scholarly journals MANAGEMENT OF ANESTHESIA ON PATIENTS WHO WALK IN SESAROUS SECTION WITH ARTERITICAL TAKAYASU DISEASE

2020 ◽  
Vol 3 (2) ◽  
pp. 91-98
Author(s):  
Muhammad Dwi Satriyanto
Keyword(s):  
Postoperative Complications ◽  
Caesarean Section ◽  
Pulmonary Artery ◽  
Cerebral Perfusion ◽  
Hemodynamic Stability ◽  
Sensory Blockade ◽  
Hypertensive Patients ◽  
Takayasu Disease ◽  
Idiopathic Disease ◽  
Anesthesia Epidural

Takayasu Arteritis Disease (TA) is a chronic inflammatory,  progressive,  and idiopathic disease causes  narrowing, obstruction and aneurysms in systemic arterial and pulmonary artery, which mainly attacks the aorta and its branches. During pregnancy, these patients should be given special attention, in connection with any complications that may occur. Case is a woman 32 years 38 weeks pregnant with TA disease with changes in several branches of the aorta since thirteen years ago. During pregnancy there are no complaints, and now she went to the hospital with 37-38 weeks gestation. Caesarean section has been done with regional anesthesia - epidural. Local anesthesia is administered by titration with the hope of sensory blockade obtained gradually. After procedure patient had observation in the recovery room and hemodynamic was stable  then moved to ward. Conclusion of the case is some complications can affect pregnancy in patients with TA. In pre anesthetic evaluation should be done carefully, treatment of complications and anesthetic planning are essential. Maintenance of perfusion is a major concern for patients and neuraxial blocks can be used without harming the mother and fetus. In patients with complications of TA was still compensated, monitoring during the procedure the same as routinely used. Provision of continuous epidural anesthesia with titration to maintain hemodynamic stability and allows monitoring of cerebral perfusion through the levels of consciousness. To avoid hypoperfusion or postoperative complications of hypertensive patients should be monitored closely for 24 hours.

scholarly journals Repeat Spinal Anaesthesia for Caesarean section: An Experience at Paropakar Maternity and Women’s Hospital

2018 ◽  
Vol 12 (2) ◽  
pp. 58-60
Author(s):  
Ritu Pradhan ◽  
Sangeeta Shrestha ◽  
Tara Gurung ◽  
Amirbabu Shrestha
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Intrathecal Injection ◽  
Common Adverse Effect ◽  
Haemodynamic Effects ◽  
Sensory Blockade ◽  
Repeat Administration ◽  
Complete Failure ◽  
Motor Effects

Aims: This study aims to review the haemodynamic effects of the repeat spinal anaesthesia and to identify the different doses of Bupivacaine heavy used for the repeat spinal anaesthesia for the failed spinal in caesarean section.Methods: This study was conducted by reviewing medical anaesthesia records of the cases of the repeat spinal anesthesia regarding any adverse haemodynamic effects. The second dose of bupivacaine heavy, maximum sensory blockade and intraoperative events like bradycardia, hypotension, high spinal, nausea vomiting, conversion to general anaesthesia and inadequate block were also reviewed.Results: Out of 8040 caesarean section under subarachnoid block, 51(0.63%) cases were conducted under repeat spinal anaesthesia from April 2014 to December2016. All the cases had complete spinal failure with no sensory and motor effects even after 10 minutes of the intrathecal injection. The second dose of bupivacaine heavy used was variable but reduced than the first dose. The most common adverse effect was hypotension (27.5%). 50% of cases were uneventful. One case was converted to general anaesthesia even after repeat spinal anaesthesia and 9.8% cases had high spinal above T4.Conclusions: Repeat administration of Bupivacaine heavy in reduced dose and volume can be used in complete failure of administration of first spinal anaesthesia. However, it always requires careful assessment and the judicious monitoring.

scholarly journals The inevitable and incidental caesarian myomectomy

2019 ◽  
Vol 9 (1) ◽  
pp. 421
Author(s):  
Vinita Sarbhai
Keyword(s):  
Postoperative Complications ◽  
Caesarean Section ◽  
Traditional Approach ◽  
Bishop Score ◽  
Pregnant Uterus

