{"title":"Sinus Bradycardia and Hypotension Following Reconstructive Hemi Mandibulectomy. Unusual Complication of Orofacial Reconstructive Surgery","authors":"T. Nagarajah","doi":"10.4038/slja.v30i2.8932","DOIUrl":"https://doi.org/10.4038/slja.v30i2.8932","url":null,"abstract":"Postoperative complications following pectoralis major myocutaneous flap in orofacial reconstruction are a well-known entity. Still, literature search didn’t reveal sinus bradycardia as one of those post-operative complications. One of our patients, a 63-year-old gentleman with squamous cell carcinoma in the right cheek, who underwent wide local excision with right side hemimandibulectomy and pectoralis major myocutaneous flap reconstruction, developed symptomatic sinus bradycardia and hypotension as a postoperative complication. Initially there was a struggle to find out the underlying cause but later, carotid sinus hypersensitivity was suspected as a probable cause. Ultimately, it was alleviated by a debulking surgery to reduce the pressure in the neck.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42245449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Posterior Reversible Encephalopathy Syndrome Following Cadaveric-Donor Kidney Transplantation; A Challenging Diagnosis","authors":"R. Ranamuni, V. Dassanayake","doi":"10.4038/slja.v30i2.9060","DOIUrl":"https://doi.org/10.4038/slja.v30i2.9060","url":null,"abstract":"A 19-year-old girl with haemolytic uraemic syndrome (HUS) and hypertension underwent a diseased donor kidney transplantation. She developed two episodes of generalised tonic-clonic convulsions on the second postoperative day. Posterior reversible encephalopathy syndrome (PRES) was diagnosed based on the history and imaging. PRES was likely as it is associated with factors which co-exist with chronic kidney disease. Perioperative MMF, tacrolimus and prednisolone were prescribed by the nephrologist. Her serum tacrolimus level was normal at the time of convulsions. Other causes of seizures such as hypoglycaemia, electrolyte abnormalities, infection and intracranial haemorrhages were excluded. Elevated blood pressure associated with severe visual impairment was noted during the second episode of convulsions. Clinical diagnosis was confirmed by magnetic resonance imaging (MRI). She had a complete recovery without residual neurological deficits. Her blood pressure was controlled at the time of discharge and she had a well-functioning graft. Timely detection and institution of early treatment led to a successful recovery.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48206132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative study to evaluate the effect of intubation box on tracheal intubation difficulty with King Vision ® and TRUVIEW video laryngoscope in manikin in a tertiary care hospital","authors":"N. Nazir, A. Saxena","doi":"10.4038/slja.v30i1.8860","DOIUrl":"https://doi.org/10.4038/slja.v30i1.8860","url":null,"abstract":"Background: The procedures related to airway can be associated with increased risk of aerosolization of SARS-CoV-2 virus posing a high risk to the personnels involved. Novel methods like the intubation box have been developed to increase the safety of healthcare workers during intubation. Methods: In this study, 33 anaesthesiologist and critical care specialists intubated the trachea of the airway manikin (US Laerdal Medical AS) 4 times using a King Vision ® videolaryngoscope and TRUVIEW PCD TM videolaryngoscope (with and without an intubation box as described by Lai). Intubation time was primary outcome. Secondary outcomes were first-pass intubation success rate, percentage of glottic opening (POGO) score and peak force to maxillary incisors measured with a pressure sensing device. Results: Intubation time and the pressure exerted on the incisors (detected by a click sound) were considerably higher in both groups when an intubation box was used. (Table 1) When comparing the two laryngoscopes, intubation time with the King Vision ® video laryngoscope was lower than that of TRUVIEW laryngoscope, both with and without the intubation box. (P<0.001) In both groups, rate of first pass successful intubation was higher without the intubation box, although the difference was statistically insignificant. POGO Score was not affected by intubation box but higher score was observed with King Vision ® laryngoscope. (Table 1,2). Conclusion: This study indicates that use of an intubation box makes intubation difficult and increases the time. King Vision ® videolaryngoscope results in lesser intubation time and better glottic view as compared to TRUVIEW laryngoscope.","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49023013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bhaagya Gunetilleke, N. Welikala, R. Ranamuni, D. Jayaweera, Thamosha De Silva, Oshini Amerasinghe, C. Liyanage, Janaki Dissanayake, C. Appuhamy, Meranthi Fernando, S. Thilakarathne, A. Dassanayake, M. Niriella, R. Siriwardana, E. Gilbert-kawai
{"title":"Optimizing Intraoperative Haemodynamics and Haemostasis to Enhance Recovery After Liver Transplantation for Cirrhosis in Adults","authors":"Bhaagya Gunetilleke, N. Welikala, R. Ranamuni, D. Jayaweera, Thamosha De Silva, Oshini Amerasinghe, C. Liyanage, Janaki Dissanayake, C. Appuhamy, Meranthi Fernando, S. Thilakarathne, A. Dassanayake, M. Niriella, R. Siriwardana, E. Gilbert-kawai","doi":"10.4038/slja.v30i1.9070","DOIUrl":"https://doi.org/10.4038/slja.v30i1.9070","url":null,"abstract":"","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44470583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Sen, Prabhakar Kandasamy, R. Sarna, N. Bhardwaj, S. Sethi, J. Ram
{"title":"Midazolam-Dexmedetomidine Combination versus Midazolam Alone for Premedication in Children Undergoing Pediatric Cataract Surgeries: a Double‐Blinded Randomized Controlled Trial","authors":"I. Sen, Prabhakar Kandasamy, R. Sarna, N. Bhardwaj, S. Sethi, J. Ram","doi":"10.4038/slja.v30i1.8802","DOIUrl":"https://doi.org/10.4038/slja.v30i1.8802","url":null,"abstract":"","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49203175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Lethal Apparatus: Life Saver Converted Deadly","authors":"B.M Munasinghe, N. Subramaniam, J. Ranatunga","doi":"10.4038/slja.v30i1.8832","DOIUrl":"https://doi.org/10.4038/slja.v30i1.8832","url":null,"abstract":"","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44900368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving Quality and Safety of Perioperative Care in Sri Lanka Through Patient Empowerment; Role of the Anaesthetist","authors":"A.A.S.P. Jayasinghe, V. Pinto","doi":"10.4038/slja.v30i1.9061","DOIUrl":"https://doi.org/10.4038/slja.v30i1.9061","url":null,"abstract":"","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41898961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In response to ‘A Good Outcome Following Delayed Debridement of Lumbar Paraspinal Abscess after Postoperative Epidural Catheterization: Case Report’","authors":"B.M Munasinghe","doi":"10.4038/slja.v30i1.8963","DOIUrl":"https://doi.org/10.4038/slja.v30i1.8963","url":null,"abstract":"","PeriodicalId":41531,"journal":{"name":"Sri Lankan Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45942767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}