Dr. Ravishankar M

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  • user warning: Table './mgmcri_deptz/cache_views_data' is marked as crashed and should be repaired query: UPDATE cache_views_data SET data = 'a:4:{s:4:\"head\";s:0:\"\";s:3:\"css\";a:0:{}s:2:\"js\";a:0:{}s:6:\"output\";s:17638:\"<div class=\"view view-publication-types view-id-publication_types view-display-id-page_1 view-dom-id-1\">\n \n \n \n <div class=\"views-row views-row-1 views-row-odd views-row-first\">\n <div id=\"node-496\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Maclean, J, DK. T, S. P, M. R.</span>&nbsp; \n2013.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/comparative-evaluation-gum-elastic-bougie-and-introducer-tool-aids-posi\">Comparative evaluation of gum-elastic bougie and introducer tool as aids in positioning of ProSeal laryngeal mask airway in patients with simulated restricted neck mobility</a>, 2013. </span>Indian journal of anaesthesia. 57(3):248-252.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Comparative+evaluation+of+gum-elastic+bougie+and+introducer+tool+as+aids+in+positioning+of+ProSeal+laryngeal+mask+airway+in+patients+with+simulated+restricted+neck+mobility&amp;rft.title=Indian+journal+of+anaesthesia&amp;rft.isbn=0019-5049&amp;rft.date=2013&amp;rft.volume=57&amp;rft.issue=3&amp;rft.spage=248&amp;rft.epage=252&amp;rft.aulast=Maclean&amp;rft.aufirst=Jennyl\"></span><a href=\"/anaesthesiology/publications/comparative-evaluation-gum-elastic-bougie-and-introducer-tool-aids-posi\" class=\"biblio-abstract-link toggle\"> Abstract</a><div class=\"biblio-abstract-display slider\"><p>BACKGROUND: The ProSeal laryngeal mask airway (PLMA) is a unique laryngeal mask with a modified cuff to improve seal and a channel to facilitate gastric tube placement. This is a better device in difficult airway situations compared to classic laryngeal mask airway. This prompted us to study the ease of insertion and positioning of PLMA in patients with simulated restricted neck mobility while using gum elastic bougie (GEB) group or introducer tool (group IT) to aid insertion.METHODS: Sixty ASA I or II patients, aged between 18 years and 60 years, undergoing minor non-head and neck surgeries in the supine position were studied. A rigid neck collar was used to simulate restricted neck mobility in all patients. After anaesthetising the patients with a standard protocol, the PLMA was inserted using either of the technique using the tongue depressor to open the mouth. The ease of insertion, positioning, haemodynamic responses to insertion and other complications related to the procedure were noted.<br />\nRESULTS: Regarding demographic variables, both groups were similar. The mean time taken for insertion of PLMA in group GEB was 67.80 s as compared to 46.79 s in group IT (P&lt;0.05). Patients of group GEB had better positioning assessed by an intubating fiberscope with less end tidal carbon-di-oxide (ETCO2) values. Systolic and diastolic blood pressures were similar. The incidence of sore throat, dysphagia, and dysphonia were higher in IT group in the 12 h, but similar in 24 h.<br />\nCONCLUSION: Guided insertion technique with GEB took a longer time, but had a better positioning and lower ETCO2 values when compared to IT technique.</p>\n\n</div><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-2 views-row-even\">\n <div id=\"node-500\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">R., S, VR. HK, M. R.</span>&nbsp; \n2013.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/internal-leaks-anaesthesia-machines-unaddressed-problem-0\">Internal leaks into anaesthesia machines: an unaddressed problem.</a>. </span>British journal of anaesthesia . 111(1):126-127.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Internal+leaks+into+anaesthesia+machines%3A+an+unaddressed+problem.&amp;rft.title=British+journal+of+anaesthesia+&amp;rft.date=2013&amp;rft.volume=111&amp;rft.issue=1&amp;rft.spage=126&amp;rft.epage=127&amp;rft.aulast=R.&amp;rft.aufirst=Sripriya\"></span><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-3 views-row-odd\">\n <div id=\"node-504\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">S., P, M. R.</span>&nbsp; \n2012.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/electroacupuncture-complex-regional-pain-syndrome\">Electroacupuncture in complex regional pain syndrome .</a>. </span>Interesting cases in Orthopedics. <span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.atitle=Electroacupuncture+in+complex+regional+pain+syndrome+.&amp;rft.title=Interesting+cases+in+Orthopedics&amp;rft.btitle=Interesting+cases+in+Orthopedics&amp;rft.date=2012&amp;rft.aulast=S.&amp;rft.aufirst=Parthasarathy\"></span><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-4 views-row-even\">\n <div id=\"node-70\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Jahagirdar, SM, Karthikeyan P, Ravishankar M.</span>&nbsp; \n2011.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/acute-airway-obstruction-unusual-presentation-vallecular-cyst\">Acute airway obstruction, an unusual presentation of vallecular cyst</a>, 2011/09//. </span>Indian Journal of Anaesthesia. 55:524-527.