The management of fibroid encountered during caesarean remains controversial. The traditional approach has always been, not to perform myomectomy, because of the fear of haemorrhage due to increased vascularity and uterine atonicity of pregnant uterus and increased morbidity. Caesarean section was performed in 27-year G2P1 in view of previous LSCS, short inter-conception period, frank leaking and poor bishop score. After delivery of baby a fibroid of 6 cm by 5 cm was seen jutting out of left side of incision line. Myomectomy was performed, without any complication, as it was not possible to approximate the incision line without that. No excessive hemorrhage or postoperative complications were encountered.

scholarly journals Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients?

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Gulbin Sezen ◽  
Yavuz Demiraran ◽  
Ilknur Suidiye Seker ◽  
Ibrahim Karagoz ◽  
Abdulkadir Iskender ◽  
...  
Keyword(s):  
Hemodynamic Stability ◽  
Hypertensive Patients

scholarly journals Our Experience with Iatrogenic Ureteric Injuries among Women Presenting to University College Hospital, Ibadan: A Call to Action on Trigger Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Olatunji Lawal ◽  
Oluwasomidoyin Bello ◽  
Imran Morhason-Bello ◽  
Rukiyat Abdus-salam ◽  
Oladosu Ojengbede
Keyword(s):  
Postoperative Complications ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Abdominal Hysterectomy ◽  
Ureterovaginal Fistula ◽  
Ureteric Injury ◽  
College Hospital ◽  
University College ◽  
Retrospective Data Collection ◽  
Ureteric Injuries

Background. Ureteric injuries leading to ureterovaginal fistula (UVF) is less common than vesicovaginal fistula, as a cause of urinary incontinence. Recently, there is a surge in the number of UVF cases presenting to University College Hospital (UCH) following a caesarean delivery. The urogynaecology unit at UCH is at the forefront of providing surgical repair for women with all forms of genitourinary fistulas. We describe our experience with managing UVF arising from ureteric injury. Methods. A retrospective data collection of UVF cases managed from January 2012–December 2017 at UCH is presented. Information on sociodemographic and obstetric characteristics, presenting complaints, antecedent surgery, treatment received, findings at surgery, and postoperative complications were obtained with a structured proforma. Results. Eighteen cases of UVFs due to iatrogenic ureteric injury were managed. Majority (N=11; 61.1%) of the women suffered the injury following the emergency caesarean section (EMCS). Abdominal hysterectomy operation accounted for four (22.2%) cases, and one case each (5.6%) was due to vaginal hysterectomy and destructive operations. Prolonged obstructed labour (POL) (81.8%) was the most common indication for the EMCS, while 18.2% had surgery on account of lower uterine segment fibroid. Most of the ureteric injuries were on the left side. Postoperative complications documented were haemorrhage, urinary tract infection, wound infection, and injury to the neighbouring structure. Conclusion. Caesarean section being one of the most performed surgical operations in Nigeria was surprisingly found to be the most common cause of ureteric injury ahead of hysterectomy. It is a pointer that the surgeons might not have properly learnt the art of the caesarean delivery well. We recommend adequate surgical training of medical officers/surgeons that are involved.

Isolated Takayasu Disease of the Pulmonary Artery Mimicking Recurrent Pulmonary Embolis

CHEST Journal ◽  
2003 ◽  
Vol 124 (4) ◽  
pp. 298S
Author(s):  
Juan E. Morales ◽  
Daniel Iltchev ◽  
James N. Allen ◽  
Namita Sood
Keyword(s):  
Pulmonary Artery ◽  
Takayasu Disease

scholarly journals A comparative study of intrathecal bupivacaine and levobupivacaine for patients undergoing caesarean section

2019 ◽  
Vol 6 (6) ◽  
pp. 1792
Author(s):  
Kiranpreet Kaur ◽  
Sanjay Johar ◽  
Anil Kumar ◽  
Mamta Jain ◽  
Prashant Kumar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Onset Time ◽  
Sensory Block ◽  
P Value ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Pregnant Females ◽  
Haemodynamic Stability ◽  
Group B

