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Vaithialingam B, Haran V, Rudrappa S. Intra-operative Triggered EMG Monitoring - "Total Intravenous Anesthesia is not Indispensable". Neurol India 2024; 72:425-426. [PMID: 38691492 DOI: 10.4103/neurol-india.neurol-india-d-23-00556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/20/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Balaji Vaithialingam
- Division of Neuroanaesthesia, International Institute of Neurosciences, Aster Whitefield Hospital, Bengaluru, Karnataka, India
| | - Vignesh Haran
- Department of Neurology, Manipal Hospital, Old Airport Road, Bengaluru, Karnataka, India
| | - Satish Rudrappa
- Department of Neurosurgery and Spine Surgery, International Institute of Neurosciences, Aster Whitefield Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Rudrappa S. Intraoperative visualisation of 3 Hz spike-wave epileptic discharges in the electroencephalographic signal of bispectral index monitor in a patient with absence seizures. Indian J Anaesth 2024; 68:209-210. [PMID: 38435653 PMCID: PMC10903765 DOI: 10.4103/ija.ija_710_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/11/2023] [Accepted: 11/12/2023] [Indexed: 03/05/2024] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Satish Rudrappa
- Department of Neurosurgery, Sakra World Hospital, Bengaluru, Karnataka, India
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3
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Vaithialingam B. Scope of snorkel technique during pediatric gas induction. Minerva Anestesiol 2024:S0375-9393.24.17966-7. [PMID: 38298036 DOI: 10.23736/s0375-9393.24.17966-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
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Abstract
How to cite this article: Vaithialingam B, Gopal S, Masapu D. Author Response. Indian J Crit Care Med 2024;28(1):87-88.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Swaroop Gopal
- Department of Neurosurgery, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Dheeraj Masapu
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Vemulapalli S, Rudrappa S. Dynamic magnetic resonance imaging-guided tracheal intubation in Hirayama myelopathy. Minerva Anestesiol 2023; 89:1148-1149. [PMID: 37671542 DOI: 10.23736/s0375-9393.23.17578-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Affiliation(s)
| | | | - Satish Rudrappa
- Institute of Neurosciences, Sakra World Hospital, Bengaluru, India
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Vaithialingam B, Sriganesh K. Trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) in neuroanesthesia practice: A review. J Anaesthesiol Clin Pharmacol 2023; 39:521-527. [PMID: 38269192 PMCID: PMC10805210 DOI: 10.4103/joacp.joacp_92_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/16/2022] [Accepted: 07/02/2022] [Indexed: 01/26/2024] Open
Abstract
Respiratory management is an important aspect of care in neuroanesthesia practice for neurosurgical patients. A wide variety of procedures are performed under sedation in the neurosurgical population, and maintaining oxygenation is of paramount importance during these procedures. The high-flow oxygen devices improve arterial oxygenation by providing higher inspiratory oxygen concentration and maintaining higher dynamic positive airway pressure. These devices have gained importance during the recent years with regard to enhancing patient safety. This narrative review focuses on the role of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) and high-flow nasal oxygenation (HFNO) techniques in the neuroanesthesia practice and electroconvulsive therapy.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Kamath Sriganesh
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Vaithialingam B, Gopal S, Chandrashekhar S. Severe Oculorespiratory Reflex during Ophthalmic Artery Catheterization in an Infant with Retinoblastoma. Indian J Radiol Imaging 2023; 33:574-575. [PMID: 37811175 PMCID: PMC10556302 DOI: 10.1055/s-0043-1770084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Swaroop Gopal
- Department of Neuro-Endovascular Surgery, Sakra World Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Bansal S, Muthuchellappan R, Thirthalli J, Chakrabarti D, Venkatapura RJ. Comparison of hands-free Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) with conventional facemask ventilation technique for oxygenation in patients undergoing electroconvulsive therapy - A cross over study. Asian J Psychiatr 2023; 88:103734. [PMID: 37619421 DOI: 10.1016/j.ajp.2023.103734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVES Modified ECT is routinely conducted using face mask (FM) and bag ventilation technique. Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is a novel hands-free insufflation technique that provides oxygenation and prolongs apnoea time. There is limited literature comparing the two techniques. Primary objective of this study was to compare oxygen desaturation between THRIVE and FM techniques during ECT while secondary objective was to compare hemodynamics and complications. METHODS Patients aged 18-50 years undergoing 3rd-5th ECT treatments were enrolled. First ECT was with FM technique followed by THRIVE (with LUBO collar) in the next ECT. Except for the oxygenation technique, the protocol for ECT administration was similar with both techniques. SpO2 values were recorded every minute for 10 min while hemodynamic parameters were measured at 2 min and 5 min following administration of electrical stimulus. Any drop in SpO2 below 92 % was considered as a desaturation event. RESULTS A total of 201 patients underwent ECTs, one each with FM and THRIVE technique. Median age of patients was 28 years. There was no difference in SpO2 between the techniques (main effect P = 0.324, interaction P = 0.14). Only one patient had desaturation with THRIVE requiring intervention with FM. None of the patients had any airway complications in terms of nasal injury, hoarseness, or pneumothorax with THRIVE. CONCLUSION THRIVE is a safe alternative option for hands-free oxygenation while administering ECT. However, considering patient safety, an anaesthesiologist competent in airway management must be readily available.
