Browsing by Author "Manikandan, S"
Now showing 1 - 20 of 31
Results Per Page
Sort Options
Item 2-Dimensional Echocardiography and M-Mode Doppler of the Interatrial Septum for Assessment of Left Ventricular Diastolic Function(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2011) Neema, PK; Misra, S; Manikandan, S; Rathod, RCItem A case of a missing J-tip of the guidewire during internal jugular vein cannulation: A fractured and embolized J-tip or a manufacturing defect?(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008) Manikandan, S; Neema, PK; Rathod, RCItem A comparative study to evaluate the efficacy of virtual versus direct airway assessment in the preoperative period in patients presenting for neurosurgery. ( Project - 5403 )(SCTIMST, 2021-04-30) Ajay Prasad, Hrishi; Unnikrishan, P; Ranganatha Praveen, CS; Smita, V; Manikandan, SItem A Rounded Image Inside the Left Ventricle: The Mechanism of the Artifact Formation(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2010) Neema, PK; Singha, S; Manikandan, SItem A Sudden Increase in Bispectral Index Score During Carotid Endarterectomy After Shunt Insertion(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2009) Neema, PK; Manikandan, S; Rathod, RCItem Airway problems caused by hypogonadism in male patients undergoing neurosurgery(ANESTHESIA AND ANALGESIA, 2005)Unanticipated difficult endotracheal intubations can pose challenges for the anesthesiologist. Risks include airway injury, hypoxemia, and death. There is intubation difficulty in various conditions including Downs syndrome, achondroplasia, acromegaly, and dwarfism. We describe difficulty in intubating the trachea with an appropriate sized endotracheal tube in two young male patients with hypogonadism presenting for neurosurgical procedures under general anesthesia. We discuss the role of hypogonadism and the effects of gonadotropin hormones on pubertal laryngeal growth in male patients.Item Anesthetic Management of a Child With Severe Dystonia and G6PD Deficiency for Deep Brain Stimulation(JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2015) Sriganesh, K; Manikandan, SItem Anesthetic management of a patient with polycythemia vera for neurosurgery(JOURNAL OF ANESTHESIA, 2016) Gautham, NS; Arulvelan, A; Manikandan, SPolycythemia vera (PV) is a myeloproliferative disorder characterized by excess red cell clonality. The increased number of red blood cells can lead to increased viscosity of the blood and ultimately compromise the blood supply to the end organs. Thromboembolic and hemorrhagic complications can also develop. Patients with PV presenting with neurological diseases that require surgical intervention are at an increased risk due to various factors, such as immobility, prolonged surgical time, hypothermia and dehydration. We report anesthetic management of a patient with PV who underwent neurosurgical intervention for vestibular schwannoma excision.Item Author's reply to: anesthesia care for muscle biopsy in children with myopathies by Dr Ferrari Fabio(PEDIATRIC ANESTHESIA, 2009) Manikandan, S; Neema, PK; Rathod, RCItem Bradycardia and sinus arrest following saline irrigation of the brain during epilepsy surgery(JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2004)Adverse cardiac events during the intraoperative period are life-threatening. The authors report three episodes of severe bradycardia and sinus arrest that occurred in a patient undergoing anterior temporal lobectomy and amygdalo-hippocampectomy for the treatment of epilepsy. The first episode occurred during resection of the amygdala; the other two episodes were observed during subsequent irrigation of the exposed brain structures, most likely the brain stem structures, because of a rent that the surgeon had deliberately made into the basilar cistern for better anatomic appreciation of the structures to be excised. The patient responded well to treatment with no adverse outcomes. The probable mechanisms leading to this event are discussed; the authors excluded insular cortex stimulation, the effects of the anesthetic drugs used, and venous air embolism as a cause of bradycardia and sinus arrest. The amygdala resection was the most likely cause of the first episode of bradycardia; the second episode of bradycardia and sinus arrest occurred because of inadvertent stimulation of brain structures by the high temperature (42degreesC) of the saline used for irrigation. To counter its effects, saline irrigation at room temperature (20degreesC) was started, and this caused the third episode of bradycardia, most likely because of "temperature shock" of the exposed brain. Prompt communication with the surgical team and vigilance are crucial for the appropriate management of such an incident, which may pose a threat to life. Avoiding irrigation of the exposed brain with high-temperature saline may prevent such an incident.Item Complications of unrecognized urinary bladder distension(ANESTHESIA AND ANALGESIA, 2007) Neema, PK; Rao, S; Manikandan, S; Rathod, RCItem Development of cost effective ventilator ( Project - 8239 )(SCTIMST, 2021-06-07) Nagesh, DS; Sarath S, Nair; Vinodkumar, V; Manikandan, S; Manoj, CSItem Effect of Loading Dose of Dexmedetomidine on Dynamic Cerebral Blood Flow Autoregulation in Patients