Background: The present study was conducted to compare the effects of 0.5% isobaric levobupivacaine and 0.5% hyperbaric bupivacaine in pregnant females undergoing caesarean section.Methods: Study was conducted on 100 pregnant females undergoing caesarean section. They were randomly divided into two groups B and L receiving 2 ml of 0.5% hyperbaric bupivacaine and 0.5% levobupivacaine respectively. Two groups were compared with regard to sensory block, motor block, haemodynamic stability and complications if any.Results: Time to achieve sensory blockade till T6 dermatome was prolonged in group B (162.52±80.55 sec) as compared to group L (139.40±49.79 seconds) (p value= 0.087). Prolonged duration of motor blockade was observed in group B (160.76±6.56 minutes) as compared to group L (131.48±14.42 minutes) (p<0.001). Less haemodynamic stability was seen in patients of group B with more incidence of hypotension and bradycardia.as compared to group L.Conclusions: Levobupivacaine is nearly equally effective to bupivacaine to produce sensory and motor blockade with comparable onset time and better haemodynamic stability with lesser side effects.

scholarly journals A Comparison of Perioperative Hemodynamic Stability with Amlodipine and Telmisartan during Laparoscopic Cholecystectomy in known Hypertensive Patients

2019 ◽  
Vol 8 (2) ◽  
pp. AN04-AN07
Author(s):  
Mandeep Manohar Harison Madia ◽  
◽  
Atul Kumar Singh ◽  
Subhdeep Manohar Wrangler Richi ◽  
Ram Badan Singh ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hemodynamic Stability ◽  
Hypertensive Patients

INTRATHECALLY ADMINISTERED ADJUVANTS MIDAZOLAM AND CLONIDINE WITH BUPIVACAINE ON HEMODYNAMIC STABILITY- A PROSPECTIVE STUDY

2021 ◽  
pp. 12-14
Author(s):  
Ganga Nagalakshmi ◽  
Subha . J
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Respiratory Rate ◽  
Pulse Rate ◽  
Normal Saline ◽  
Sensory Block ◽  
Sensory Level ◽  
Motor Blockade ◽  
Hemodynamic Stability ◽  
Sensory Blockade

We conducted a double blinded randomized control study in 60 patients belonging to ASA I and II undergoing elective lower abdominal surgeries. Patients of both sexes ranging between 22 to 65 years of age were included. Our aim was to evaluate the effects of intrathecal midazolam 2mg and clonidine 30 mcg as adjuvant to bupivacaine for hemodynamic stability and postoperative analgesia. Patients were divided randomly using closed cover technique into two groups of 25 each.Group BM received 3ml of 0.5% heavy bupivacaine 0.4ml midazolam (preservative free) and 0.1ml of normal saline. Group BC received 3ml of 0.5% heavy bupivacaine, 0.2ml clonidine and 0.3 ml of normal saline. The total volume of the injected solution was 3.5ml in both groups. The onset of sensory and motor blockade, the duration of sensory and motor blockade, peak sensory level, time to achieve maximum sensory level, changes in pulse rate, changes in mean arterial pressure, duration of analgesia, respiratory rate, o saturation, 2 sedation score and adverse effects were noted in both groups. The data collected were analyzed by Chi square test and students't' tests. We found that onset of sensory and motor blockade, time to achieve maximum sensory level, and duration of complete motor recovery was earlier in BM group than BC group. Duration of Sensory block and duration of analgesia were prolonged in BM group than BC group. In both groups, no signicant changes were observed in respiratory rate, O saturation and sedation in our study. Intrathecal Midazolam as an adjuvant to bupivacaine 2 comparing to Clonidine resulted Rapid onset of sensory and motor blockade, Achieves maximum sensory level at a shorter interval, Increased duration of sensory blockade and decreased duration of Motor blockadeIt gives stable mean arterial pressure and pulse rate.

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