Browsing by Author "Chatterjee, N"

Now showing 1 - 10 of 10
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    Abducens Nerve Palsy After Percutaneous Radiofrequency Ablation of Gasserian Ganglion
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2014) Chatterjee, N; Chatterjee, S; Roy, C
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    Accuracy of a Chest X-Ray-Based Method for Predicting the Depth of Insertion of Endotracheal Tubes in Pediatric Patients Undergoing Cardiac Surgery
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2016) Koshy, T; Misra, S; Chatterjee, N; Dharan, BS
    Objectives: The incidence of endotracheal tube (ETT) malposition in children with various described methods is 15% to 30%. Chest x-ray (CXR) is the gold standard for confirming appropriate ETT position. The aim of this study was to measure the accuracy of a preoperative CXR-based method in determining depth of insertion of ETTs and to compare it with methods based on the intubation depth mark or formulae (age, height, and ETT internal diameter) in children undergoing cardiac surgery. Design: Prospective observational study. Setting: University-affiliated tertiary care hospital. Participants: Sixty-six consecutive children scheduled for elective pediatric cardiac surgery. Interventions: None. Measurements and Main Results: The distance from carina to, mid-trachea was measured for each child preoperatively on the CXR displayed as a computed radiography image in a picture archival and communications system computer. Following intubation, ETTs deliberately were pushed endobronchially and then pulled back to the carina; they were further withdrawn by the previously measured carina to mid-tracheal distance and secured. CXRs postoperatively were repeated to confirm ETT position. The ETT position was measured with other methods using the picture archival and communications system ruler on the postoperative CXR and compared with the CXR method. The proportion of appropriate ETT position with the CXR method was 98.5% (p < 0.001 v other methods). In children younger than 3 years, the appropriate proportion was 97.4%. Conclusion: The appropriate positioning of ETTs in the trachea by the CXR method is superior to other methods. (C) 2016 Elsevier Inc. All rights reserved.
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    Bispectral Index monitoring facilitates early detection of catheter-induced vasospasm during neuro-endovascular procedures
    (ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2009) Sriganesh, K; Chatterjee, N; Singha, S
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    Cited heavily, taken lightly, matters hardly
    (NEUROLOGY INDIA, 2016) Vilanilam, GC; Gopalakrishnan, MS; Misra, S; Chatterjee, N
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    Dexmedetomidine as an Anesthetic Adjuvant in Patients Undergoing Transsphenoidal Resection of Pituitary Tumor
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2015) Gopalakrishna, KN; Dash, PK; Chatterjee, N; Easwer, HV; Ganesamoorthi, A
    Background: Transnasal transsphenoidal (TNTS) resection of pituitary tumors involves wide fluctuation in hemodynamic parameter and causes hypertension and tachycardia due to intense noxious stimuli during various stages of surgery. None of routinely used anesthetic agents effectively blunts the undesirable hemodynamic responses, and therefore usually there is a need to use increased doses of anesthetic agents. Dexmedetomidine (DEX) an alpha-2 adrenergic receptor agonist, because its sympatholytic and antinociceptive properties may ensure optimal intraoperative hemodynamic stability during critical moments of surgical manipulation. In addition, DEX reduced the anesthetic requirement with rapid recovery at the end of surgery. The main aim of our study was to evaluate the effect of DEX on perioperative hemodynamics, anesthetic requirements, and recovery characteristics in patients undergoing TNTS resection of pituitary tumors. Materials and Methods: Forty-six patients scheduled for elective TNTS resection of pituitary tumor were randomized to receive a continuous infusion of DEX (group D) or 0.9% saline (group C). Patients in both the groups were subjected to a standardized anesthesia comprising of induction with propofol, fentanyl, vecuronium, and positive pressure ventilation with O-2/air (1: 1)/isoflurane. The response entropy target range during maintenance of anesthesia was 40 to 60. The hemodynamic variables at various stages of surgery, intraoperative anesthetic, and analgesic and recovery characteristics were recorded. Results: Total fentanyl consumption during the study period was significantly lower in group D compared with group C (4.7 and 7.7 mu g/kg, respectively; P < 0.01). End-tidal isoflurane concentration requirement was found to be significantly reduced in group D compared with group C throughout the surgical period. Fentanyl and end-tidal isoflurane concentration requirement was reduced in group D compared with group C by 40% and 33.3%, respectively. Heart rate and mean arterial pressure were significantly higher in the group C compared with group D after intubation, during various stages of surgery and immediately after extubation. The group D had excellent surgical conditions and lesser bleeding in comparison to group C. Emergence time and extubation time were significantly shorter in group D compared with group C. Conclusions: DEX as an anesthetic adjuvant improved hemodynamic stability and decreased anesthetic requirements in patients undergoing TNTS resection of pituitary tumor. In addition, DEX provided better surgical field exposure conditions and early recovery from anesthesia.
