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Research paper thumbnail of Height-adjusted dose of intrathecal bupivacaine on surgical anesthesia for the cesarean section

Journal of Obstetric Anaesthesia and Critical Care

Research paper thumbnail of Analgesic Efficacy of Suprascapular Nerve Block versus Combined Suprascapular and Axillary Nerve Block in Patients Undergoing Shoulder Arthroscopy: A Prospective, Randomized, Comparative Study

Indian Journal of Pain, Jan 9, 2024

Research paper thumbnail of Height-adjusted dose of intrathecal bupivacaine on surgical anesthesia for the cesarean section

Journal of Obstetric Anaesthesia and Critical Care, 2023

Research paper thumbnail of Comparison of Equivalent Doses of Intrathecal Hyperbaric Levo-bupivacaine and Hyperbaric Bupivacaine for Caesarean Section: A Prospective Randomised Double-Blind Study

Journal of clinical and diagnostic research, 2024

Research paper thumbnail of Analgesic efficacy of suprascapular nerve block versus combined suprascapular and axillary nerve block in patients undergoing shoulder arthroscopy: A prospective, randomized, comparative study

Background and aim: This study aimed to compare the efficacy of combined suprascapular nerve bloc... more Background and aim: This study aimed to compare the efficacy of combined suprascapular nerve block (SSNB) and axillary nerve block (ANB) with SSNB alone for analgesia after shoulder arthroscopy in terms of level of pain scores, total analgesic consumption and patient satisfaction in 24 hours. Methods: Forty one patients posted for shoulder arthroscopy were randomly allocated into two groups, group S (n=20), receiving SSNB and group C (n=21) receiving combined SSNB and ANB. Visual analogue scale (VAS) both at rest and during movement at 1, 3, 6, 12, 24 hours and at the time of first demand, total consumption of analgesics in 24 hours and patient satisfaction score at 12 and 24 hours were noted. Results: The VAS scores both at rest and during movement were significantly less in group C at 1, 6, 12 hours and at the time of first demand of analgesic (p < 0.05). Compared to group S, group C had a longer pain free duration (154.3 ± 11.41 min vs 36.60 ± 6.553 min; p < 0.001) and less...

Research paper thumbnail of Comparative Study of Intra Articular Hyaluronic Acid and Intra Articular and Para Articular Dextrose Prolotherapy in Mild to Moderate Knee Osteoarthrosis

Introduction: Osteoarthrits is the most common joint disease worldwide with a prevalence of 22 to... more Introduction: Osteoarthrits is the most common joint disease worldwide with a prevalence of 22 to 39% in India. Minimally invasive treatments are a success when conservative methods fail. The aim of the study was to compare the established treatment of intra-articular hyaluronic acid with the more novel approach of intra-articular and para-articular dextrose. Material and methods: Thirty patients with Knee OA were divided into two groups of fifteen each and were either injected intra-articularly with high molecular weight hyaluronic acid (group H) or a mixture of 12.5% dextrose and 1% lidocaine (group D). Pre and post procedure Visual Analogue Scale and Western Ontario and McMaster University Arthritis Index assessment scale scores were compared before and two months after the procedure. Data were analysed using chisquared test, unpaired and paired t-test. Results: There was a significant reduction of both Visual Analogue Scale (VAS) and Western Ontario and McMaster University Arthritis Index assessment scale (WOMAC) scores at two months when compared to pre-procedure scores (p<0.05) for both groups. However, the reduction in both the scores were significantly lower in post procedure period for intra-articular dextrose when compared to hyaluronic acid (p=0.011 and p=0.004 respectively). Conclusion: Intraarticular dextrose is certainly one of the better minimally invasive treatment for knee OA when compared to high molecular weight hyaluronic acid and at amuch lower cost.