With Intracranial Glial Neoplasms(JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2015) Arulvelan, A; Manikandan, S; Easwer, HV; Krishnakumar, KBackground: Dexmedetomidine has been widely used in neuroanesthesia and critical care settings. The effects of dexmedetomidine on cerebral vascular autoregulation and hemodynamics in patients with intracranial pathology are not well defined. This study is aimed to address this issue. Methods: Fifteen patients with unilateral supratentorial glial tumor (group S) and 15 patients without any intracranial pathology (group C) were included in this study. Transient hyperemic response testing was conducted bilaterally in both groups with transcranial color Doppler. Dynamic autoregulation was assessed with transient hyperemic response ratio (THRR) and strength of autoregulation (SA) at baseline and after infusion of inj. dexmedetomidine (1 mcg/kg) over 10 minutes. Results: THRR and SA values in the hemisphere that had tumor (group S) showed no difference from baseline after a loading dose of dexmedetomidine (P=0.914, 0.217). In the nontumor hemisphere of group S and in both the hemispheres of group C, significant reduction in THRR and SA values were observed (P<0.001) after administration of a loading dose of dexmedetomidine. THRR values were higher in the tumor hemisphere when compared with the nonpathologic hemispheres (P<0.001), suggesting the possibility of baseline hyperemia. Conclusions: In the hemisphere that had glial tumor, autoregulatory indices showed no significant change after dexmedetomidine. It can be because of abnormal vascular architecture and its altered reactivity to dexmedetomidine, or because of baseline hyperemia itself, but the exact mechanism needs to be elucidated. In the nonpathologic hemispheres, THRR and SA values were decreased, suggesting impaired autoregulation with the use of loading dose of dexmedetomidine.Item Endotracheal tube migration following transoesophageal echocardiography probe placement in a child(EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 2006) Neema, PK; Manikandan, S; Rathod, RCItem Fatal endotracheal haemorrhage in a patient undergoing repair of a large ascending aortic aneurysm(EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 2007) Neema, PK; Manikandan, S; Rathod, RC; Varma, PKItem Infrarenal abdominal aortic aneurysm repair in presence of coronary artery disease: optimization of myocardial stress by controlled phlebotomy.(Annals of cardiac anaesthesia, 2009)The repair of abdominal aortic aneurysm (AAA) in the presence of significant coronary artery disease (CAD) carries a high-risk of adverse peri-operative cardiac event. The options to reduce cardiac risk include perioperative beta-blockade, preoperative optimization by myocardial revascularization and simultaneous (combined) coronary artery bypass grafting and aneurysm repair. We describe intra-operative controlled phlebotomy to optimize myocardial stress during repair of infrarenal AAA in a patient with significant stable CAD.Item Origin of the Right Subclavian Artery Distal to a Coarctation of the Aorta: Anesthetic Implications(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008) Manikandan, S; Neema, PK; Rathod, RCItem Perioperative implications of retrograde flow in both the subclavian arteries in an adult undergoing surgical repair of coarctation of aorta(INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2011) Neema, PK; Manikandan, S; Bodhey, N; Gupta, AKDuring surgical repair of coarctation of aorta (CoA), management of spinal cord ischemia and prevention of paraplegia is an important issue. The risk factors for paraplegia include level and duration of aortic-clamping, clamping of left subclavian artery (SCA), intraoperative temperature, variability of collateral circulation to the spinal cord, cerebrospinal fluid pressure, upper body arterial pressure, and aortic pressure beyond the aortic clamp. A short clamp time (<30 min), and distal aortic pressure >60 mmHg, minimizes the risks of spinal cord injury. In an adult patient during surgical repair of CoA, the arterial pressure in the femoral artery remained around 45 mmHg and repair took 83 min of aortic-clamping. Neurological assessment on regaining consciousness showed no deficit of lower limbs. Aortic root angiogram had shown retrograde filling of both SCAs. A unique situation in which clamping of SCAs would increase flow to the spinal cord as their clamping would stop stealing of blood and aortic-clamping proximal to CoA will further increase collateral flow; because of these reasons, the patient tolerated prolonged aortic-clamping despite low distal aortic pressure without neurological deficit. However, aortic-clamping increased left ventricular after-load and the patient developed worsening of mitral regurgitation and pulmonary hypertension during aortic clamping. (C) 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.Item Physical incompatibility of injection diclofenac sodium with Isolyte P(ANESTHESIA AND ANALGESIA, 2004) Sinha, PK; Neema, PK; Manikandan, S; Unnikrishnan, KPItem Problems of central venous access in the internal jugular vein in a sinus venosus atrial septal defect(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008) Manikandan, S; Neema, PK; Rathod, RC