Surgery

Cureus, 2023

Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperativ... more Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperative nausea and vomiting (PONV). It is a 5-hydroxytryptamine 3 (5-HT 3) receptor antagonist. Although relatively safe, few cases of ondansetron-induced bradycardia are described in the literature. Here, we present the case of a 41-year-old female with a burst fracture of the lumbar (L2) vertebrae following a fall from height. The patient underwent spinal fixation in the prone position. The intra-operative period was otherwise uneventful, except for an unprecedented incidence of bradycardia and hypotension following administration of intravenous (IV) ondansetron, at the time of closure of the surgical wound site. It was managed with IV atropine and fluid bolus. The patient was shifted to a intensive care unit (ICU) postoperatively. The postoperative period was uneventful, and the patient was discharged in good health on postoperative day three.

Research paper thumbnail of A peripheral nerve stimulator guided popliteal sciatic nerve block combined with adductor canal block in lower leg surgery- A sole anesthetic technique

Indian Journal of Clinical Anaesthesia, Mar 15, 2023

In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD ... more In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD surgeries choice of anesthesia is usually regional anesthesia. When these patients are associated with co-morbid cardio-respiratory problems then it will become challenge for anesthesiologist to maintain homeostasis with good surgical anesthesia. Ayukut urfalioglu suggested another alternative technique in the form of Adductor canal block plus Lateral approach popliteal sciatic block as good alternative for these surgeries with better Intra-operative Haemodynamic Stability, additional post-operative pain relief and less requirement of systemic analgesia post-operatively. Materials and Methods: In this prospective randomised controlled trial, we aim to explore the efficacy of Adductor canal block plus Popliteal Sciatic Block for Lower leg surgeries. Sixty patients (ASA I, II, III) undergoing lower limb surgeries were randomly allocated in 2 groups (30 patients in each group). In Group P patients received PNS guided Adductor canal block combined with popliteal sciatic block and in group S patients received unilateral spinal anesthesia. Objectives: The primary objectives were to evaluate duration of sensory and motor block and postoperative pain relief. Secondary objectives included intra operative requirements of additional anesthesia and intraoperative haemodynamic stability. Results: There was significant intraoperative haemodynamic stability and post-operative pain relief attributable to Group P. Time for first requirement of rescue analgesia post-operatively was significantly higher in Group P compared to Group S (Group P Mean SD15.9±5.26 vs 6.05±1.23 in Group S with p= < 0.0001). Conclusion: Combined adductor canal block and popliteal sciatic block can be an alternative technique with advantage of prolonged post-operative analgesia and haemodynamic stability. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Research paper thumbnail of Comparison of McGrath videolaryngoscope with conventional Macintosh laryngoscope for tracheal intubation in pediatric patients with normal airway

The Indian Anaesthetists Forum

Research paper thumbnail of A peripheral nerve stimulator guided popliteal sciatic nerve block combined with adductor canal block in lower leg surgery- A sole anesthetic technique

Indian Journal of Clinical Anaesthesia

In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD ... more In lower leg surgeries involving fractures of distal tibia, ankle surgeries, debridement and PVD surgeries choice of anesthesia is usually regional anesthesia. When these patients are associated with co-morbid cardio-respiratory problems then it will become challenge for anesthesiologist to maintain homeostasis with good surgical anesthesia. Ayukut urfalioglu suggested another alternative technique in the form of Adductor canal block plus Lateral approach popliteal sciatic block as good alternative for these surgeries with better Intra-operative Haemodynamic Stability, additional post-operative pain relief and less requirement of systemic analgesia post-operatively.In this prospective randomised controlled trial, we aim to explore the efficacy of Adductor canal block plus Popliteal Sciatic Block for Lower leg surgeries. Sixty patients (ASA I, II, III) undergoing lower limb surgeries were randomly allocated in 2 groups (30 patients in each group). In Group P patients received PNS gui...

Research paper thumbnail of Evaluation of efficacy of ketamine nebulization on reduction of incidence and severity of postoperative sore throat due to tracheal intubation- A prospective randomized controlled study

Indian Journal of Clinical Anaesthesia, Nov 15, 2022

Postoperative sore throat (POST) following endotracheal intubation during general anaesthesia (GA... more Postoperative sore throat (POST) following endotracheal intubation during general anaesthesia (GA) is a common complication that leads to patient pain and is estimated to occur in approximately 21-65 percent of patients. The purpose of this study was to determine the efficacy of topical ketamine administration by nebulization in reducing the occurrence and severity of POST. Materials and Methods: After given written informed consent, a total of 134 patients with ASA I-II in the age range of 18-60 years, of either sex, undergoing surgery under GA were selected for this prospective, randomised, placebo-controlled, and double-blind trial. Patients were randomly assigned to one of two groups: group S received 5.0 ml saline nebulisation, while group K got ketamine 50 mg (1.0 ml) in combination with 4.0 ml saline nebulization for 15 minutes. GA was induced 10 minutes after nebulization was completed. After extubating, and at 2, 4, 6, 8, 12, and 24 hours post-operatively, POST monitoring was performed. POST was graded on a scale of 0 to 3. Result: POST occurred in 44.03 percent of patients overall, with 41 patients in group S (61.19 percent) and 18 patients in group K (26.86 percent) experiencing POST throughout the study period. (0.001) (P = 0.001). At 2, 4, 6, 12, and 24 hours postoperatively, the use of ketamine nebulization significantly reduced POST (P 0.05). At 2 h (P=0.04) and 4 h (P = 0.002) postextubation, the severity of sore throat was also greater in the saline group than in the ketamine group. Conclusion: Preoperative nebulized ketamine is helpful at reducing the occurrence and severity of postoperative sore throat without causing any adverse effects. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Research paper thumbnail of Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Cureus

Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative den... more Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative dental injuries include difficult intubation, use of transesophageal echocardiography (TEE) probe, motor-evoked potential (MEP) monitoring, poor dental hygiene, etc. Our patient was a case of a thalamic cavernoma who underwent craniotomy in a sitting position with the neck flexed along with MEP and TEE monitoring. At the end of the surgery, the lower three incisors were found to be subluxated. The subluxated teeth were stabilized using a 2-0 Ethilon suture in the operation room. Immediate dental consultation was sought postoperatively. Sitting position surgeries with associated neck flexion, simultaneous, advanced monitoring techniques like TEE and MEP, poor dental condition, and the use of hard bite blocks can predispose patients to dental injury. Preoperative dental evaluation and explanation of neuromonitoring-associated injuries can be beneficial.

Research paper thumbnail of A Rare Case of Bradycardia and Hypotension Following Administration of Ondansetron to a Patient During Spinal Fixation Surgery

Cureus

Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperativ... more Ondansetron is commonly used during the peri-operative period for the prophylaxis of postoperative nausea and vomiting (PONV). It is a 5-hydroxytryptamine 3 (5-HT 3) receptor antagonist. Although relatively safe, few cases of ondansetron-induced bradycardia are described in the literature. Here, we present the case of a 41-year-old female with a burst fracture of the lumbar (L2) vertebrae following a fall from height. The patient underwent spinal fixation in the prone position. The intra-operative period was otherwise uneventful, except for an unprecedented incidence of bradycardia and hypotension following administration of intravenous (IV) ondansetron, at the time of closure of the surgical wound site. It was managed with IV atropine and fluid bolus. The patient was shifted to a intensive care unit (ICU) postoperatively. The postoperative period was uneventful, and the patient was discharged in good health on postoperative day three.