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Acute+airway+obstruction%2C+an+unusual+presentation+of+vallecular+cyst&amp;rft.title=Indian+Journal+of+Anaesthesia&amp;rft.isbn=0976-2817&amp;rft.date=2011&amp;rft.volume=55&amp;rft.spage=524&amp;rft.epage=527&amp;rft.aulast=Jahagirdar&amp;rft.aufirst=Sameer\"></span><a href=\"/anaesthesiology/publications/acute-airway-obstruction-unusual-presentation-vallecular-cyst\" class=\"biblio-abstract-link toggle\"> Abstract</a><span class=\"teaser-extra\"><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22174474\">Website</a></span><div class=\"biblio-abstract-display slider\"><p>A 18-year-old female presented to us with acute respiratory obstruction, unconsciousness, severe respiratory acidosis, and impending cardiac arrest. The emergency measures to secure the airway included intubation with a 3.5-mm endotracheal tube and railroading of a 6.5-mm endotracheal tube over a suction catheter. Video laryngoscopy done after successful resuscitation showed an inflamed swollen epiglottis with a swelling in the left vallecular region, which proved to be a vallecular cyst. Marsupialisation surgery was performed on the 8(th) post admission day and the patient discharged on 10(th) day without any neurological deficit.</p>\n\n</div><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-5 views-row-odd\">\n <div id=\"node-105\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Parthasarathy, S, Ravishankar M.</span>&nbsp; \n2011.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/continuous-spinal-anesthesia-epidural-catheters-experience-periphery\">Continuous spinal anesthesia with epidural catheters: An experience in the periphery</a>. </span>Anesthesia: Essays and Researches. 5:187., Number 2<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Continuous+spinal+anesthesia+with+epidural+catheters%3A+An+experience+in+the+periphery&amp;rft.title=Anesthesia%3A+Essays+and+Researches&amp;rft.issn=0259-1162&amp;rft.date=2011&amp;rft.volume=5&amp;rft.spage=187&amp;rft.aulast=Parthasarathy&amp;rft.auinit=S&amp;rft_id=info%3Adoi%2F10.4103%2F0259-1162.94770\"></span><a href=\"/anaesthesiology/publications/continuous-spinal-anesthesia-epidural-catheters-experience-periphery\" class=\"biblio-abstract-link toggle\"> Abstract</a><span class=\"teaser-extra\"><a href=\"http://www.aeronline.org/text.asp?2011/5/2/187/94770\">Website</a></span><div class=\"biblio-abstract-display slider\"><p>Background and Aim: Continuous spinal anesthesia (CSA) offers considerable advantages over \"singleshot\" spinal or epidural anesthesia since it allows administration of well-controlled anesthesia using small doses of local anesthetics and a definite end point with less failure rate. There are described technical difficulties with introduction of spinal micro catheters and hence this study was undertaken by using epidural catheters.<br />\nMaterials and Methods: Sixty patients of ASA grade II to III were selected and they were administered continuous spinal anesthesia with Portex 18-G epidural catheters.<br />\nResults: The introduction was done in first attempt and was easy in all cases. The intraoperative period was uneventful in all cases. Early postoperative analgesia was achieved in all cases. Only two patients (3%) had postdural puncture headache controlled with simple analgesics. In a 3 month postoperative followup, the incidence of neurological complication is nil.<br />\nConclusion: We conclude CSA with epidural catheters is a simple and safe alternative for prolonged procedures with negligible failure rate especially in high-risk patients and in patients with possible difficulties in administration of general anesthesia.</p>\n\n</div><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-6 views-row-even\">\n <div id=\"node-187\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Ravishankar, M.</span>&nbsp; \n2011.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/uptake-and-distribution-inhaled-anaesthetics\">Uptake and distribution of inhaled anaesthetics</a>, 26 December. </span>ISACON 2011, 59th Annual National Conference of Indian Society of Anaesthesiologists . , Grant Hyat, Mumbai<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&amp;rft.title=Uptake+and+distribution+of+inhaled+anaesthetics&amp;rft.date=2011&amp;rft.aulast=Ravishankar&amp;rft.auinit=M&amp;rft.place=Grant+Hyat%2C+Mumbai\"></span><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-7 views-row-odd\">\n <div id=\"node-509\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">MVP., C, NM. J, JM. E, M. R.</span>&nbsp; \n2011.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/invasive-pulmonary-aspergillosis-caused-aspergillus-versicolor-patient-\">Invasive pulmonary aspergillosis caused by Aspergillus Versicolor in a patient on mechanical ventilation</a>. </span>AMJ. 4(11):632-634.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Invasive+pulmonary+aspergillosis+caused+by+Aspergillus+Versicolor+in+a+patient+on+mechanical+ventilation&amp;rft.title=AMJ&amp;rft.date=2011&amp;rft.volume=4&amp;rft.issue=11&amp;rft.spage=632&amp;rft.epage=634&amp;rft.aulast=MVP.&amp;rft.aufirst=Charles\"></span><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-8 views-row-even\">\n <div id=\"node-71\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Pusapati, RN, Sivashanmugam T, Ravishankar M.</span>&nbsp; \n2010.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/respiratory-changes-during-spinal-anaesthesia-gynaecological-laparoscop\">Respiratory changes during spinal anaesthesia for gynaecological laparoscopic surgery</a>, October 1, 2010. </span>Journal of Anaesthesiology Clinical Pharmacology. 