Papers by Dr. Sushmita Bairagi
Rhino-orbito-cerebral mucormycosis is an aggressive and potentially lethal invasive fungal infect... more Rhino-orbito-cerebral mucormycosis is an aggressive and potentially lethal invasive fungal infection. Surgical debridement and amphotericin B remain the mainstay of treatment, however, associated side effects of amphotericin B like nephrotoxicity, hypokalemia, hypertension and arrhythmias need to be addressed. We discuss the anesthetic management of a 47 year old male with uncontrolled diabetes diagnosed with left sinoorbital mucormycosis posted for surgical debridement. The patient received amphotericin B and insulin preoperatively. Nephrotoxicity due to amphotericin B led to hypokalemia in this patient. We also discuss the role of liposomal formulation in preventing hypokalemia and other side effects associated with use of amphotericin.
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The Indian Anaesthetists Forum
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Rhino-orbito-cerebral mucormycosis is an aggressive and potentially lethal invasive fungal infect... more Rhino-orbito-cerebral mucormycosis is an aggressive and potentially lethal invasive fungal infection. Surgical debridement and amphotericin B remain the mainstay of treatment, however, associated side effects of amphotericin B like nephrotoxicity, hypokalemia, hypertension and arrhythmias need to be addressed. We discuss the anesthetic management of a 47 year old male with uncontrolled diabetes diagnosed with left sinoorbital mucormycosis posted for surgical debridement. The patient received amphotericin B and insulin preoperatively. Nephrotoxicity due to amphotericin B led to hypokalemia in this patient. We also discuss the role of liposomal formulation in preventing hypokalemia and other side effects associated with use of amphotericin.
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Indian journal of anaesthesia, 2017
© 2017 Indian Journal of Anaesthesia | Published by Wolters Kluwer ‐ Medknow using oxygen, nitrou... more © 2017 Indian Journal of Anaesthesia | Published by Wolters Kluwer ‐ Medknow using oxygen, nitrous oxide, and sevoflurane administered through the tracheostomy tube using a Jackson–Rees modification of Ayre's T-piece. Intubation was attempted with 4, and then, 3.5-mm endotracheal tube which we failed to negotiate. A size of 3-mm tube could be inserted snugly. Surgeons evaluated the stoma and cleared nearly 50–70 live maggots and cleaned the stoma using povidione-iodine [Figure 1b]. TT 3.5-mm ID was reinserted. Subsequent perioperative period was uneventful. The surgeons decided not to explore the trachea to extract the already migrated maggots because at that time, there were no clinical signs of airway obstruction by the worms and air entry was bilaterally equal. The stomal site gradually healed, and the child was successfully decannulated after 18 days and discharged with thorough advice about home care and hygiene to the parents. Few cases of tracheostomal myiasis have been reported in the literature.[1-4]
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Papers by Dr. Sushmita Bairagi