87 yr female pt for # femur...k/c/o NMO taken treatment and at presan5 symptom free....k/c/o br asthama on treatment and controled, HT +IHD but controled. .ECG lat lead ST-T changes,  2D echo almost normal..no ronchi........
What should be the plan???

hi, is anybody ueses CSA technique...???
i have used for few cases..
but micro spinal catheters are not available in india......
which companies are making it ?????

for gynac and upper GI laproscopic surgery..........how much Hb is allowable.....????? what is the fluid management stategies....????????

what is the significant of high eosinophil count in otherwise normal looking child ????????

what is the practical guidelines for child with URTI...

how many days we should postpond..
what investigations are useful to make child fit...????
only running nose but no cough.....what to do ????

many time we come accross the situation where pt is previously non hypertensive and just before the surgery blood pressure is out of control........

what should be the strategy for it practically..????????? ???

what should be the ideal prtocol for totally failed spinal and partially acted spinal anaesthesia..???????


failed spinal is no action clinically with apparantly perfact spinal anaesthesia....


reply with ur experiences........

thank you... ???

hi, i realy want's to know , how many of us keep record of our own cases with us(not in the pt's file) ???????
do u have some good anaesthesia record formates available ???
please send some formate for differant conditions .


regardes.

hi, i have observed mild to moderate change in pulse and B.P. immediately after cementing in major orthopedic surgery specially femur. almost 20 % of pt showes such responce !!!!
  what is your experience ?????

i have come across two pt who had some differant complain after epidural analgesia for labour.
both the pt where given CSE for labour analgesia, and delivered normally.
Epidural catheter was removed after 12 hr of delivary. on 5 th day pt had complain of back ache which is at the level of epidural insertion site and at the same time sharpe shooting type of pain radiating to lower limb as well as to neck( current like sudden sensation radiating from back to upwards and downwards both.)
this felling is for the moment and it stops by it's own.
it typically happened for once or twice in the day. not related to any posture. and with advice of some extra rest for two day, it dissappear permanently.
any comment????????????????

Hi, very frequently we have noticed perioperative hyponitramia in elderly pt spacialy with long bone fractures.
any suugestions to prevant it?????????

regards.
dr. kalpesh shah

Hi, please coment on this case.
50 year old male pt with DM since 10 yr., on OHA since then, regular and controlled. no other medical illeness.
had mild chest disscomfort 6 month back, investiged by MD physicion in remote place, starte with ecosprine, since then taking it regularly, no problem after that.(angiography not done).
posted for removal of sub dental cysts(two moderat cyst below left molar and cannine).
ecosprine stoped since 15 days, CBC, HBSag, HIV, SUGAR, ECG are normal on the day of the surgery.
Taken 4 surger with nasal intubation, intraop hemodynamics were normal. af 1 hr of surgery pt extubated. 3 min af extubation pt has profuse bleeding.reintubated with great difficulties, but hematoma below the tongue in midline, which is reexplored and drained.for saftey tight nasal packing done. BTCT AND PT INR send. PT WAS 24 SEC AND INR was 21.1. pt managed with 4 units of FFP.bleeding stoped. PT came normal af 6 hrs.in retrospactive history nothing significant fount like any other medicine, or childhood trauma bleedig history.
any role of ecosprine? any guielines for pre op investigation?
medicolegal issues?

Hi, incidence of post extubation throat irritation is quite high even after useing all various methods like lignocaine spray, lignocaine gelly, use of HME filter, adequate size ET tube, monitoring endotracal cuff presser(manually!!!!!).
what is the best way for prevantion?

regards.

ST segment mapping intra operative, How much significant?

regards.

what is the significance of QT, QTc and deltaQT?

Hi,
is any one uses TOF WATCH machine for nerve location?
I wants to know the use of that machine in" micro culombe" not in popular MA formate.
share the expirience.
regards.

Hi, I want's to know the expirience with midazolam nasal spray.

Hi,
is inj. nalbuphine recommended intrathecally and epidurally?. pharma company has started giving articals on it.
How do we come to know whether perticular" medicine " and " route of administration is approved by regulatory body(FDA!!!!). ??? ??? ???