26:475-479.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Respiratory+changes+during+spinal+anaesthesia+for+gynaecological+laparoscopic+surgery&amp;rft.title=Journal+of+Anaesthesiology+Clinical+Pharmacology&amp;rft.date=2010&amp;rft.volume=26&amp;rft.spage=475&amp;rft.epage=479&amp;rft.aulast=Pusapati&amp;rft.aufirst=Raju\"></span><a href=\"/anaesthesiology/publications/respiratory-changes-during-spinal-anaesthesia-gynaecological-laparoscop\" class=\"biblio-abstract-link toggle\"> Abstract</a><span class=\"teaser-extra\"><a href=\"http://www.joacp.org/text.asp?2010/26/4/475/74588\">Website</a></span><div class=\"biblio-abstract-display slider\"><p><b>Background:</b> It is currently presumed that spinal anaesthesia can compromise respiratory muscle function during carbon dioxide (CO2) pneumoperitoneum. This observational study was designed to delineate the respiratory effects of CO2 pneumoperitoneum under spinal anaesthesia.<b>Patients &amp; Methods:</b> Forty one patients undergoing elective gynecological laparoscopy were administered spinal anaesthesia with 15 mg heavy bupivacaine and 50 mcg of fentanyl. Heart rare, blood pressure, tidal volume, respiratory rate and end tidal CO2 were serially recorded before, during and after the pneumoperitoneum. Arterial blood gas analysis was done before and 20 min after initiation of pneumoperitoneum.</p>\n\n</div><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-9 views-row-odd\">\n <div id=\"node-72\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Parthasarathy, S, Ravishankar M, Aravindan U.</span>&nbsp; \n2010.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/total-radical-gastrectomy-under-continuous-thoracic-epidural-anaesthesi\">Total radical gastrectomy under continuous thoracic epidural anaesthesia</a>, 2010/07//. </span>Indian Journal of Anaesthesia. 54:358-359.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Total+radical+gastrectomy+under+continuous+thoracic+epidural+anaesthesia&amp;rft.title=Indian+Journal+of+Anaesthesia&amp;rft.isbn=0976-2817&amp;rft.date=2010&amp;rft.volume=54&amp;rft.spage=358&amp;rft.epage=359&amp;rft.aulast=Parthasarathy&amp;rft.auinit=S\"></span><a href=\"/anaesthesiology/publications/total-radical-gastrectomy-under-continuous-thoracic-epidural-anaesthesi\" class=\"biblio-abstract-link toggle\"> Abstract</a><span class=\"teaser-extra\"><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20882190\">Website</a></span><div class=\"biblio-abstract-display slider\"><p>n/a</p>\n\n</div><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n <div class=\"views-row views-row-10 views-row-even views-row-last\">\n <div id=\"node-73\" class=\"node node-type-biblio node-teaser\">\n <div class=\"node-inner\">\n <div class=\"os-links\">\n </div>\n <span class=\"biblio-authors\">Parthasarathy, S, Ravishankar M.</span>&nbsp; \n2010.&nbsp;&nbsp;<span class=\"biblio-title\"><a href=\"/anaesthesiology/publications/tight-bag\">Tight bag</a>, 2010/05//. </span>Indian Journal of Anaesthesia. 54:193-198.<span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.atitle=Tight+bag&amp;rft.title=Indian+Journal+of+Anaesthesia&amp;rft.isbn=0976-2817&amp;rft.date=2010&amp;rft.volume=54&amp;rft.spage=193&amp;rft.epage=198&amp;rft.aulast=Parthasarathy&amp;rft.auinit=S\"></span><a href=\"/anaesthesiology/publications/tight-bag\" class=\"biblio-abstract-link toggle\"> Abstract</a><span class=\"teaser-extra\"><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20885863\">Website</a></span><div class=\"biblio-abstract-display slider\"><p>Tight bag is a clinical situation where excessive pressure needs to be applied to a reservoir bag of a breathing system to an intubated patient, which may or may not produce satisfactory ventilation. The various clinical scenarios and the appropriate steps for its prevention are described.</p>\n\n</div><div class=\"links links-inline\"></div> </div> <!-- /node-inner -->\n</div> <!-- /node --> </div>\n \n <div class=\"item-list\"><ul class=\"pager\"><li class=\"pager-current first\">1</li>\n<li class=\"pager-item\"><a href=\"/anaesthesiology/publications/term/118?page=1\" title=\"Go to page 2\" class=\"active\">2</a></li>\n<li class=\"pager-item\"><a href=\"/anaesthesiology/publications/term/118?page=2\" title=\"Go to page 3\" class=\"active\">3</a></li>\n<li class=\"pager-item\"><a href=\"/anaesthesiology/publications/term/118?page=3\" title=\"Go to page 4\" class=\"active\">4</a></li>\n<li class=\"pager-next\"><a href=\"/anaesthesiology/publications/term/118?page=1\" title=\"Go to next page\" class=\"active\">next ›</a></li>\n<li class=\"pager-last last\"><a href=\"/anaesthesiology/publications/term/118?page=3\" title=\"Go to last page\" class=\"active\">last »</a></li>\n</ul></div> \n \n \n \n \n</div> \";}', created = 1556259005, expire = 1556345405, headers = '', serialized = 1 WHERE cid = 'anaesthesiology:publication_types:page_1:output:d56b80c5de5eb69255f7b542f12d93c1' in /home/mgmcri/public_html/depts/includes/cache.inc on line 108.
Showing results in 'Publications'. Show all posts
Maclean, J, DK. T, S. P, M. R.  2013.  Comparative evaluation of gum-elastic bougie and introducer tool as aids in positioning of ProSeal laryngeal mask airway in patients with simulated restricted neck mobility, 2013. Indian journal of anaesthesia. 57(3):248-252. Abstract