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Affiliation(s)
| | - Sonia Bansal
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Radhakrishnan Muthuchellappan
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560029, India
| | - Dhritiman Chakrabarti
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Ramesh J Venkatapura
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, India.
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Vinaik T, Vaithialingam B, Chandrashekhar S. An unevaluated case of massive mediastinal lymphoma for anesthesia-STRIVE-Hi to the rescue. Indian J Thorac Cardiovasc Surg 2023; 39:560-561. [PMID: 37609611 PMCID: PMC10441959 DOI: 10.1007/s12055-023-01562-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 08/24/2023] Open
Affiliation(s)
- Tulika Vinaik
- Department of Anesthesia, Sakra World Hospital, Bellandur, Bengaluru, 560103 Karnataka India
| | - Balaji Vaithialingam
- Department of Anesthesia, Sakra World Hospital, Bellandur, Bengaluru, 560103 Karnataka India
| | - Shishir Chandrashekhar
- Department of Anesthesia, Sakra World Hospital, Bellandur, Bengaluru, 560103 Karnataka India
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Thandapani M, Pothu SK, Govindasamy R, Rudrappa S, Vaithialingam B. Concomitant Occurrence of the Ossified Posterior Longitudinal Ligament with a Posterior C2 Defect. Asian J Neurosurg 2023; 18:688-689. [PMID: 38152519 PMCID: PMC10749828 DOI: 10.1055/s-0043-1771321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Affiliation(s)
| | - Sudheer Kumar Pothu
- Institute of Neurosciences, Sakra World Hospital, Bengaluru, Karnataka, India
| | | | - Satish Rudrappa
- Institute of Neurosciences, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Surve RM. Persistent Atrial Fibrillation following Intra-Arterial Nimodipine Injection. Neurol India 2023; 71:1015-1016. [PMID: 37929447 DOI: 10.4103/0028-3886.388097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rohini M Surve
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Vaithialingam B, Gopal S, Masapu D. "Locked-in State" Following Anterior Circulation Aneurysmal Subarachnoid Hemorrhage. Indian J Crit Care Med 2023; 27:601-602. [PMID: 37636843 PMCID: PMC10452776 DOI: 10.5005/jp-journals-10071-24501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
How to cite this article: Vaithialingam B, Gopal S, Masapu D. "Locked-in State" Following Anterior Circulation Aneurysmal Subarachnoid Hemorrhage. Indian J Crit Care Med 2023;27(8):601-602.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Swaroop Gopal
- Department of Neurosurgery, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Dheeraj Masapu
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Rudrappa S, Gopal S, Masapu D. Ergonomic challenges and intraoperative concerns during O-arm ®-guided neurosurgical procedures. Indian J Anaesth 2023; 67:644-646. [PMID: 37601925 PMCID: PMC10436712 DOI: 10.4103/ija.ija_107_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/19/2023] [Accepted: 05/04/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Satish Rudrappa
- Institute of Neurosciences, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Swaroop Gopal
- Institute of Neurosciences, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Dheeraj Masapu
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Gopal S, Chandrashekhar S, Mallik D. Anesthetic management of super-selective intra-arterial Melphalan injection in an infant with retinoblastoma. Saudi J Anaesth 2023; 17:434-436. [PMID: 37601488 PMCID: PMC10435815 DOI: 10.4103/sja.sja_236_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 08/22/2023] Open
Abstract
Intra-arterial Melphalan injection is an emerging treatment for children with advanced retinoblastoma. The procedure, which is frequently performed under general endotracheal anesthesia, can be complicated by technical difficulty and cardiorespiratory instability, which the anesthesiologist should be aware of. We describe the anesthetic management and special concerns during super-selective intra-arterial Melphalan injection in an infant with advanced retinoblastoma.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Anesthesia, Sakra World Hospital, Bellandur, Bengaluru, Karnataka, India