Research paper thumbnail of Comparision of airway assessment by Mallampati classification and cormack and lehane grading in Indian population

Introduction: This prospective cross-sectional observational study was undertaken to compare prea... more Introduction: This prospective cross-sectional observational study was undertaken to compare preanaesthetic predictive value of Modified Mallampati classification in relation to Cormac Lehane grades in Indian population. Materials and Methods: One hundred patients of either sex, who have underwent general anaesthesia were includes in the study. Inclusion criteria were aged between 18 to 60 years, ASA grades I and II, weighing between 45- 80 kg. The parameters observed were, Mallampati class (MMT) during pre anaesthetic assessment and their percentages, Cormack and Lehane grades (CL) at intubation and their percentages and correlation of Cormack and Lehane grading and Mallampati classification. Results: Out of 100 patients, men women ratio was 1: 2.1(32: 68), mean age of the patients were 43.15± 12.96yrs, mean BMI of the patients were 23.34 ± 1.34 kg/m?2;. The corrected chi square test showed a value of 76.8 with a P value of &lt; 0&gt; Conclusion: To increase predictive value of pre assessment of difficult airway, Mallampati test should be supplemented by other airway assessment tools. Keywords: Mallampati test, Predictive value, Difficult intubation.

Research paper thumbnail of Correlation between the spinal levels identified by palpation of the iliac crests and the posterior superior iliac spine and radiology in patients undergoing lower limb orthopaedic surgeries

Indian Journal of Clinical Anaesthesia

Introduction: The assessment of spinal levels by palpation using the superior aspect of iliac cre... more Introduction: The assessment of spinal levels by palpation using the superior aspect of iliac crest as a guide is a routine practice. Through this study we want to assess the accuracy of the determination of lumbar spinal spaces by palpation of iliac crest and posterior superior iliac spine using an X- ray image intensifier. Materials and Methods: 132 Patients scheduled for lower limb orthopaedic surgery were included. The spinal level corresponding to the intercristal line (ICL) and posterior superior iliac spine (PSIS) line was identified by palpation and marked with a radio-opaque marker in the sitting position. A radiology image was then taken in supine position to locate the position of the markers. Results: The levels identified by palpation were in agreement with radiological levels in 51.5% of cases. In 39% cases the level identified was one space higher and in 9.5% cases it was two spaces higher. PSIS line identified the L5-S1 inter-spinous space in 34 (25.75%) patients, S1 and S2 spinous processes in 52 (39%) patients and 17 (12.8%) patients respectively. Conclusion: In 49% of the cases there was an inaccurate identification of the spinal level by palpation of iliac crest in cephalad direction, more so in elderly patients and patients with higher BMIs. So in these cases a clinician should be doubtful of the palpated landmark to be corresponding to a higher level. PSIS line ranges from L4-L5 interspace to S2 spinous process and therefore cannot be a reliable guide for identification of a spinal level.

Research paper thumbnail of Comparision of airway assessment by Mallampati classification and cormack and lehane grading in Indian population

Indian Journal of Clinical Anaesthesia

Introduction: This prospective cross-sectional observational study was undertaken to compare prea... more Introduction: This prospective cross-sectional observational study was undertaken to compare preanaesthetic predictive value of Modified Mallampati classification in relation to Cormac Lehane grades in Indian population. Materials and Methods: One hundred patients of either sex, who have underwent general anaesthesia were includes in the study. Inclusion criteria were aged between 18 to 60 years, ASA grades I and II, weighing between 45- 80 kg. The parameters observed were, Mallampati class (MMT) during pre anaesthetic assessment and their percentages, Cormack and Lehane grades (CL) at intubation and their percentages and correlation of Cormack and Lehane grading and Mallampati classification. Results: Out of 100 patients, men women ratio was 1: 2.1(32: 68), mean age of the patients were 43.15± 12.96yrs, mean BMI of the patients were 23.34 ± 1.34 kg/m?2;. The corrected chi square test showed a value of 76.8 with a P value of &lt; 0&gt; Conclusion: To increase predictive value of pre assessment of difficult airway, Mallampati test should be supplemented by other airway assessment tools. Keywords: Mallampati test, Predictive value, Difficult intubation.

