Naresh Kaul

Khoula Hospital · Department of Anaesthesia

(Acta Anaesthesiol Scand. 2020;64:1028)

Succinylcholine is administered in small doses to relieve post-extubation laryngospasm. We report a 3-month-old infant weighing 5.1 kg who developed severe laryngospasm after tracheal extubation following reversal of rocuronium bromide neuromuscular block. Succinylcholine 2.5 mg promptly relieved the spasm but apnea lasted for nearly an hour in a p...

Sir, it is interesting to read the findings of Wodarski et al's study where they have analyzed several risk factors for shivering during Caesarean section

Majority of Indian hospitals still lack the provision of acute postoperative pain relief service. In other parts of the world, field of acute pain management strategy has witnessed a surge in its implementation. Today, acute pain has begun to be recognized not merely as a distressing symptom but also as a precursor of chronic, debilitating pain. Th...

Background: Shivering is an undesirable, unpleasant experience after spinal anesthesia. Injecting cold bupivacaine has been incriminated as a contributory factor. Aims and Objective: In this prospective study we evaluated the efficacy of warming the heavy bupivacaine to body temperature for prevention of shivering and if it influences analgesic qua...

Background: Tracheal intubation using Storz's C-Mac D-blade(TM) videolaryngoscope is associated with difficult negotiation of the tracheal tube into the glottis due to steep angulation of its blade. Objectives: In this study, we hypothesized that Truflex(TM) articulating stylet with its ability to dynamically tailor the ETT shape to patients' or...

Introduction: Although last one decade has seen the emergence of optic and videolaryngoscopes that provide superior glottic view due to enhanced anterior angulation of their blades [1, 2] but negotiation of the endotracheal tube (ETT) towards the glottis becomes difficult and at times a failure [3, 4]. One such videolaryngoscope is the Truview PCD™...

Objectives: Sympathetic block following spinal anaesthesia is often associated with a fall in blood pressure. This fall has been shown to be attenuated by using transcutaneous nerve stimulation at the P6 point in patients receiving spinal anaesthesia for Caesarean section. The aim of this study was to evaluate the efficacy of stimulation at the P6...

P-9064] Postoperative pain relief a. blood loss after total knee replacement: A study of the attenuating efficacy of intra a. extracapsular bupivacaine infiltration with and without adrenaline. Introduction: Joint replacement surgery is usually associated with significant postoperative pain1 & blood loss.2-4 Nearly 60% patients undergoing (TKR) pro...

Despite recent refinements in the technique of total knee replacement surgery, pain and blood loss continues to be a serious issue. The purpose of this pilot study was to determine whether a simple technique of local infiltration of the wound site by 40 mL of 0.25% bupivacaine with or without adrenaline would be effective in attenuating post operat...

Background: A variety of videolaryngoscopes with angulated blade have been recently introduced into clinical practice. They provide an indirect view of the glottic structures in normal and challenging clinical settings. Despite the very good visualization of the laryngeal structures by these devices, the insertion and advancement of the endotrache...

Objective: To compare the sealing pressure of the Baska® Mask (BM) with Proseal® laryngeal mask (PLM) in patients undergoing general anesthesia for a variety of elective non-head and neck surgical procedures. . Design: Prospective, randomized, ethical issues committee approved interventional study. Setting: Operating rooms of Khoula Hospital, Musca...

A 36-year-old male patient with posttraumatic cervical cord damage and resultant quadriparesis, demonstrated hypotension and periods of bradycardia. For most of his two-month stay in the Intensive Care Unit (ICU), he was dependent on dopamine support to maintain hemodynamic stability. Keeping in mind evidence from the literature, that electrostimul...

Acute tongue enlargement is a potentially lethal complication which is mostly reported in neurosurgical cases in sitting position. Very rarely it is reported in supine position. Most importantly it is reported at the end of the surgical procedures. Throat pack used along with tracheal intubation for protection of lower respiratory tract from soilin...