BACKGROUND: The ProSeal laryngeal mask airway (PLMA) is a unique laryngeal mask with a modified cuff to improve seal and a channel to facilitate gastric tube placement. This is a better device in difficult airway situations compared to classic laryngeal mask airway. This prompted us to study the ease of insertion and positioning of PLMA in patients with simulated restricted neck mobility while using gum elastic bougie (GEB) group or introducer tool (group IT) to aid insertion.METHODS: Sixty ASA I or II patients, aged between 18 years and 60 years, undergoing minor non-head and neck surgeries in the supine position were studied. A rigid neck collar was used to simulate restricted neck mobility in all patients. After anaesthetising the patients with a standard protocol, the PLMA was inserted using either of the technique using the tongue depressor to open the mouth. The ease of insertion, positioning, haemodynamic responses to insertion and other complications related to the procedure were noted.
RESULTS: Regarding demographic variables, both groups were similar. The mean time taken for insertion of PLMA in group GEB was 67.80 s as compared to 46.79 s in group IT (P<0.05). Patients of group GEB had better positioning assessed by an intubating fiberscope with less end tidal carbon-di-oxide (ETCO2) values. Systolic and diastolic blood pressures were similar. The incidence of sore throat, dysphagia, and dysphonia were higher in IT group in the 12 h, but similar in 24 h.
CONCLUSION: Guided insertion technique with GEB took a longer time, but had a better positioning and lower ETCO2 values when compared to IT technique.

