Papers by Pradnya Bhalerao
Medical journal of Dr. D.Y. Patil Vidyapeeth, Jun 2, 2023
Anesthesia: Essays and Researches
Annals of Cardiac Anaesthesia
Thiamine deficiency presents as dry and wet beriberi. Wet beriberi is a complication of the cardi... more Thiamine deficiency presents as dry and wet beriberi. Wet beriberi is a complication of the cardiovascular system. Acute form of wet beriberi known as Shoshin beriberi is an acute presentation of cardiogenic shock which is rapidly reversed with thiamine administration. Here we present successful management of intraoperative acute decompensated heart failure, probably due to thiamine deficiency.
Emergency and Critical Care Medicine
Archives of Anesthesia and Critical Care
Background: Brachial plexus surgery requires neural repair with the use of intraoperative periphe... more Background: Brachial plexus surgery requires neural repair with the use of intraoperative peripheral nerve stimulation without muscle relaxants. Methods: Twelve cases were conducted under total intravenous anaesthesia, receiving intravenous propofol, fentanyl and dexmedetomidine infusion. Intraoperative hemodynamic conditions and postoperative functional recovery were assessed. Results: 9 out of 12 cases were stable while one was in a lighter plane requiring 20 mg propofol and increased dexmedetomidine, two had bradycardia requiring reduced dexmedetomidine infusion. At three months, five cases showed improvement. Conclusion: Satisfactory conditions were achieved including hemodynamic stability, and muscle-sparing improving prognoses of brachial plexus surgeries.
Journal of Kathmandu Medical College, 2018
Hypertrophic cardiomyopathy is a genetic disorder characterized by asymmetric left ventricular hy... more Hypertrophic cardiomyopathy is a genetic disorder characterized by asymmetric left ventricular hypertrophy with or without left ventricular outflow tract obstruction. From asymptomatic state to sudden death comprise its varied clinical range. Owing to complex patho-physiology and very high risk of cardiac events, its peri-operative management demands meticulous maintenance of hemodynamic parameters. Prevention and prompt correction of factors such as hypovolemia, tachycardia, and increased contractility that can exacerbate the left ventricular outflow obstruction, arrhythmias and myocardial ischemia are essential for improving patient outcome. Laparoscopic surgeries in these patients can further amplify anaesthetic concerns and add to the challenges. A 58 year female was scheduled for surgery having suffered frequent complications of cholelithiasis. As there is paucity of reports evaluating laparoscopic surgery, we report this patient diagnosed with hypertrophic obstructive cardiomy...
Indian Journal of Pain, 2018
Context: Inadequately controlled postoperative pain has undesirable physiological and psychologic... more Context: Inadequately controlled postoperative pain has undesirable physiological and psychological consequences. It increases postoperative morbidity, delays recovery, and hence causes a delayed return to normal daily living. Furthermore, the lack of adequate postoperative pain treatment may lead to persistent pain after surgery, which is often overlooked. Overall, inadequate pain management increases the use of health care resources and health care costs. Aim: To evaluate the knowledge and attitudes of first-year postgraduate students toward postoperative pain. Study Design: This questionnaire-based cross-sectional study was conducted on 42 first-year postgraduate students. Materials and Methods: A 20-point questionnaire was prepared based on the various aspects of postoperative pain services. The students were asked to provide their answers on a five-point Likert scale ranging from “strongly disagree” to “strongly agree.” The responses were kept anonymous, and the results were ex...
Background: Laparoscopic appendectomy is preferred because of increasing popularity and certain b... more Background: Laparoscopic appendectomy is preferred because of increasing popularity and certain benefits over open method. Laparoscopic surgeries are conventionally done under general anaesthesia with positive pressure ventilation to avoid shoulder pain, respiratory embarrassment and abdominal discomfort caused by pneumoperitoneum. The data regarding use of spinal anaesthesia for laparoscopic appendectomy is limited. This study was designed to evaluate laparoscopic appendectomy under spinal anaesthesia along with the use of intravenous injection ketamine and intravenous injection dexmedetomidine. Objectives of this study were to observe efficacy of both drugs in reducing shoulder pain, need of rescue analgesia, need of conversion to open method due patient discomfort, changes in hemodynamic parameters, postoperative nausea and vomiting. Methods: After approval of ethical committee of institute , 100 patients of age group between 18-60 years with ASA grade I or II undergoing laparosc...