| | - Swaroop Gopal
- Department of Neuro-Endovascular Surgery, Sakra World Hospital, Bellandur, Bengaluru, Karnataka, India
| | | | - Dattatraya Mallik
- Department of Neurosurgery, Sakra World Hospital, Bellandur, Bengaluru, Karnataka, India
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Vaithialingam B, Arun BG. High-flow Tracheal Oxygenation with Airway Exchange Catheter: A Novel Approach. Indian J Crit Care Med 2023; 27:456. [PMID: 37378365 PMCID: PMC10291670 DOI: 10.5005/jp-journals-10071-24476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
How to cite this article: Vaithialingam B, Arun BG. High-flow Tracheal Oxygenation with Airway Exchange Catheter: A Novel Approach. Indian J Crit Care Med 2023;27(6):456.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
| | - BG Arun
- Department of Anaesthesiology, Sakra World Hospital, Bengaluru, Karnataka, India
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Vaithialingam B, Gopal S, Sohrab M. Catheter Embolization of an Orbital Arteriovenous Fistula in a Patient With Wyburn-Mason Syndrome. Cureus 2023; 15:e36949. [PMID: 37131550 PMCID: PMC10149032 DOI: 10.7759/cureus.36949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
A 24-year-old female presented to the emergency department with swelling of the forehead and oculus sinister. A soft, compressible glabellar swelling with proptosis of the oculus sinister was noted on clinical examination. Cerebral angiography revealed a left medial orbital wall arteriovenous fistula with feeders from the left internal maxillary artery, left superficial temporal artery, and left ophthalmic artery. During the cerebral angiography, a diffuse intracranial venous anomaly and left basal ganglia arteriovenous malformations were also noted. A diagnosis of Wyburn-Mason syndrome was made, and the patient underwent catheter embolization of the orbital arteriovenous fistula. After glue embolization of the left external carotid artery feeders, the patient experienced a 50% reduction in glabellar swelling in the immediate postoperative period. Glue embolization of the left ophthalmic artery feeder was planned after six months during the follow-up period.
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Vaithialingam B, Arun BG. Heat and moisture exchanger filter as a substitute for T-piece device - A novel approach. Asian J Med Sci 2023. [DOI: 10.3126/ajms.v14i2.51099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Letter to Editor
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Muacevic A, Adler JR, Govindasamy R, Rudrappa S, Vaithialingam B. Thoracic Compressive Myelopathy in a Patient With Takayasu Arteritis. Cureus 2023; 15:e33496. [PMID: 36756014 PMCID: PMC9902057 DOI: 10.7759/cureus.33496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2023] [Indexed: 01/09/2023] Open
Abstract
Takayasu arteritis (TA), also known as occlusive thromboaortopathy, is a type of chronic inflammatory arteritis that primarily affects large vessels. Compressive thoracic myelopathy is a rare and distinct manifestation of TA. We present the case of a 60-year-old woman who developed gradually progressive spastic paraplegia over one year. Magnetic resonance imaging revealed a well-defined extra-dual, intensely enhancing ventrodorsal lesion with severe spinal cord impingement. The aortogram revealed dilatation of the aortic arch (with narrowing of arch vessels) and descending aorta, as well as a right paravertebral soft tissue mass at the D4 level. Given the likelihood of TA, the patient underwent decompressive laminectomy and spinal fusion due to severe spinal cord compression. The biopsy of the dural-based lesion revealed an inflammatory granuloma, and the patient was treated postoperatively with oral prednisolone and mycophenolate mofetil. After six months of immunotherapy, there was excellent neurological recovery and near-total resolution of the lesion.