R., S, VR. HK, M. R.  2013.  Internal leaks into anaesthesia machines: an unaddressed problem.. British journal of anaesthesia . 111(1):126-127.
S., P, M. R.  2012.  Electroacupuncture in complex regional pain syndrome .. Interesting cases in Orthopedics.
Jahagirdar, SM, Karthikeyan P, Ravishankar M.  2011.  Acute airway obstruction, an unusual presentation of vallecular cyst, 2011/09//. Indian Journal of Anaesthesia. 55:524-527. AbstractWebsite

A 18-year-old female presented to us with acute respiratory obstruction, unconsciousness, severe respiratory acidosis, and impending cardiac arrest. The emergency measures to secure the airway included intubation with a 3.5-mm endotracheal tube and railroading of a 6.5-mm endotracheal tube over a suction catheter. Video laryngoscopy done after successful resuscitation showed an inflamed swollen epiglottis with a swelling in the left vallecular region, which proved to be a vallecular cyst. Marsupialisation surgery was performed on the 8(th) post admission day and the patient discharged on 10(th) day without any neurological deficit.

Parthasarathy, S, Ravishankar M.  2011.  Continuous spinal anesthesia with epidural catheters: An experience in the periphery. Anesthesia: Essays and Researches. 5:187., Number 2 AbstractWebsite

Background and Aim: Continuous spinal anesthesia (CSA) offers considerable advantages over "singleshot" spinal or epidural anesthesia since it allows administration of well-controlled anesthesia using small doses of local anesthetics and a definite end point with less failure rate. There are described technical difficulties with introduction of spinal micro catheters and hence this study was undertaken by using epidural catheters.
Materials and Methods: Sixty patients of ASA grade II to III were selected and they were administered continuous spinal anesthesia with Portex 18-G epidural catheters.
Results: The introduction was done in first attempt and was easy in all cases. The intraoperative period was uneventful in all cases. Early postoperative analgesia was achieved in all cases. Only two patients (3%) had postdural puncture headache controlled with simple analgesics. In a 3 month postoperative followup, the incidence of neurological complication is nil.
Conclusion: We conclude CSA with epidural catheters is a simple and safe alternative for prolonged procedures with negligible failure rate especially in high-risk patients and in patients with possible difficulties in administration of general anesthesia.

Ravishankar, M.  2011.  Uptake and distribution of inhaled anaesthetics, 26 December. ISACON 2011, 59th Annual National Conference of Indian Society of Anaesthesiologists . , Grant Hyat, Mumbai
Pusapati, RN, Sivashanmugam T, Ravishankar M.  2010.  Respiratory changes during spinal anaesthesia for gynaecological laparoscopic surgery, October 1, 2010. Journal of Anaesthesiology Clinical Pharmacology. 26:475-479. AbstractWebsite

Background: It is currently presumed that spinal anaesthesia can compromise respiratory muscle function during carbon dioxide (CO2) pneumoperitoneum. This observational study was designed to delineate the respiratory effects of CO2 pneumoperitoneum under spinal anaesthesia.Patients & Methods: Forty one patients undergoing elective gynecological laparoscopy were administered spinal anaesthesia with 15 mg heavy bupivacaine and 50 mcg of fentanyl. Heart rare, blood pressure, tidal volume, respiratory rate and end tidal CO2 were serially recorded before, during and after the pneumoperitoneum. Arterial blood gas analysis was done before and 20 min after initiation of pneumoperitoneum.

Parthasarathy, S, Ravishankar M, Aravindan U.  2010.  Total radical gastrectomy under continuous thoracic epidural anaesthesia, 2010/07//. Indian Journal of Anaesthesia. 54:358-359. AbstractWebsite

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Parthasarathy, S, Ravishankar M.  2010.  Tight bag, 2010/05//. Indian Journal of Anaesthesia. 54:193-198. AbstractWebsite

Tight bag is a clinical situation where excessive pressure needs to be applied to a reservoir bag of a breathing system to an intubated patient, which may or may not produce satisfactory ventilation. The various clinical scenarios and the appropriate steps for its prevention are described.