Introduction: In therapeutic management of psych therapy may be attenuated if an used for electro... more Introduction: In therapeutic management of psych therapy may be attenuated if an used for electroconvulsive therapy should provided smooth and rapid induction, a rapid recovery, minimal alteration of the physiological effects of antagonistic effects on seizure activity. Material and methods: In study of 120 patients with ASA grade I or II, having indication for Electroconvulsive therapy, half were randomly anaesthetized by 2.5% Thiopental Sodium with dose 3 mg/kg (Group I) and 1% Propofol in 1.5 administered for 0.5 seconds. The settings and position of the electrodes were kept constant by the psychiatrist. Pulse and Blood pressure monitoring and Seizure response were eval side effects if any. Observation: After Induction, systolic BP in the 2 Groups did not show any significant (p>0.05) difference while the diastolic BP was significantly (p<0.05) lower in the propofol group. After suxamethonium systolic and diastolic BP were significantly (p<0.05) decreased in the propofol...
Medical Journal of Dr. D.Y. Patil University, 2017
Cerebral palsy (CP) occurs as a result of an insult to the developing brain which may be due to b... more Cerebral palsy (CP) occurs as a result of an insult to the developing brain which may be due to birth asphyxia, trauma, infection, or prematurity in the antenatal, perinatal, or postnatal period. It is characterized by varying degrees of motor, sensory, and intellectual impairment. CP clinically manifests as spastic, dyskinetic, ataxic, and mixed type according to the involvement of brain. Additional developmental disabilities such as mental retardation, epilepsy, visual, hearing, speech, cognitive, behavioral abnormalities, and chronic systemic diseases may be present in these patients. Here, we have discussed the successful management of a case of spastic CP for removal of bladder calculus with proper perioperative care.
Journal of Research & Innovation in Anesthesia, 2019
Tetralogy of fallot (TOF) is a cyanotic congenital heart disease (CHD) characterized by aortic ov... more Tetralogy of fallot (TOF) is a cyanotic congenital heart disease (CHD) characterized by aortic over riding, right ventricular outflow tract (RVOT) obstruction, pulmonary stenosis, and ventricular septal defect (VSD). We report a case of a neonate with TOF and anorectal malformation posted for a transverse colostomy. During this procedure, our objectives were to prevent cyanotic spells, balance pulmonary vascular resistance, and systemic vascular resistance.
Indian Journal of Anaesthesia, 2021
The important perioperative challenges during surgical debridement for post-coronavirus disease (... more The important perioperative challenges during surgical debridement for post-coronavirus disease (COVID)-19 rhino-orbital-cerebral mucormycosis include difficult airway, uncontrolled diabetes mellitus (DM), side effects of amphotericin B (AmB), presence of other comorbidities and post-COVID-19 systemic abnormalities including a decline in respiratory function.[1] We report the successful management of a patient with post-COVID-19 mucormycosis with a permanent pacemaker in situ posted for functional endoscopic sinus surgery (FESS) under general anaesthesia.
Saudi Journal of Anaesthesia, 2020
Context: Post Caesarean pain is described as moderate to severe. Although advances in the new ana... more Context: Post Caesarean pain is described as moderate to severe. Although advances in the new analgesics techniques, no current standard exists for optimizing and managing. Taking into consideration of acute post Caesarean pain, this novel technique of surgically assisted anterior abdominal field block at linea semilunaris have proved considerable analgesic potential along with multimodal analgesia. Aims: Although advances have been made in the understanding of the pathophysiology and in the development of new analgesics, patients still suffer from moderate-to-severe post-Cesarean pain. Taking into consideration the consequences of pain, this anterior approach to abdominal field block technique was performed to minimize acute pain experienced during post-Cesarean section. Settings and Design: Prospective observational study design. Materials and Methods: In the present study, a total of 120 parturients undergoing cesarean section (CS), after closure of uterine incision were included. We intraoperatively, under all asepsis, performed surgically assisted abdominal field block at linea semilunaris, by bilaterally injecting 20 mL 0.25% bupivacaine on each side, in addition to standard analgesic 100 mg diclofenac suppository. Each patient was assessed at 0, 4, 8, 12, and 24 h after surgery, by an independent observer for pain using NRS 0–10 and the time of the first demand for analgesic diclofenac paracetamol and its side effects. Statistical Analysis Used: The entire data is statistically analyzed using Statistical Package for Social Sciences (SPSS ver. 21.0, IBM Corporation, USA) for MS Windows. The categorical variables were compared using Wilcoxon's signed-rank test. Results: Of the total 120 patients, it is worth noting that none of the patients had severe or worst pain. The percentage of patients who did not require analgesia were (96.7%) at 4 h, (81.7%) at 8 h, (77.5%) at 12 h, and (90.8%) at 24 h. The mean analgesic consumption of paracetamol diclofenac on 4, 8, 12, 16, and 24 h after CS was significantly less. No patient required opioid supplementation. Patient satisfaction was high and was early ambulated. Conclusions: There is considerable potential for anterior approach abdominal field block, (linea semilunaris block) to comprise an effective component of a multimodal regimen for post-Cesarean section analgesia and is easy to perform within limited resources.