Trauma has assumed epidemic proportion. 10% of global road accident deaths occur in India. Hypoxia and airway mismanagement are known to contribute up to 34% of pre-hospital deaths in these patients. A high degree of suspicion for actual or impending airway obstruction should be assumed in all trauma patients. Objective signs of airway compromise i...

Postoperative shivering is commonly observed in patients after general anesthesia. A double-blind randomized controlled trial was conducted in patients undergoing day care knee arthroscopy to test the hypothesis that a single intraoperative dose of hydrocortisone would prevent or attenuate postoperative shivering. One hundred and twenty patients we...

We report a 44 year-old, American Society of Anesthesiologist Class I (ASA I), female patient scheduled for elective excision of a small lipoma of the left thigh. She went into a 90 minute apnea and complete muscle paralysis as evidenced by the absence of all stimulatory responses by a peripheral nerve stimulator after receiving midazolam (1.0 mg)...

We report a 58-years old patient, who underwent surgery for a fracture to the neck of the femur. Tracheal intubation was performed with the aid of a stylet; however, 15 minutes later, it was brought to the notice of the attending anesthesiologist that a broken piece of stylet had been left inside the lumen of the endotracheal tube. Prior to this, t...

Performance degradation due to insertion of BIST logic into high-speed designs has been analyzed. A framework to introduce BIST into random logic circuits, without causing timing violations has been proposed. Various heuristics for selecting flip-flops for BIST have been developed and studied in detail. Experimental results indicate an improvement...

Multi-level circuit simulators have been developed by researchers to reduce the simulation complexity for ICs manufactured by VLSI and beyond technologies. The main problems with these simulators have been the identification of sub-circuits which is usually left to the user and the communication between different levels for increased efficiency. We...

This paper develops a general framework for efficient problem solving at multiple levels of abstraction in complex systems. The goal is to address two important control issues in the behavior generation process: (i) the selection problem, which deals with the right level of detail to solve a problem; and (ii) the efficiency problem, which deals wit...

An efficient computer simulation algorithm set, SITA, predicts the vulnerability of data stored in and processed by complex combinational logic circuits to SEU. SITA is described in detail to allow researchers to incorporate it into their error analysis packages. Required simulation algorithms are based on approximate closed-form equations modeling...

Modeling the state of knowledge a student has during a problem solving process is one of the most difficult tasks in intelligent tutoring systems (ITS) research. The paper describes the implementation of an ITS that teaches CMOS digital circuit design. The overall goal is to teach circuit design at the undergraduate level, while the specific aim is...

This paper develops a qualitative reasoning methodology for problem solving at multiple levels of abstraction. The goal is to address two important control issues in the behavior generation process: (i) the selection problem, which deals with the right level of detail to solve a problem, and (ii) the efficiency problem, which deals with information...

The effects of design and bias on the radiation tolerance of ICs are studied, and an automated design tool is described that produces different designs for a logic function and presents important parameters of each design to a circuit designer for tradeoff analysis. It was shown by simulation and experimentally verified that the logic implementatio...

There are in existence a number of CAD tools that perform circuit simulations and analyze circuit performance before fabrication. Most of these simulators do not take long-term environmental effects into account. These environmental effects on VLSI circuits are specifically more important for performance estimation in hostile environments such as h...

A switch-level simulator (PARA) has been developed which identifies the total dose failure modes in CMOS digital ICs. The approach used is highly cost-effective in terms of the computation involved. PARA identifies all the possible failure modes and the critical subcircuit responsible for the occurrence of the failure. The dose level at which the f...

A 50-year old male patient with multi-organ failure and gangrene of the face was brought to the operation theater for an emergency debridement of the gangrenous tissue. Poor oral hygiene with loose teeth and limited mouth opening led to failure of rigid Macintosh laryngoscopy. Fiberoptic tracheal intubation was not adopted as an intubating aid as t...