Research paper thumbnail of Phantom tooth pain: The atypical facial pain

Indian Journal of Pain, 2015

Research paper thumbnail of Height-adjusted dose of intrathecal bupivacaine on surgical anesthesia for the cesarean section

Journal of Obstetric Anaesthesia and Critical Care

Research paper thumbnail of Analgesic Efficacy of Suprascapular Nerve Block versus Combined Suprascapular and Axillary Nerve Block in Patients Undergoing Shoulder Arthroscopy: A Prospective, Randomized, Comparative Study

Indian Journal of Pain, Jan 9, 2024

Research paper thumbnail of Height-adjusted dose of intrathecal bupivacaine on surgical anesthesia for the cesarean section

Journal of Obstetric Anaesthesia and Critical Care, 2023

Research paper thumbnail of Comparison of Equivalent Doses of Intrathecal Hyperbaric Levo-bupivacaine and Hyperbaric Bupivacaine for Caesarean Section: A Prospective Randomised Double-Blind Study

Journal of clinical and diagnostic research, 2024

Research paper thumbnail of Analgesic efficacy of suprascapular nerve block versus combined suprascapular and axillary nerve block in patients undergoing shoulder arthroscopy: A prospective, randomized, comparative study

Background and aim: This study aimed to compare the efficacy of combined suprascapular nerve bloc... more Background and aim: This study aimed to compare the efficacy of combined suprascapular nerve block (SSNB) and axillary nerve block (ANB) with SSNB alone for analgesia after shoulder arthroscopy in terms of level of pain scores, total analgesic consumption and patient satisfaction in 24 hours. Methods: Forty one patients posted for shoulder arthroscopy were randomly allocated into two groups, group S (n=20), receiving SSNB and group C (n=21) receiving combined SSNB and ANB. Visual analogue scale (VAS) both at rest and during movement at 1, 3, 6, 12, 24 hours and at the time of first demand, total consumption of analgesics in 24 hours and patient satisfaction score at 12 and 24 hours were noted. Results: The VAS scores both at rest and during movement were significantly less in group C at 1, 6, 12 hours and at the time of first demand of analgesic (p < 0.05). Compared to group S, group C had a longer pain free duration (154.3 ± 11.41 min vs 36.60 ± 6.553 min; p < 0.001) and less...

Research paper thumbnail of Comparative Study of Intra Articular Hyaluronic Acid and Intra Articular and Para Articular Dextrose Prolotherapy in Mild to Moderate Knee Osteoarthrosis

Introduction: Osteoarthrits is the most common joint disease worldwide with a prevalence of 22 to... more Introduction: Osteoarthrits is the most common joint disease worldwide with a prevalence of 22 to 39% in India. Minimally invasive treatments are a success when conservative methods fail. The aim of the study was to compare the established treatment of intra-articular hyaluronic acid with the more novel approach of intra-articular and para-articular dextrose. Material and methods: Thirty patients with Knee OA were divided into two groups of fifteen each and were either injected intra-articularly with high molecular weight hyaluronic acid (group H) or a mixture of 12.5% dextrose and 1% lidocaine (group D). Pre and post procedure Visual Analogue Scale and Western Ontario and McMaster University Arthritis Index assessment scale scores were compared before and two months after the procedure. Data were analysed using chisquared test, unpaired and paired t-test. Results: There was a significant reduction of both Visual Analogue Scale (VAS) and Western Ontario and McMaster University Arthritis Index assessment scale (WOMAC) scores at two months when compared to pre-procedure scores (p<0.05) for both groups. However, the reduction in both the scores were significantly lower in post procedure period for intra-articular dextrose when compared to hyaluronic acid (p=0.011 and p=0.004 respectively). Conclusion: Intraarticular dextrose is certainly one of the better minimally invasive treatment for knee OA when compared to high molecular weight hyaluronic acid and at amuch lower cost.