Ain-Shams Journal of Anaesthesiology, 2016
A 28-year-old female presented with complaints of fever with chills and dizziness on and off for ... more A 28-year-old female presented with complaints of fever with chills and dizziness on and off for the last 3 months. On admission, she was investigated and found to have anemia and thrombocytopenia. On examination, the patient was pale and had a palpable huge spleen. Past history revealed a diagnosis of Wilson’s disease 15 years ago. This disease, due to altered copper metabolism, may influence the conduct and outcome of anesthesia secondary to abnormalities in hemopoietic, cardiovascular, connective tissue, immune, and nervous systems. In this study, we present a patient, a diagnosed case of Wilson’s disease, with massive splenomegaly posted for splenectomy under general anesthesia and the concerns involved therein.
Indian Journal of Anaesthesia, 2014
Indian Journal of Anaesthesia, 2012
All the states can select their candidate during their annual conference and send them with the r... more All the states can select their candidate during their annual conference and send them with the recommendation of the Secretary. Only one candidate is allowed from each state. In case, if two states have a combined annual meet but separate as per the records, have to select one candidate from each state. If more than 15 states recommend the candidates for the award, selection will be made on first come first served basis.
Indian Journal of Anaesthesia, 2011
Anesthesia: Essays and Researches, 2016
Background: Postoperative nausea and vomiting (PONV) is a common occurrence after laparoscopic su... more Background: Postoperative nausea and vomiting (PONV) is a common occurrence after laparoscopic surgeries. A number of pharmacological agents (antihistamines, butyrophenones, dopamine receptor antagonists) have been tried of which the 5-hydroxytryptamine type 3 receptor antagonists are devoid of most side effects and highly effective in prevention and treatment of PONV. Thus, we evaluated the effectiveness of granisetron and palonosetron in prevention of PONV after laparoscopic surgeries under general anesthesia. Aims: We conducted a study to evaluate the effectiveness of granisetron and palonosetron, to compare the duration of action and side effects if any, in patients undergoing elective laparoscopic surgery under general anesthesia. Settings and Design: This was a prospective, randomized, double-blinded, comparative study. Sixty patients (18–65 years of age) of the American Society of Anesthesiologists Grade I and II undergoing elective laparoscopic surgeries were considered. Materials and Methods: They were randomly allocated into one of the two groups (Group G and Group P) of thirty patients each. Group G received injection granisetron 0.05 mg/kg; Group P received injection palonosetron 1.5 mcg/kg intravenous bolus 30 min before the induction of anesthesia. Statistical Tests: All statistical analyses were performed using the SPSS® statistical package version 18.0 (Chicago: SPSS Inc). Two independent sample t-test was used for quantitative data, and the χ2 or Fisher's exact test was used for qualitative data. A difference was regarded as statistically significant at a P< 0.05. Results: The need for rescue antiemetic was significantly lower in Group P in the 24–72 h postoperative period (ρ - 0.007). The PONV score was significantly less in Group P in the same period (ρ - 0.008). The incidence of side effects was statistically insignificant in both the groups (ρ - 0.999). Conclusion: Prophylactic therapy with palonosetron is more effective than granisetron in the prevention of PONV after laparoscopic surgeries under general anesthesia.
Indian journal of anaesthesia, 2014
Indian Journal of Clinical Anaesthesia, 2015
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Papers by Pradnya Bhalerao