Analgesia for normal labor and delivery Introduction: The experience of child birth ranges from agony to ecstasy. One of the most thrilling and gratifying experience in mother life will be the birth of her child. Labour pain rank among the most intense pain, as recorded on McGill pain questionnaire 1 and it is typically worse […]
Continue ReadingVenous Air Embolism
Venous Air Embolism in Neuro Surgery (VAE) Rate of occurrence of VAE depand on Procedure Intra-operative Position Method of detection Associated – principally hazard of post. fossa procedures Surgery → performed in sitting position and upper cervical spine Can occur with supratentorial procedures like facine menigiomas encroaching post. half of sagital sinus, craniosynostosis. Pin sites […]
Continue ReadingIntracranial Aneurysms
Contemporary management of intracranial aneurysm after Sub arachnoid haemorrhage (SAH) calls for early intervention Early – within 72 hrs of SAH Ultra early → within 18 hrs of SAH Intervention applied to I to IV grades of “world federation of neurosurgeons SAH scale”( WFNS) or I to III of “hunt –Hess classification” WFNS classification → […]
Continue ReadingEffects of Anaesthetic agents on cerebral physiology
Effects of Anaesthetic agents on cerebral Physiology Most general anaesthetics have favourable effect on the CNS by reducing electrical Activity Carbohydrate metabolism energy stores in the form of ATP, phosphocreatine & ADP ↑ Effect of specific agent is complicated by concomitant administration of other drugs and ➤ Surgical stimulation ➤ Intracranial compliance ➤ BP ➤ […]
Continue ReadingAnatomy of Heart
Posted on by Dr.Ajita A
Anatomy of heart- Four chambers 1.Rt.atrium 2.Rt.ventricle 3.Lt.atrium 4.Lt.ventricle Two great arteries- 1.Aorta 2.Pulmonary arteries Pericardium. 1.Parietal 2.Visceral Chambers are as following- Right atrium : Chamber receives systemic venous drainage through SVC and IVC Coronary venous drainage through coronary sinus Important characteristics for identification: Limbus for fossa ovalis Wide based blunt ended Right sided atrial […]
Continue ReadingMyocardial Revascularisation
Posted on by Dr.Ajita A
Defination: The restoration of an adequate blood supply to a part of heart by means of a blood vessel graft [ aortocoronary bypass] or stenting the plaque site. Anatomy of coronary arteries: Aortic root- Aortic root contains 3 cusps – Rt.coronary,Lt.coronary and non-coronary from first two cusps respective coronary arteries arises. Coronary arterial circulation- Rt coronary artery Arises from Rt sinus of valsalva of aortic root. Best seen in Lt anterior oblique view […]
Continue ReadingMitral Valve and Pathology
Posted on by Dr.Ajita A
Mitral Stenosis [MS] ☛ Etiology – congenital / Acquired [adult ] ☛ Congenital MS is very rare .Associated with other anomalies as shave’s complex ☛ Acquired – Moss common is Rheumatic heart disease ☛ 25% rheumatic heart disease pure MS. ☛ 40% have MS with MR. ☛ 10% have pure MR. Rare causes are Systemic […]
Continue ReadingPressure volume loop in valvular heart disease
Posted on by Dr.Ajita A
Aortic Regurgitation As ventricle relaxes blood from aortic flow back into ventricle so no true isovolumetric relaxation,so ventricle gets filled before mitral valve opens,throughout diastole ventricle gets filled from aorta so end diastolic volume is increased as shown in PV loop By chronic dilatation of ventricle EDV increases No true isovolumetric contraction as blood […]
Continue ReadingPeripheral Signs of AR
Posted on by Dr.Ajita A
Classical signs for severe aortic regurgitation are as follows- 1.WIDE PULSE PRESSURE ☛ Mild 40-60 mmHg ☛ Moderate 60-80 mmHg ☛ Severe > 80 mmHg 2.HILLS SIGN ☛ difference between systolic BP in LL & UL ☛ Mild AR- 20-40 mmHg ☛ Mod- 40-60 mmHg ☛ Sev- >60 mmHg 3.ALFRED DE MUSET SIGN ☛ Oscillation […]
Continue ReadingIPC-Ischemic Preconditioning
Posted on by Dr.Ajita A
Ischemic preconditioning: Inhalational and opiod induced ischemic preconditioning as following Defn: Ischaemic preconditioning involves – brief period of (1 to 4sec.)occlusion of artery & the same period of reperfusion before performing the anastomosis. Ischaemic preconditioning can be done, By surgeons occluding the artery before starting the actual anastomosis. Inhalational anaesthetics are also proved to be […]
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