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19
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Vaithialingam B, Kumar S. Severe hydrocephalus in an infant with Ellis–van creveld syndrome: A rare entity. J Pediatr Neurosci 2023. [DOI: 10.4103/jpn.jpn_79_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Vaithialingam B, Chakrabarti D. Location of the Ground Electrode can Minimize the Leakage Current Interference During the Evoked Potential Monitoring. Neurol India 2023; 71:194-195. [PMID: 36861618 DOI: 10.4103/0028-3886.370444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Dhritiman Chakrabarti
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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21
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Vaithialingam B, Sundaram M, Bhadrinarayan V. Transient Horner's Syndrome following Posterior Cervical Spine Instrumentation: A Postoperative Dilemma. J Neuroanaesth Crit Care 2022. [DOI: 10.1055/s-0042-1757170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mouleeswaran Sundaram
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Varadarajan Bhadrinarayan
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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22
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Vaithialingam B. Successful management of anterior tracheal rent with endoscopic instillation of fibrin sealant. Indian J Thorac Cardiovasc Surg 2022; 38:570-571. [PMID: 36050988 PMCID: PMC9424442 DOI: 10.1007/s12055-022-01357-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/22/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka 560029 India
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23
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Vaithialingam B, Kotwal A. Lubo Airway Collar as a Rescue in Magnetic Resonance Imaging. Cureus 2022; 14:e27063. [PMID: 35989751 PMCID: PMC9389023 DOI: 10.7759/cureus.27063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Adverse respiratory events in the out-of-operation theatre premises can be challenging to anesthesiologists. Manual jaw thrust application by anesthesiologists can be a temporary solution during an adverse airway event in remote locations. This report highlights the utility of a novel collar in alleviating upper airway obstruction in a patient in the MRI suite under IV sedation. The Lubo collar provides an automated jaw thrust and can also be applied electively for patients undergoing MRI under sedation and who are at risk of upper airway obstruction.
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Vaithialingam B, Vankayalapati S. Anterior Circulation Infarct Following the Placement of Flow-Diverting Stent for Basilar Artery Aneurysm - A Conundrum. Neurol India 2022; 70:1740-1741. [PMID: 36076714 DOI: 10.4103/0028-3886.355092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sriharish Vankayalapati
- Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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25
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Vaithialingam B, Muthuchellappan R. Phenytoin-Induced Toxic Epidermal Necrolysis with Immediate Remission Post Intravenous Immunoglobulin Therapy. J Neuroanaesth Crit Care 2022. [DOI: 10.1055/s-0042-1744393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Radhakrishnan Muthuchellappan
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Vaithialingam B, Bansal S, Ramesh VJ, Muthuchellappan R. Corrigendum to "Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) ventilation during electroconvulsive therapy (ECT) for a pregnant patient - A novel technique" [Asian J. Psychiatry 70 (2022) 103023]. Asian J Psychiatr 2022; 70:103045. [PMID: 35219982 DOI: 10.1016/j.ajp.2022.103045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.
| | - Sonia Bansal
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India
| | - V J Ramesh
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India
| | - Radhakrishnan Muthuchellappan
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India
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Vaithialingam B, Bansal S, Ramesh VJ, Muthuchellappan R. Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) ventilation during electroconvulsive therapy (ECT) for a pregnant patient- A novel technique. Asian J Psychiatr 2022; 70:103023. [PMID: 35183042 DOI: 10.1016/j.ajp.2022.103023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/05/2022] [Accepted: 02/11/2022] [Indexed: 11/02/2022]
Abstract
Maintaining oxygenation and ventilation is imperative in a pregnant patient undergoing electroconvulsive therapy (ECT). Here, we present the successful utilization of Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) in a six-month pregnant patient who received ECT under general anesthesia.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.
| | - Sonia Bansal
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.
| | - V J Ramesh
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.
| | - Radhakrishnan Muthuchellappan
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.
