Browsing by Author "Unnikrishnan, KP"

Now showing 1 - 13 of 13
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    An alternative and simple technique of guidewire retrieval in a failed Seldinger technique
    (ANESTHESIA AND ANALGESIA, 2005) Unnikrishnan, KP; Sinha, PK; Nalgirkar, RS
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    An alternative site for entropy sensor placement
    (ANESTHESIA AND ANALGESIA, 2006) Sinha, PK; Suneel, PR; Unnikrishnan, KP; Smita, V; Rathod, RC
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    An unusual cause of high airway pressure and inadequate ventilation because of a defective connector despite accurate placement of a double-lumen tube
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2006) Koshy, T; Sinha, PK; Vijayakumar, A; Dash, PK; Unnikrishnan, KP
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    Anesthesia for craniotomy in a patient with previous paralytic polio
    (JOURNAL OF CLINICAL ANESTHESIA, 2008) Suneel, PR; Sinha, PK; Unnikrishnan, KP; Abraham, M
    Poliomyelitis remains endemic in many developing nations. Patients may develop residual muscle weakness in one or more, limbs after an attack of poliomyelitis in childhood. We report an adult patient who presented for right temporal cortical grid placement. He had childhood poliomyelitis and, while showing no evidence of postpolio syndrome, demonstrated excessive sensitivity to nondepolarizing muscle relaxants and developed prolonged muscle weakness during the postoperative period. (c) 2008 Elsevier Inc. All rights reserved.
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    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.
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    Effect of lung ventilation with 50% oxygen in air or nitrous oxide versus 100% oxygen on oxygenation index after cardiopulmonary bypass
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2006)
    Objective: This study was designed to assess the use of 100% oxygen or 50% oxygen in air or nitrous oxide after cardiopulmonary bypass (CPB) on atelectasis, as evidenced by the oxygenation index (PaO2/F1O2), after coronary artery bypass graft (CABG) surgery.Design: Prospective, randomized clinical study.Setting: University teaching hospital.Participant: Thirty-six adult patients undergoing CABG surgery.Interventions: Patients either received 50% O-2 in air (50% O-2 group), 50% O-2 in N2O (50% N2O group), or 100% O-2 (100% 02 group) after CPB.Measurements and Main Results: Apart from demographic and perioperative clinical data, extubation time, mediastinal drainage, and pulmonary complications were also recorded. After CPB, arterial blood gases done at various time points until 3 hours postextubation and oxygenation index were calculated. No significant differences were noted in demographic and perioperative data except preoperative hemoglobin and fluid use. Significant deterioration in arterial oxygenation was noted in the 100% O-2 group from the baseline value, whereas significant improvement was seen in the 50% O-2 group at 4 time points from baseline value and at all time points from the 100% O-2 group. After initial deterioration in oxygenation, no further change was evident in the 50% N2O group. Furthermore, there was a greater increase in the oxygenation index as compared with the 100% O-2 group. Time to extubation was also longer in the 100% O-2 group than the 50% O-2 group.Conclusion: Significant deterioration in arterial oxygenation and an increase in the extubation time occurred with the use of 100% O-2 after CPB, whereas better oxygenation was evident with the use of 50% O-2 in air. (c) 2006 Elsevier Inc. All rights reserved.
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    High cuff pressure in the silicone endotracheal tube of the LMA-Fastrach: implications for patient safety
    (JOURNAL OF CLINICAL ANESTHESIA, 2011) Suneel, PR; Koshy, T; Unnikrishnan, KP
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    Mandibular dislocation from yawning during induction of anesthesia
    (CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 2006) Unnikrishnan, KP; Sinha, PK; Rao, S
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    Modified Deep Transgastric Bicaval View for Revealing Superior Vena Caval Obstruction in a Patient Undergoing Sinus Venosus Atrial Septal Defect Repair: A Case Report
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2016) Aggarwal, N; Unnikrishnan, KP; Suneel, PR; Mathew, T
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    Physical incompatibility of injection diclofenac sodium with Isolyte P
    (ANESTHESIA AND ANALGESIA, 2004) Sinha, PK; Neema, PK; Manikandan, S; Unnikrishnan, KP
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    Possible explanation for why blue blushed
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2006) Sinha, PK; Suneel, PR; Unnikrishnan, KP
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    Unusual cause of intraoperative hypertension and tachycardia
    (ANESTHESIA AND ANALGESIA, 2003) Unnikrishnan, KP; Sinha, PK; Neema, PK