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    Efficacy of Combined Treatment with Medial Branch Radiofrequency Neurotomy and Steroid Block in Lumbar Facet Joint Arthropathy
    (JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2012) Roy, C; Chatterjee, N; Ganguly, S; Sengupta, R
    Purpose: To evaluate the long-term efficacy of combined radiofrequency (RF) neurotomy and steroid nerve block in patients with lumbar facet joint arthropathy. Materials and Methods: Combined RF neurotomy and steroid nerve block was performed in 34 patients with chronic paravertebral low back pain. The diagnosis was confirmed by comparative double diagnostic block of the medial branch with bupivacaine and lidocaine. Under fluoroscopy, RF thermal ablation of the medial branch was performed (at RF needle tip temperature 85 degrees C for 90 seconds), three times for each target nerve. At the end of the procedure, 20 mg of methylprednisolone acetate (sustained-release preparation) was infiltrated on each ablated nerve. Outcome variable was the degree of improvement in pain using visual analog scale (VAS) and numerical rating scale (NRS). Improvement in the quality of life was assessed using the Roland-Morris (RM) questionnaire. The procedure was repeated in cases of unbearable pain (> 5 VAS score). Results: Patients had a mean VAS score of 8.6 before the procedure. Thereafter, VAS score was 0.91 immediately after the procedure and 3.0, 2.8, 3.7, and 3.6 at 1 month, 2 months, 6 months, and 1 year. NRS showed pain relief after the procedure of 85%, 65%, 78%, 62%, and 59.5% at the same time points. RM score was 18 before the procedure, 7.6 at 6 months after the procedure, and 8.5 at 1 year after the procedure. No major complication was noted except local pain in all patients and numbness of the back in six patients after the procedure. Conclusions: Combined RF neurotomy and steroid nerve block produced substantial improvement in terms of long-term pain relief and quality of life.
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    Pulsed Radiofrequency for the Suprascapular Nerve for Patients With Chronic Headache
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2014) Chatterjee, N; Roy, C
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    Usefulness of flat detector CT (FD-CT) with biplane fluoroscopy for complication avoidance during radiofrequency thermal rhizotomy for trigeminal neuralgia
    (JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2016) Easwer, HVI; Chatterjee, N; Thomas, A; Santhosh, K; Raman, KT; Sridhar, R
    Introduction Trigeminal neuralgia (TN) is characterized by episodes of shooting pain in the areas innervated by one or more divisions of the trigeminal nerve. The initial treatment of TN is with drugs but the increased frequency and intensity of the neuralgic episodes often force the patient to seek alternative therapies. Microvascular decompression (MVD) and radiofrequency thermal lesioning of trigeminal rootlets (RFTR) offer close to the best results for TN. MVD has the disadvantage of being an open surgical procedure with its attendant risks and longer hospital stay, whereas RFTR is a short, day-care' procedure. However this latter procedure involves positioning of the RF needle in the area behind the trigeminal ganglion through the foramen ovale, which can pose significant challenges. Objective To use the fluoroscopic support of a biplane catheter laboratory to access the foramen, and flat detector CT to confirm the location of the tip of the RF needle in the optimal position. Methods Fifty-three patients with TN underwent RFTR under local anesthesia with conscious sedation. Results All patients reported pain relief with hypesthesia over the offending trigeminal division. In seven patients the needle tip required repositioning according to the CT images. Two patients each had loss of corneal reflex and abducens nerve palsy after the procedure. No other complications were seen. Conclusions The superior view in two planes coupled with the anatomical confirmation of the position of the needle tip in the Meckel's cave during the rhizotomy reduces the need for multiple passages of the needle to access the foramen ovale and achieves accurate needle tip positioning. The technique increases the safety and precision of such treatments and helps to manage potential complications.