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Vaithialingam B, Muthuchellappan R, Sundaram M. Fatal multiorgan dysfunction following repeated iodinated radiocontrast injection in a patient on low dose oral methotrexate. Korean J Anesthesiol 2022; 75:283-285. [PMID: 35286798 PMCID: PMC9171540 DOI: 10.4097/kja.22067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Methotrexate is an antimetabolite drug that blocks the dihydrofolate reductase enzyme and impairs cell DNA synthesis. Administration of intravenous iodinated radiocontrast agents can precipitate life-threatening toxicity in patients receiving methotrexate. Case A 60-year-old female patient, a known case of rheumatoid arthritis, underwent craniotomy and clipping of distal anterior cerebral artery aneurysm. The patient was on low dose oral methotrexate for the past 5 years that was interrupted 2 days prior to surgery. The patient received the first intravenous contrast injection (Iohexol) during diagnostic cerebral angiography , one day prior to surgery (50 ml) and the second contrast dose on the first postoperative day (60 ml). The patient developed severe methotrexate toxicity leading to fatal multiorgan failure and death following repeated contrast imaging with intravenous Iohexol. Conclusions Even though oral low methotrexate has a minor adverse effect, life-threatening toxicity can get precipitated in the presence of iodinated contrast agents.
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Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru (560029), Karnataka India
| | - Radhakrishnan Muthuchellappan
- Department of Neuroanesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru (560029), Karnataka India
| | - Mouleeswaran Sundaram
- Department of Neuroanesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru (560029), Karnataka India
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Vaithialingam B, Muthuchellappan R. Feasibility of THRIVE oxygenation and intra-operative lung-protective ventilation in morbidly obese patients undergoing neurosurgical procedures. Saudi J Anaesth 2022; 16:361-363. [PMID: 35898536 PMCID: PMC9311174 DOI: 10.4103/sja.sja_198_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 11/05/2022] Open
Abstract
The conduct of anesthesia in morbidly obese patients undergoing neurosurgical procedures can be challenging considering the multi-system organ involvement. Implementation of conventional lung-protective ventilation in morbidly obese patients can have a negative impact on the intra-cranial dynamics. We report a series of three patients with morbid obesity and a difficult airway for the neurosurgical procedure. The patients were oxygenated with high-flow oxygen devices to ensure an adequate oxygen reserve in the peri-operative period. A modified intra-operative lung-protective ventilation with normocarbia was implemented with no impact on the intra-cranial pressure in the prone position in two of the patients. Oxygenation with high-flow devices should be considered during the peri-operative period in morbidly obese patients to avert an adverse respiratory event, and a modified lung-protective ventilation technique is feasible with normal intra-cranial dynamics intra-operatively.
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Vaithialingam B, Bharadwaj S. Intraoperative return of motor evoked potential following decompressive laminectomy: An early indicator of successful decompression? Saudi J Anaesth 2022; 16:508-509. [PMID: 36337416 PMCID: PMC9630678 DOI: 10.4103/sja.sja_174_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022] Open
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Vaithialingam B, Venkataramaiah S. Parkinson's induced severe restrictive respiratory dysfunction for deep brain stimulation – Anaesthesiologists' perspective. Indian J Anaesth 2022; 66:540-541. [PMID: 36111100 PMCID: PMC9469003 DOI: 10.4103/ija.ija_93_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 11/09/2022] Open
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Vaithialingam B. Anesthesia for triggered electromyography-guided cord detethering in a three-month-old infant. Saudi J Anaesth 2022; 16:270-271. [PMID: 35431744 PMCID: PMC9009558 DOI: 10.4103/sja.sja_49_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 12/03/2022] Open
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Vaithialingam B. Utility of a novel airway collar in electroconvulsive therapy - A handsfree technique. Korean J Anesthesiol 2021; 75:191-192. [PMID: 34883009 PMCID: PMC8980284 DOI: 10.4097/kja.21481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanaesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru (560029) , Karnataka, India
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Vaithialingam B, Sriganesh K. Clinical utility of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) during awake craniotomy. Indian J Anaesth 2021; 65:262-263. [PMID: 33776123 PMCID: PMC7989483 DOI: 10.4103/ija.ija_1188_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/12/2020] [Accepted: 12/07/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Balaji Vaithialingam
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kamath Sriganesh
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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