Search

Background and Aims: Preoperative anxiety can complicate patient outcomes. Music is a noninvasive method to allay anxiety, as revealed in studies. Self-selected (SS) versus prefixed (PF) music had not been studied much. This study was performed to compare SS and PF music in anxiety reduction in patients undergoing elective laparoscopic surgery. Methods: In this prospective study, 90 adults of the American Society of Anesthesiologists grade 1–2, either sex, aged 18–65 years were randomized into three groups, SS, PF music, and control (C), and offered music using headphones 20 min before surgery. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were noted preoperatively (T1), preinduction (T2), 10 min post-induction (T3), 5 min (T4), 1 (T5), and 2 h (T6) postsurgery. The Visual Analog Scale for anxiety (VAS-A) at T1 and T2, VAS-pain and postoperative nausea and vomiting at T5 and T6, and serum cortisol at T1 and T5 were recorded. Results: Group C showed higher VAS-A, HR, SBP, DBP, VAS-pain, and nausea than group-SS and PF (P < 0.05), and higher MAP than group-SS (P < 0.05). The PF group showed higher VAS-A, SBP, DBP, MAP, and VAS-pain than the SS group (P < 0.05). The change in serum cortisol was statistically insignificant. Conclusion: Music (SS > PF) reduces preoperative anxiety, postoperative pain, and nausea–vomiting with better hemodynamic stability.

The COVID-19 pandemic has affected nearly millions of populations worldwide. The range of symptomatology is vast, though predominantly respiratory, and ranges from mild flu-like symptoms to severe respiratory illness with acute respiratory distress syndrome. COVID-19 is associated with many non-respiratory complications affecting the heart, kidneys, gastrointestinal system, central nervous system, and blood vessels. Myocardial injury in COVID-19 patients has varied presentations ranging from arrhythmias, myocardial infarction, myocarditis, and cardiomyopathy to cardiogenic shock. It is usually associated with elevated levels of cardiac biomarkers, with or without any changes in electrocardiography or cardiac imaging. Diagnosis may be difficult based on clinical symptoms or electrocardiogram changes alone, and it can be made using 2D echocardiography, coronary angiogram, CT coronary angiogram, or cardiac magnetic resonance imaging, depending on clinical suspicion. COVID-19-associated cardiac injury increases overall morbidity and mortality. In this case series, five COVID-19 cases with different cardiac manifestations were reported with the intention of presenting the various manifestations of cardiac complications, the course of the disease, and the challenges associated with the complications. This case series showed that cardiac complications are common in the 2nd week during the cytokine storm phase, and timely case-specific specialized diagnostic and therapeutic cardiac interventions might improve the chances of patient survival.

Background and Aims: Airway management in cervical spine injury patients requires manual in-line stabilization (MILS) of the neck to avoid exacerbation of cord injury, which impedes visualization of glottis during laryngoscopy. Specially designed blades such as McCoy and C-MAC D-blades can improve laryngoscopic view in such patients. This study was performed to compare the efficacy of C-MAC D-blades and the McCoy laryngoscope for oro-tracheal intubation using MILS in patients undergoing cervical spine surgery. Material and Methods: This randomized, prospective study was performed in 60 adult patients of American Society of Anesthesiologists grade I–III, either sex, 18 to 60 years of age undergoing elective cervical spine surgery. Patients were randomly categorized into two groups, group D and group M. Intubation was performed using a C-MAC D-blade videolaryngoscope in group D and a McCoy laryngoscope in group M using MILS. The intubation difficulty scale (IDS) score, laryngoscopy and intubation times, percentage of glottic opening (POGO) score, Cormack Lehane (CL) grading with and without external laryngeal pressure (ELP), need for bougie or change of blade or operator, and change in hemodynamics following intubation were recorded. Results: Group D showed lower mean IDS scores than group M (P value < 0.0001). There were statistically significant differences found in duration of laryngoscopy (group D < group M), CL grading without ELP (group D: CL-1,2a >CL-2b, 3; group M: CL-1,2a group M), need for ELP and lifting force (group D < group M), and hemodynamic responses after intubation (group D < group M). Conclusion: A C-MAC D-blade videolaryngoscope provides better and rapid visualization of glottis with less intubation difficulties than a McCoy laryngoscope during intubation using MILS in patients with cervical spine injury.

Aplastic anemia (AA) is a rare hematologic disease and a unique example of bone marrow failure syndromes. The disease presents with clinical features of reduction in all blood cell counts, i.e., anemia, infections, and hemorrhage. We are reporting the successful anesthetic management of a case of 6-year-old, 20 kg male child, diagnosed case of AA operated for a fungating lesion (osteomyelitis) in the right wrist.