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Biomedical subjects

M Radhakrishnan

Publications and source records attributed to M Radhakrishnan.

6 recordsLinked to original sources
PubMed2006

Lidocaine infiltration of the scalp does not completely abolish increased intraocular pressure due to skull pin insertion.

Insertion of skull pins results in haemodynamic perturbations, which can be blunted by local anaesthetic infiltration of the pin sites. No study has assessed the effects on intraocular pressure. General anaesthesia was induced in 71 patients undergoing cervical spine surgery with attachment of Gardner Wells tongs to the skull. Skull pins were attached five minutes after induction following either saline (group I, 35 patients) or lidocaine (group II, 36 patients) infiltration of scalp. Intraocular pressure, mean arterial pressure and heart rate were recorded before (baseline), immediately after, and 60 s following pin insertion and analysed statistically. Insertion of pins increased intraocular pressure in both groups (from 8.4+/-2.7 to 14.2+/-3.0 mmHg in group I, and from 8.8+/-2.3 to 12.7+/-2.7 mmHg in group II, P < 0.001), which persisted even at 60 s but the increase was significantly greater in group I. Insertion of pins significantly increased blood pressure in group I only. We conclude that lidocaine infiltration at the skull pin sites for Gardner Wells tong attachment fails to completely abolish increased intraocular pressure.

Adult↗
PubMed2006

Heparin-induced transient prolongation of the QT interval during endovascular embolisation of intracranial aneurysm.

Prolonged QT interval and increased QT(C) dispersion have been described immediately following rupture of intracranial aneurysm, due to increased sympathetic activity. Here, we report a patient with transient prolongation of the QT interval, probably due to heparin-induced hypocalcaemia, which occurred during coiling of a right internal carotid aneurysm, 54 days after ictus. Correction of the hypocalcaemia led to resolution of the electrocardiogram and blood pressure abnormalities.

Anticoagulants↗
PubMed2005

Effect of preemptive gabapentin on postoperative pain relief and morphine consumption following lumbar laminectomy and discectomy: a randomized, double-blinded, placebo-controlled study.

Synergism between gabapentin and morphine in treating incisional pain has been demonstrated in animal experiments and clinical studies. The efficacy of gabapentin for treatment of perioperative pain remains controversial. This study was designed to detect the influence of gabapentin premedication on morphine consumption in the immediate postoperative period in patients undergoing lumbar laminectomy and discectomy. Either gabapentin 800 mg (in two equally divided doses) or placebo was given preoperatively to 60 adult patients undergoing elective lumbar laminectomy or discectomy in a double-blinded, placebo-controlled, randomized study. Standard general anesthesia was given to all the patients. Morphine was administered via patient-controlled analgesia pump in the immediate postoperative period for first 8 hours. Pain at rest and on movement was assessed using a Verbal Rating Scale (VRS) every 2 hours for the first 8 postoperative hours. There were no differences in demographics or surgical duration between the two groups. The amount of fentanyl administered in the intraoperative period was similar between the two groups. In the postoperative period, the VRS score for pain at 0, 2, 4, 6, and 8 hours was not significantly different between the two groups. Highest median VRS score was recorded at 0 hours postoperatively in both groups (VRS: rest = 6, movement = 8 in placebo group; rest = 6, movement = 8 in gabapentin group). Total morphine consumption and side effects were similar in the two groups. Gabapentin does not decrease the morphine requirement or morphine side effects in the immediate postoperative period following lumbar laminectomy and discectomy.

Adolescent↗
PubMed2004

Inadvertent insertion of nasogastric tube into the brain.

An unusual case of a nasogastric (Ryle's) tube inserted in the brain in a patient having severe head injury with skull base fractures is reported here along with a brief review of literature. A 35 years male was referred from a peripheral institute following head trauma with endotracheal tube and nasogastric tube in situ. A CT scan of the brain showed multiple skull base fractures and a high parietal extradural hematoma. It also revealed that the nasogastric tube had inadvertently found its way into the brain through the lamina cribrosa of the ethmoid bone. The tube was removed under aseptic conditions in the operation theatre but the patient expired on day 2 of admission due to the head injuries sustained.

Adult↗
PubMed2002

Inverse Marcus Gunn phenomenon.

Inverse Marcus-Gunn phenomenon is very rare. It is usually acquired. We report a young male patient presenting with congenital ptosis and inverse Marcus-Gunn phenomenon.

Adult↗