nitin alaspurkar - Academia.edu (original) (raw)

Papers by nitin alaspurkar

Research paper thumbnail of Difficult airway management of 17 years old patient with Osteosarcoma of jaw

Medical Science

The management of a problematic airway is one of the most critical tasks for an anaesthesiologist... more The management of a problematic airway is one of the most critical tasks for an anaesthesiologist. Airway issues are one of the most common causes of anaesthesia-related morbidity and mortality. Poor airway management has been recognised as a serious patient safety issue for nearly three decades, emphasising the significance of a comprehensive airway assessment before to anaesthesia induction.Mask ventilation and endotracheal intubation are considered challenging in patients with osteosarcoma of the jaw, where the mass protrudes from the mouth. Video laryngoscopic equipment, retrograde intubation, the laryngeal mask airway, Fibreoptic bronchoscope-guided intubation, and the pliable fibre optic stylet are among the procedures and equipment used to facilitate tracheal intubation in patients who are expected to have a difficult intubation. Anesthetists as well as surgeon prefer awake fibreoptic endotracheal intubation. Fiberoptic intubation with sedatives and local anaesthetics is a safe procedure for securing the airway in a difficult situation; even if the patient does not consent to an awake intubation. Here we report airway management of a 17 years old patient with osteosarcoma of jaw.

Research paper thumbnail of Effectiveness and Safety in the Postoperative Period after the Epidural Insertion with Local Anesthetics and Steroids

Journal of Pharmaceutical Research International, 2021

Introduction: Postoperative analgesia is one of the major concerns to significant patients posted... more Introduction: Postoperative analgesia is one of the major concerns to significant patients posted for major surgeries. One of the gold standard techniques to control postoperative pain in significant surgeries like lower abdominal and lower limb surgeries is epidural analgesia administration with local anesthetic and opioids. The difficulty in developing a realistic risk/benefit analysis of epidural analgesia has led clinicians to frequently wonder if epidurals are beneficial for post-operative pain management and whether the procedure is safe, which has limited the adoption of the technique. The effectiveness and safety in the postoperative period after the epidural insertion with local anesthetics and steroids in persons posted for surgery are discussed in this review. Methodology: This review article was written with a systemic literature review with the help of a data search machine-like Pub Med, Scopus, web of sciences, and Google scholar. In this article, observational studies...

Research paper thumbnail of Evaluation of Acromio-Axillary-Suprasternal Notch Index in Predicting Difficulty in Visualization of Larynxs in Adult Patients

Journal of Evolution of Medical and Dental Sciences

BACKGROUND In medical specialty, expertise in airway management is essential. Maintaining the air... more BACKGROUND In medical specialty, expertise in airway management is essential. Maintaining the airway and providing oxygenation is the responsibility of the anaesthesiologist. He is also responsible for reducing the morbidity, and mortality related to difficult intubation. To reduce the risk associated with difficult visualization of larynx, preoperative assessment of airway is required. To protect patient's airway, endotracheal intubation is the gold standard. Direct laryngoscopy easily enables the securing the airway. This study was for predictive validity of the current system called acromio-axillo-suprasternal notch index in the assessment of difficult airway management. METHODS A total of 60 adult patients, of either gender, aged 18-65 years, of ASA class 1 and 2, undergoing elective surgery under general anaesthesia requiring tracheal intubation participated in this prospective, comparative, observational study. AASI was used for preoperative assessment of airway. Sensitivity, and specificity were calculated for AASI. In this study, data analysis was done using chi-square. p < 0.05 was considered statistically significant. RESULTS Difficult Visualization of Larynx was observed in 3.6 % [95 % confidence interval (1.9-5.4 %)] patients. Our study found that sensitivity and specificity were 75 % and 95.7 % respectively. CONCLUSIONS Acromio-Axillary-Suprasternal Notch Index (≥ 0.5) is a clear indicator of difficult larynx visualization with direct laryngoscopy.

Research paper thumbnail of Difficult airway management of 17 years old patient with Osteosarcoma of jaw

Medical Science

The management of a problematic airway is one of the most critical tasks for an anaesthesiologist... more The management of a problematic airway is one of the most critical tasks for an anaesthesiologist. Airway issues are one of the most common causes of anaesthesia-related morbidity and mortality. Poor airway management has been recognised as a serious patient safety issue for nearly three decades, emphasising the significance of a comprehensive airway assessment before to anaesthesia induction.Mask ventilation and endotracheal intubation are considered challenging in patients with osteosarcoma of the jaw, where the mass protrudes from the mouth. Video laryngoscopic equipment, retrograde intubation, the laryngeal mask airway, Fibreoptic bronchoscope-guided intubation, and the pliable fibre optic stylet are among the procedures and equipment used to facilitate tracheal intubation in patients who are expected to have a difficult intubation. Anesthetists as well as surgeon prefer awake fibreoptic endotracheal intubation. Fiberoptic intubation with sedatives and local anaesthetics is a safe procedure for securing the airway in a difficult situation; even if the patient does not consent to an awake intubation. Here we report airway management of a 17 years old patient with osteosarcoma of jaw.

Research paper thumbnail of Effectiveness and Safety in the Postoperative Period after the Epidural Insertion with Local Anesthetics and Steroids

Journal of Pharmaceutical Research International, 2021

Introduction: Postoperative analgesia is one of the major concerns to significant patients posted... more Introduction: Postoperative analgesia is one of the major concerns to significant patients posted for major surgeries. One of the gold standard techniques to control postoperative pain in significant surgeries like lower abdominal and lower limb surgeries is epidural analgesia administration with local anesthetic and opioids. The difficulty in developing a realistic risk/benefit analysis of epidural analgesia has led clinicians to frequently wonder if epidurals are beneficial for post-operative pain management and whether the procedure is safe, which has limited the adoption of the technique. The effectiveness and safety in the postoperative period after the epidural insertion with local anesthetics and steroids in persons posted for surgery are discussed in this review. Methodology: This review article was written with a systemic literature review with the help of a data search machine-like Pub Med, Scopus, web of sciences, and Google scholar. In this article, observational studies...

Research paper thumbnail of Evaluation of Acromio-Axillary-Suprasternal Notch Index in Predicting Difficulty in Visualization of Larynxs in Adult Patients

Journal of Evolution of Medical and Dental Sciences

BACKGROUND In medical specialty, expertise in airway management is essential. Maintaining the air... more BACKGROUND In medical specialty, expertise in airway management is essential. Maintaining the airway and providing oxygenation is the responsibility of the anaesthesiologist. He is also responsible for reducing the morbidity, and mortality related to difficult intubation. To reduce the risk associated with difficult visualization of larynx, preoperative assessment of airway is required. To protect patient's airway, endotracheal intubation is the gold standard. Direct laryngoscopy easily enables the securing the airway. This study was for predictive validity of the current system called acromio-axillo-suprasternal notch index in the assessment of difficult airway management. METHODS A total of 60 adult patients, of either gender, aged 18-65 years, of ASA class 1 and 2, undergoing elective surgery under general anaesthesia requiring tracheal intubation participated in this prospective, comparative, observational study. AASI was used for preoperative assessment of airway. Sensitivity, and specificity were calculated for AASI. In this study, data analysis was done using chi-square. p < 0.05 was considered statistically significant. RESULTS Difficult Visualization of Larynx was observed in 3.6 % [95 % confidence interval (1.9-5.4 %)] patients. Our study found that sensitivity and specificity were 75 % and 95.7 % respectively. CONCLUSIONS Acromio-Axillary-Suprasternal Notch Index (≥ 0.5) is a clear indicator of difficult larynx visualization with direct laryngoscopy.