Browsing by Author "Misra, S"

Now showing 1 - 11 of 11
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    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, RC
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    A Novel Technique for Easy Identification of the Subclavian Vein During Ultrasound-Guided Cannulation
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2010) Muralikrishna, T; Koshy, T; Misra, S; Sinha, PK
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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intubation, ETTs deliberately were pushed endobronchially and then pulled back to the carina; they were further withdrawn by the previously measured carina to mid-tracheal distance and secured.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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    An unusual case of looping of the central venous catheter: Who is the culprit?
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008) Misra, S; Sinha, PK
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    Anesthesia in Developing Countries: One-Way Traffic?
    (ANESTHESIA AND ANALGESIA, 2009) Misra, S; Koshy, T
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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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    Intraoperative Identification of Chyle Leak During Coarctation Repair Using Fluorescein Dye
    (ANNALS OF THORACIC SURGERY, 2015) Mathew, T; Idhrees, M; Misra, S; Menon, S; Dharan, BS; Karunakaran, J
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    One-Lung Ventilation Can Alter the Severity of Aortic Regurgitation
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2010) Sinha, PK; Misra, S; Koshy, T
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    The Effect of Gabapentin Premedication on Postoperative Nausea, Vomiting, and Pain in Patients on Preoperative Dexamethasone Undergoing Craniotomy for Intracranial Tumors
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2013) Misra, S; Parthasarathi, G; Vilanilam, GC
    Background:In patients undergoing craniotomy, the incidence of postoperative nausea and vomiting (PONV) is 55% to 70% and that of moderate to severe postoperative pain is 60% to 84%. We hypothesized that gabapentin plus dexamethasone would be superior, compared with placebo and dexamethasone in reducing the incidences of PONV and pain after craniotomy.Methods:Patients undergoing craniotomy received either placebo (group D) or gabapentin (600 mg) (group GD) premedication orally, 2 hours before induction of anesthesia. In addition, all patients received 4 mg of intravenous dexamethasone on the morning of surgery and continued receiving it after every 8 hours. The 24-hour incidence of nausea, emesis, or PONV (nausea, emesis, or both) (primary outcome) and postoperative pain scores (secondary outcome) were analyzed with the (2) test and the Wilcoxon rank-sum test as applicable.Results:A significant difference was observed between the groups in the incidence of nausea (odds ratio [OR], 0.23; 95% confidence interval [CI], 0.07, 0.80; P=0.02), PONV (OR, 0.3; 95% CI, 0.08, 0.8; P=0.02), and the requirement for antiemetics (OR, 0.30; 95% CI, 0.09, 0.9; P=0.03). The number of emetic episodes were also reduced in group GD, but this did not assume statistical significance (OR, 0.34; 95% CI, 0.10, 1.1; P=0.06). However, there was no significant difference in either the postoperative pain scores or the opioid consumption between the 2 groups.Conclusions:A dosage of 600 mg of gabapentin plus 4 mg of dexamethasone significantly reduced the 24-hour incidence of nausea and PONV. However, there was no reduction in either the postoperative pain scores or opioid consumption.
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    Transesophageal echocardiographic evaluation of left ventricular systolic and diastolic function in response to 20% mannitol and 3% hypertonic saline infusion in neurosurgical patients undergoing cran
    (J Neurosurg Anesthesiol., 2014-07) Gayatri, P; Misra, S; Menon, G; Arulvelan, A; Jissa, VT
    BACKGROUND: Mannitol and hypertonic saline (HS) are routinely used during craniotomy. Both increase myocardial preload and reduce afterload, and may improve cardiac output. It is not currently known whether this results in an improvement in the global myocardial function. Thus, the aim of this study was to compare the effects of a single equiosmolar bolus of 20% mannitol (5 mL/kg) or 3% HS (5 mL/kg) on the global myocardial function by tissue Doppler-derived myocardial performance index (TD-MPI) in patients undergoing craniotomy. METHODS: Fifty adult patients were included and randomized to receive either mannitol or 3% HS. Transesophageal echocardiography was performed in all patients. Early (E) and late (A) peak mitral inflow velocity, early diastolic mitral annular velocity (E prime), isovolumetric relaxation time (IVRT), ejection time (ET), and isovolumetric contraction time (IVCT) were recorded at baseline and at 15, 30, 60, and 120 minutes after administration of the hyperosmolar solutions. TD-MPI was calculated as IVRT+IVCT/ET. RESULTS: There were no significant differences in the TD-MPI (HS vs. mannitol: 0.43 vs. 0.44 [baseline], 0.45 vs. 0.43 [15 min], 0.44 vs. 0.45 [30 min], 0.47 vs. 0.45 [60 min], 0.45 vs. 0.46 [120 min]), E/A ratio, IVCT, and E/E' either within or between the 2 groups at any time point. IVRT was prolonged in HS group as compared with baseline at 15, 30, and 60 minutes postinfusion. ET was decreased in both the groups at 120 minutes postinfusion. Neither of these altered the TD-MPI. CONCLUSIONS: Equiosmolar administration of 20% mannitol and 3% HS did not show any difference in global myocardial performance as measured by TD MPI.
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    Transesophageal Echocardiographic Evaluation of Left Ventricular Systolic and Diastolic Function in Response to 20% Mannitol and 3% Hypertonic Saline Infusion in Neurosurgical Patients Undergoing Craniotomy
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2014) Gayatri, P; Misra, S; Menon, G; Arulvelan, A; Thulaseedharan, JV
    Background: Mannitol and hypertonic saline (HS) are routinely used during craniotomy. Both increase myocardial preload and reduce afterload, and may improve cardiac output. It is not currently known whether this results in an improvement in the global myocardial function. Thus, the aim of this study was to compare the effects of a single equiosmolar bolus of 20% mannitol (5 mL/kg) or 3% HS (5 mL/kg) on the global myocardial function by tissue Doppler-derived myocardial performance index (TD-MPI) in patients undergoing craniotomy. Methods: Fifty adult patients were included and randomized to receive either mannitol or 3% HS. Transesophageal echocardiography was performed in all patients. Early (E) and late (A) peak mitral inflow velocity, early diastolic mitral annular velocity (E prime), isovolumetric relaxation time (IVRT), ejection time (ET), and isovolumetric contraction time (IVCT) were recorded at baseline and at 15, 30, 60, and 120 minutes after administration of the hyperosmolar solutions. TD-MPI was calculated as IVRT + IVCT/ET. Results: There were no significant differences in the TD-MPI (HS vs. mannitol: 0.43 vs. 0.44 [baseline], 0.45 vs. 0.43 [15 min], 0.44 vs. 0.45 [30 min], 0.47 vs. 0.45 [60 min], 0.45 vs. 0.46 [120 min]), E/A ratio, IVCT, and E/E' either within or between the 2 groups at any time point. IVRT was prolonged in HS group as compared with baseline at 15, 30, and 60 minutes postinfusion. ET was decreased in both the groups at 120 minutes postinfusion. Neither of these altered the TD-MPI. Conclusions: Equiosmolar administration of 20% mannitol and 3% HS did not show any difference in global myocardial performance as measured by TD MPI.