Suchergebnisse

Conversion of fetal circulation to adult-type occurs immediately after birth but neonates with problems in the development of pulmonary vasculature are prone to revert back to fetal circulation. This phenomenon is known as flip-flop circulation which may be induced perioperatively and as such anesthesiologist are central to its management. We report a case of term neonate planned for repair of duodenal atresia that despite having no respiratory symptom preoperatively developed severe hypoxemia under anesthesia that was even unresponsive to 100% oxygen. The intraoperative hemodynamics of the neonate was managed along with supportive care successfully. A postoperative echocardiogram confirmed the evidence of persistent pulmonary hypertension of the newborn.Keywords: Duodenal atresia; flip flop circulation; neonates; persistent pulmonary hypertension of newborn

Provision of anesthesia services in a deprived area particularly in low income countries is a major challenge all over the globe. Along with issues of manpower, logistics, services, there lies agendas of safety and accuracy while delivering the services. With rise in ultrasound use in regional anesthesia, pain and perioperative care, it is prudent that some of these issues can be addressed with proper training, mentoring and monitoring. The global idea needs to be implemented locally to reach out to huge volume of patients who are inadequately treated for the various painful conditions. A group of regional enthusiasts from Nepal takes the vision and mission in Nepalese context to address the issues. Keywords: Low income country; rural anesthesia; safety; ultrasound guided regional anesthesia

Background: Cooled Radiofrequency ablation is a newer technique for management of chronic knee pain in osteoarthritis. The aim of the study is to evaluate the clinical outcomes in patients with chronic osteoarthritis in terms of pain scores for first six months of cooled radiofrequency ablation using ultrasound guidance. Methods: A cross-sectional study with retrospective review of database was evaluated to analyze the change in the Numerical Rating Scale from baseline scores at 1 day, 1 month and 6 months after the Cooled Radiofrequency ablation of genicular nerves around knee in patients with chronic knee osteoarthritis. Results: Median age was 71 years [ 61-73 years (IQR: 25-75)] with more female preponderance. Numerical Rating Scale (Mean ± S.D.) was significantly less at 1 day (1.87 ± 1.22), 1 month (3.03 ± 0.99) and 6 months (3.37 ± 1.098) from baseline values (6.77 ± 1.00). No soreness and numbness were noted.Conclusions: Cooled Radiofrequency using Ultrasound guidance for management of knee pain in chronic osteoarthritis is promising and reduces Numerical Rating Score significantly from baseline at 1 month and 6 months respectively.Keywords: Cooled radiofrequency ablation; genicular nerve; numeric rating scale