Patent Ductus Arteriosus
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Anesthesia
PERIOPERATIVE FLUID MANAGEMENT IN CHILDREN
PERIOPERATIVE FLUID MANAGEMENT IN CHILDREN 1. INTRODUCTION Perioperative fluid management in children requires an understanding of age-dependent physiology, indications for fluid administration, the composition of available solutions, and the effects of anaesthesia and surgery on fluid distribution. Neonates and infants are particularly vulnerable because of their higher total body water fraction, greater extracellular fluid proportion,
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Tetralogy of fallot
Tetralogy of fallot Introduction Prevalence Tetralogy of Fallot (TOF) occurs in 5% to 10% of all CHDs. This is the most common cyanotic heart defect. The classic description of TOF includes the following four abnormalities: VSD, pulmonary stenosis (PS), right ventricular hypertrophy (RVH), and overriding of the aorta. From a physiologic point of view, TOF
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VENTILATION STRATEGIES IN CHILDREN
VENTILATION STRATEGIES IN CHILDREN INTRODUCTION Mechanical ventilation is one of the most commonly used organ-support therapies in paediatric intensive care and anaesthesia. Children differ significantly from adults in respiratory anatomy, lung mechanics, chest wall compliance, airway calibre, oxygen consumption, and respiratory muscle function. Consequently, ventilation strategies derived from adult studies cannot be simply extrapolated to
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Ketamine in Pain Management
Sub-Dissociative Dose Ketamine (SDK) in Pain Management 1. Pharmacology & Mechanism of Action Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist. In sub-dissociative analgesic doses (0.1–0.3 mg/kg IV), ketamine blocks NMDA-mediated central sensitization, wind-up phenomenon, and hyperalgesia without inducing general anesthesia or procedural dissociation. 2. Dosing Spectrum & Clinical Administration Dosing Category Intravenous Dose Range Primary
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Local Anesthetics in Pain Management
Local Anesthetics in Pain Management: Pharmacology & Safety Protocols 1. Mechanism of Action & Nerve Blockade Local anesthetics prevent conduction of nerve impulses by reversibly binding to the intracellular domain of voltage-gated sodium (Na+) channels. By stabilizing the inactivated state, local anesthetics inhibit rapid depolarization and action potential propagation in peripheral nerve fibers (C >
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Anesthesia Consideration in Patient with Coronary Artery disease.
Introduction For a patient with known coronary artery disease undergoing non-cardiac surgery, the anaesthetic goal is to prevent myocardial ischemia, maintain coronary perfusion, and avoid major hemodynamic swings. Preoperative Assessment of Patient with History of CAD • Determine the coronary artery disease history and duration of the CAD. • An acute MI is one that
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Supraclavicular brachial plexus block
Supraclavicular brachial plexus block History First introduced by Kulemkempff and Percy in 1911 for mid humerus level to hand surgeries. Relevant anatomy Targets the trunks of brachial plexus formed by C5 -T1 when they form divisions at the level of clavicle. Subclavian artery lies on top of fist rib along with brachial plexus lying
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DIFFICULT PEDIATRIC AIRWAY
DIFFICULT PEDIATRIC AIRWAY Definition A difficult paediatric airway is a clinical situation in which a conventionally trained anaesthesiologist experiences difficulty with one or more of the following: Face mask ventilation Supraglottic airway placement Tracheal intubation Extubation Front-of-neck access (FONA) Children desaturate much faster than adults because of: Higher oxygen consumption (6–8 mL/kg/min) Lower functional residual
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PEDIATRIC AIRWAY MANAGEMENT
PEDIATRIC AIRWAY MANAGEMENT Introduction Paediatric airway management is one of the most important and challenging aspects of paediatric anaesthesia. Children are not small adults; they possess unique anatomical and physiological characteristics that predispose them to airway obstruction, difficult ventilation, rapid desaturation, and airway-related complications. The primary goals of paediatric airway management are: • Maintain airway
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