The Krypton Anesthesia Essentials
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Discussion about high risk Anesthesia cases management and daily essentials Anesthesia practice secrets
MRI Brain under sedation...
? Cerebral edema
Day of life -15 day/2kg/M
Drugs used -
1) Inj. Atropine 10mcg/kg = 30 mcg
2) Inj. Midaz 20 mcg/kg = 40 mcg
3) Inj. Ketamine 2 mg/kg = 4 mg
4) inj. dexamethasone 0.2mg/kg = 0.4 mg
All given IV
Position given for MRI
After 5 min.
Inj. Fentanyl 2 mcg/kg = 4 mcg given
5 cc NS for flush
Oxygen via Nasal prongs 2 ltr./min
PMO line attached for maintenance dose,
if required
HR and RR monitored on MRI compatibile monitor
Duration = 25 min.
No need of top up dose
Recovery
Baby shows movements after stimulus
Shifted in post op room
Oxygen 1 ltr./min. Through nasal prongs for 10 min.
SpO2 -100%
HR - 145/min.
Then pt. Is maintaining room air saturation
Baby is allowed to go home after 30 min.
NBM 2 hrs.
Inform 🆘
28/04/2023
2023
24/04/2023
23/04/2023
27 years gentleman history of domestic fall from height came with bilateral lower limb complete shutdown he had traumatic fracture of L2 with retropulsion .
He was operated 5 weeks back at Nithya hospital jaysingpur by me
He underwent Spine surgery in the form of decompression and stabilization with deformity correction.
Dr Pravin Chavan played a vital role in giving Anaesthsia for such a long procedure
Now he is neurologically improving day by day. The patient is able to walk with & without support.
Dr Amarjeet Jagadale
Ortho & spine surgeon
Nithya Hospital
Jaysingpur
03/03/2023
Drager Microvent 8412600
19/02/2023
Day of Life - 32
Weight - 1.29 kg
Posted for - CT aortography to delineate arch anatomy and tracheal compression under sedation
Obstetrics history -
28 weeks born emergency LSCS - pre-eclampsia
Birth weight - 870 gm
On IPPV for 8 days
Now on nasal prongs O2 - 2ltr./min.
26G two intra-cath on both hands secured
Known case of ASD, VSD, double aortic arch.
Increased respiratory rate and effort.
Anesthesia Management -
Inj. Glycopyrolate 5 mcg
Inj.Midaz 20 mcg
Inj.Ketamine 2 mcg iv slowly given
NS -2 cc
HR -160-170/ min. Maintained
Procedure uneventful
19/02/2023
Position for Anterior vaginal wall-ureteric fistula repair
Anesthesia -
Spinal + Epidural
Spinal - Inj. Bupivacaine heavy 0.5% 2.8 + Inj. Clonidine 30 mcg
In sitting position with 27 G spinal needle
Epidural - L3-L4 level
Catheter fixed at 9 cm
Confirmed
Then pt. Kept in supine position for 20 min.
After action well settled given this position
14/12/2022
Left frontal parasaggital Meningioma
50yr/F/55 kg
No other comorbidities
MPC -2
Rest investigations normal
General Anesthesia
Premed
Inj.Glyco 0.2 mg
Inj.Fent 100 mcg
Induction
Precurarisation
Inj. Vec 2 mg
Inj. Propofol 100 mg
Inj.Vec 2 mg
Intubated with ET no.7
Air entry B/L equal and clear and fixed at 20 cm
Low flow Anesthesia after MAC 0.8 achieved
02 0.9 + Air 0.9
Sevo 0.8
Inj.Dexmed 50 mcg in 100 ml NS
Before incision
Intraop -BP 90/60 maintained
Uneventful
Duration -2 hrs.
Inj.PCT 1 gm before extubation
Inj. Xylocard 2 cc after spontaneous efforts
Extubated awake with just gentle tap
Haemodynamicaly stable
Sp02 -98 % on room air
02/12/2022
58 yr/Male/90 kg
MPC -3
Posted for DJ stent before CABG
P-98/min
BP - 150/94 mm of hg
SA - Inj. Ropivac 0.5% Heavy 1.5 cc used
T -10 level achieved
Minimal hemodynamic changes
Emergency drugs and protocol for MI salvation kept ready
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