Massive subcutaneous emphysema during emergence from anesthesia followed by seizures.
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Biomedical subjects
Publications and source records attributed to R Ganta.
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We have studied the effects of bilateral ilioinguinal nerve block and wound infiltration with 0.5% bupivacaine on postoperative pain and analgesic requirements in 62 patients undergoing Caesarean section under general anaesthesia. A control group received no local anaesthetic supplementation. Both ilioinguinal block and wound infiltration reduced significantly the pain scores and analgesic requirements in the immediate postoperative period (P < 0.05). The differences in pain scores and analgesic requirements between the study groups were not statistically significant (P > 0.05).
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We have conducted a randomized, double-blind study in 255 ASA I and II patients to compare the efficacy of lignocaine and metoclopramide in minimizing the pain of injection of i.v. propofol. When administered immediately before propofol into a dorsal hand vein, compared with placebo both drugs significantly reduced the incidence of pain on subsequent injection of propofol (P < 0.001). Twenty patients who had received metoclopramide (n = 85) experienced pain, compared with 18 who had received lignocaine (n = 85) and 42 who had been pretreated with saline (n = 85).
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In forty patients (aged 21-76 years) scheduled for elective surgery, anaesthesia was induced with either etomidate in propylene glycol (n = 20) or etomidate in ethanol (n = 20) injected via a 23-G needle over 30 s. The overall incidence of pain on injection was 60%. No statistically significant difference was found between the two groups. The incidence of venous sequelae was 5%, in both groups.
The anaesthetic management of two patients with severe muscle weakness--one suffering from acute dermatomyositis, the other from acute polymyositis--is described. Both patients presented for surgery for malignancy. Anaesthesia was induced with etomidate in one, thiopentone in the other. Alfentanil was used for analgesia and atracurium for muscle paralysis in both. Neuromuscular blockade was monitored using a peripheral nerve stimulator and no problems were experienced. Recovery of neuromuscular transmission and ventilatory function after operation were normal.
A case of tetanus sufficiently severe to require treatment with neuromuscular blocking drugs and controlled ventilation is described. The use of an infusion of vecuronium helped to minimise the cardiovascular disturbances which accompanied the disease and permitted rapid spontaneous reversal of neuromuscular blockade when the infusion was stopped.
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