Various approaches to sciatic nerve blocks at different levels have been described. In the nineteenth century, landmark techniques were employed for the nerve block, while nowadays, ultrasound-guided nerve blocks are gaining popularity. Despite the array of techniques available, challenges arise due to factors like the intricate gluteal anatomy, challenging sonoanatomy, patient positioning issues, and the learning curve associated with ultrasound and nerve locators. Among these landmarks, the inferior gluteal artery stands out as an easily identifiable feature with ultrasound assistance. We re ..read more

The first ICU in Nepal started in 1973 at Bir Hospital and now there are 1595 ICU beds in Nepal and 840 ICU Beds with ventilators but only 35 Intensivists and only 2.8 ICU Beds/100,000 population. Anesthesiologists are the main physicians working in ICU and almost all ICUs are open or semi closed. Society of Anesthesiologist of Nepal was established since November 1987 whereas after 2010 Nepalese Society of Critical Care Medicine was established. Nepal Critical Care Development Foundation was established in 2012 which started workshops & training for Nurses and also organizes various aware ..read more

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Introduction: Septic shock continues to be a significant contributor of ICU mortality. Norepinephrine stands as the primary choice for vasopressor therapy. Either epinephrine or vasopressin is added to norepinephrine or vasopressin to attain the desired mean arterial pressure target. Head-to-head comparisons of these second-line options are scarce. We aimed to compare the effect of epinephrine and vasopressin on 7-day and 28-day mortality, occurrence of acute kidney injury, the duration of mechanical ventilation, as well as the lengths of stay in the ICU and hospital among patients diagnosed w ..read more

Introduction: Pain is the earliest most common complain after elective laparoscopic cholecystectomy. Different modalities has been suggested to provide better relief from postoperative pain and to reduce opioid related side effects. Pregabalin or gabapentin on reducing postoperative pain following laparoscopic cholecystectomy has been suggested but comprehensive data regarding the optimal dosage are limited. We designed this study to compare the effectiveness of gabapentin or pregabalin for preemptive analgesia. Methodology: Seventy two patients undergoing laparoscopic cholecystectomy under ge ..read more

Introduction: Laryngoscopy and endotracheal intubation are important airway securing techniques for patients undergoing general anaesthesia in operating room. This procedure is associated with significant hemodynamic changes putting undue stress in the heart and the brain circulation . Multiple drug therapies have been used to attenuate these responses, but none have been entirely successful till date. Hence aim of the study is to evaluate effects of single, low dose dexmedetomidine premedication on hemodynamic stress response during laryngoscopy and endotracheal intubation in patient posted f ..read more

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Treacher Collins syndrome is a rare congenital craniofacial disorder occurring approximately 1 in 50,000 live births. It is a type of syndrome in which upper airway obstruction may worsen as the patient ages. This syndrome presents challenges for anesthesiologists due to its characteristic facial abnormalities, which can lead to upper airway obstruction and necessitate multiple corrective surgeries throughout their lives. The complex anesthetic and airway management required for patients with Treacher collins syndrome becomes even more intricate in ambulatory setting. Improved airway approache ..read more

Continuous peripheral nerve catheters have become a standard approach for postoperative multimodal analgesia, offering effective pain management after various surgical procedures. This method is generally regarded as safe and has improved patient outcomes by providing targeted pain relief. While considered safe, there are potential complications associated with the procedure. One such complication is catheter entanglement. In this case, we encountered a patient with a catheter entangled in the suprainguinal fascia iliaca. We were able to resolve this issue by employing a meticulously applied c ..read more

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