Browsing by Author "Sreedhar, R"

Now showing 1 - 13 of 13
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    Anesthesia management of awake craniotomy performed under asleep-awake-asleep technique using laryngeal mask airway: Report of two cases
    (NEUROLOGY INDIA, 2008) Vitthal, GS; Sreedhar, R; Abraham, M
    Asleep-awake-asleep technique of anesthesia is used during awake craniotomy with or without securing airway. We assessed this technique using laryngeal mask airway (LMA) in two patients. Patients underwent awake craniotomy for epilepsy surgery and the removal of a frontotemporal glioma. After anesthesia induction, airway was secured using LMA. Anesthesia was maintained using oxygen, nitrous oxide and sevoflurane, supplemented with an infusion of propofol and remifentanil. Twenty minutes before corticography, anesthesia was discontinued and LMA removed. Both patients were awake and cooperative during the neurological assessment and surgery on eloquent areas. The LMA was reinserted before the closure of the dura and remained in place until the end of surgery. Both patients had no recall of events under anesthesia, although experienced mild pain and discomfort during awake phase of surgery. Both expressed complete satisfaction over the anesthetic management. Asleep-awake-asleep technique using LMA offers airway protection. The painful aspect of surgery can be performed under anesthesia, hence minimizing the duration of stress and pain. Patients remained awake and cooperative throughout the time of neurological testing.
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    Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in an Infant and Adult: Intraoperative Echocardiographic Comparison
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2016) Chigurupati, K; Gadhinglajkar, S; Sreedhar, R; Karunakaran, J; Dharan, BS
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    Carotid artery injury during transsphenoidal resection of pituitary tumor: Anesthesia perspective
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2003)
    The authors describe two patients who suffered carotid artery injury during transsphenoidal resection of a pituitary tumor. Anesthesiologists were involved in resuscitation after initial hemorrhage, in securing the airway, in initiating cerebral protection strategies, and in transporting these patients. Anesthesia was provided for resection of the tumors, removal of packs from the pituitary fossae, and diagnostic and therapeutic radiologic procedures. In each case hemostasis was achieved by packing the sella turcica, sphenoid sinus, and nostrils. Both patients were electively ventilated. In one patient, a pseudoaneurysm of the carotid artery was detected by angiography in the operating room. It was treated by trapping the internal carotid artery. The other patient developed a carotid-cavernous fistula, which was treated by balloon embolization. Both patients were discharged after dealing with these complications.
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    Delayed thrombosis of left internal jugular vein and left subclavian vein: complication related to drainage of left superior vena cava.
    (Interactive cardiovascular and thoracic surgery, 2003)
    OBJECTIVES: To present a complication which occurred in relation to drainage of left superior vena cava.METHODS: A 25-year-old patient underwent intracardiac repair for Tetralogy of Fallot. Left superior vena cava was present. It was drained by insertion of a left ventricular sump vent catheter via coronary sinus. The immediate postoperative period was uneventful. The patient presented on the 18th postoperative day with painful swelling on the left side of the neck, shoulder and upper arm. The patient was subjected to post-contrast CT scan and Duplex scan of neck vessels. He received anticoagulants for 3 months after the detection of thrombus in the left internal jugular vein and left subclavian vein.RESULTS: Post-contrast CT scan and Duplex scan of neck vessels revealed organized thrombus in proximal portions of the left internal jugular vein and left subclavian vein, while the distal portions were free of thrombus and collateralized.CONCLUSIONS: The left internal jugular vein and left subclavian vein may get thrombosed due to drainage of left superior vena cava by a left ventricular sump vent catheter. Anticoagulants give immediate relief from symptoms and also prevent major thromboembolic complications.
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    Double Chamber Right Ventricle in a Patient With Supracristal Ventricular Septal Defect and Prolapsing Right Coronary Cusp: Role of Intraoperative Transesophageal Echocardiography
    (JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2009) Gadhinglajkar, S; Sreedhar, R; Krishnamanohar, SR; Jayant, A; Bhoomkar, NS
    A supracristal ventricular septal defect (VSD), an outlet VSD situated in subaortic and subpulmonic regions, has a strong association with prolapse of the aortic valve cusp. The authors report the case of a patient operated for a supracristal VSD with prolapse of the right coronary cusp. The VSD was found to be in the subaortic position on preoperative transthoracic echocardiography, which failed to detect the presence of a double-chamber right ventricle. Intraoperative transesophageal echocardiography correctly recognized the supracristal nature of the VSD and identified the double-chamber right ventricle, subsequently altering the course of surgery. (J Am Soc Echocardiogr 2009;22:754.e3-754.e5.)
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    Experiences with carotid endarterectomy at Sree Chitra Tirunal Institute
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2008) Unnikrishnan, M; Siddappa, S; Anto, R; Babu, V; Paul, B; Kapilamoorthy, TR; Sivasankaran, S; Sandhyamani, S; Sreedhar, R; Radhakrishanan, K
    Background: Atherosclerotic carotid artery disease poses a grave threat to cerebral circulation, leading to a stroke with its devastating sequelae, if left untreated. Carotid endarterectomy has a proven track record with compelling evidence in stroke prevention. Objectives: a)To confirm that carotid endarterectomy (CEA) is safe and effective in preventing stroke at both short and long term. b) to demonstrate long term patency of internal carotid artery when arteriotomy repair is performed using autologous saphenous vein patch. Materials and Methods: During ten years, from September 1997 to February 2008, thirty nine patients who underwent consecutive carotid endarterectomy at our institute, form the basis of this report. Their age ranged from thirty to seventy eight years, with a mean age of 56. There were four women in this cohort. Thirty seven patients were symptomatic with >70% stenosis and two were asymptomatic with >80% stenosis, incidentally detected. Imaging included Duplex scan and MRA for carotid territory and brain, and non-invasive cardiac assessment. Co-morbidities included smoking, hypertension, diabetes, and coronary artery disease. Carotid Endarterectomy was performed under general anaesthesia, using carotid shunt and vein patch arteriotomy repair. Results: All the patients made satisfactory recovery, without major adverse cerebral events in this series. Morbidities included Transient Ischemic Attack (TIA) in two, needing only medications in one, and carotid stenting in the other. Minor morbidities included neck hematoma in two and transient hypoglossal paresis in three patients. Yearly follow-up included duplex scan assessment for all the patients. Two patients died of contralateral stroke, two of myocardial events and two were lost to follow up. Thirty three patients are well and free of the disease during the follow up of three to 120 months. Conclusion: Carotid endarterectomy provided near total freedom from adverse cerebral events and its catastrophic sequelae, leading to excellent outcome, both short as well as long term.
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    Fixed dilatation of pupils at the end of posterior fossa surgery due to bupivacaine scalp infiltration
    (NEUROLOGY INDIA, 2010) Gadhinglajkar, S; Sreedhar, R; Gopalkrishnan, CV
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    Polymorphic ventricular tachycardia after radiofrequency maze procedure: Report of two cases
    (JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2005)
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    Role of Intraoperative Real-Time Three-Dimensional Transesophageal Echocardiography During Cone Procedure for Ebstein's Anomaly
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2016) Sujatha, M; Gadhinglajkar, S; Dharan, BS; Sreedhar, R
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    Surgery for dysphagia lusoria caused by right aberrant subclavian artery: Anesthesia perspective
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2005)
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