Research paper thumbnail of Comparision of airway assessment by Mallampati classification and cormack and lehane grading in Indian population

Introduction: This prospective cross-sectional observational study was undertaken to compare prea... more Introduction: This prospective cross-sectional observational study was undertaken to compare preanaesthetic predictive value of Modified Mallampati classification in relation to Cormac Lehane grades in Indian population. Materials and Methods: One hundred patients of either sex, who have underwent general anaesthesia were includes in the study. Inclusion criteria were aged between 18 to 60 years, ASA grades I and II, weighing between 45- 80 kg. The parameters observed were, Mallampati class (MMT) during pre anaesthetic assessment and their percentages, Cormack and Lehane grades (CL) at intubation and their percentages and correlation of Cormack and Lehane grading and Mallampati classification. Results: Out of 100 patients, men women ratio was 1: 2.1(32: 68), mean age of the patients were 43.15± 12.96yrs, mean BMI of the patients were 23.34 ± 1.34 kg/m?2;. The corrected chi square test showed a value of 76.8 with a P value of &lt; 0&gt; Conclusion: To increase predictive value of pre assessment of difficult airway, Mallampati test should be supplemented by other airway assessment tools. Keywords: Mallampati test, Predictive value, Difficult intubation.

Research paper thumbnail of Correlation between the spinal levels identified by palpation of the iliac crests and the posterior superior iliac spine and radiology in patients undergoing lower limb orthopaedic surgeries

Indian Journal of Clinical Anaesthesia

Introduction: The assessment of spinal levels by palpation using the superior aspect of iliac cre... more Introduction: The assessment of spinal levels by palpation using the superior aspect of iliac crest as a guide is a routine practice. Through this study we want to assess the accuracy of the determination of lumbar spinal spaces by palpation of iliac crest and posterior superior iliac spine using an X- ray image intensifier. Materials and Methods: 132 Patients scheduled for lower limb orthopaedic surgery were included. The spinal level corresponding to the intercristal line (ICL) and posterior superior iliac spine (PSIS) line was identified by palpation and marked with a radio-opaque marker in the sitting position. A radiology image was then taken in supine position to locate the position of the markers. Results: The levels identified by palpation were in agreement with radiological levels in 51.5% of cases. In 39% cases the level identified was one space higher and in 9.5% cases it was two spaces higher. PSIS line identified the L5-S1 inter-spinous space in 34 (25.75%) patients, S1 and S2 spinous processes in 52 (39%) patients and 17 (12.8%) patients respectively. Conclusion: In 49% of the cases there was an inaccurate identification of the spinal level by palpation of iliac crest in cephalad direction, more so in elderly patients and patients with higher BMIs. So in these cases a clinician should be doubtful of the palpated landmark to be corresponding to a higher level. PSIS line ranges from L4-L5 interspace to S2 spinous process and therefore cannot be a reliable guide for identification of a spinal level.

Research paper thumbnail of Comparision of airway assessment by Mallampati classification and cormack and lehane grading in Indian population

Indian Journal of Clinical Anaesthesia

Introduction: This prospective cross-sectional observational study was undertaken to compare prea... more Introduction: This prospective cross-sectional observational study was undertaken to compare preanaesthetic predictive value of Modified Mallampati classification in relation to Cormac Lehane grades in Indian population. Materials and Methods: One hundred patients of either sex, who have underwent general anaesthesia were includes in the study. Inclusion criteria were aged between 18 to 60 years, ASA grades I and II, weighing between 45- 80 kg. The parameters observed were, Mallampati class (MMT) during pre anaesthetic assessment and their percentages, Cormack and Lehane grades (CL) at intubation and their percentages and correlation of Cormack and Lehane grading and Mallampati classification. Results: Out of 100 patients, men women ratio was 1: 2.1(32: 68), mean age of the patients were 43.15± 12.96yrs, mean BMI of the patients were 23.34 ± 1.34 kg/m?2;. The corrected chi square test showed a value of 76.8 with a P value of &lt; 0&gt; Conclusion: To increase predictive value of pre assessment of difficult airway, Mallampati test should be supplemented by other airway assessment tools. Keywords: Mallampati test, Predictive value, Difficult intubation.

Research paper thumbnail of Phantom tooth pain: The atypical facial pain

Indian Journal of Pain, 2015