where is the tracing?  ???

in case of neonates the indications for intra op dextrose is different.in case of peadiatric patients,
1. for cases like circumscision ,herniotomy-  done under sedation combined with caudal,spinal or penile block- there is no stress response .so chances of hypeglycemia is less.we give 5% dextrose for fasting deficits and maintainence

2.children undergoing surgeries on liver-- maintainence dextrose is given along with RL for replacement of losses

3.for other cases under GA we go with RL

paediatric fluid management has always been a topic of debate and we all need to share opinions-------pros and cons

all the drugs you are using are short acting ones ,emergence reactions are definitely going to be high as there is no residual effect of either fentanyl ,propofol or sevoflurane.
midazolam premedication - 1 mg in children will give adequate amnesia,and help prevent emergencce reactions from sevoflurane
fentanyl can be topped up after 45 minutes.this will help you to cut sevo well in time and prevent hemodyanamic response to our suctioning under vision.it also supresses upper airway reflex-so no need of xylocard before extubation and the child also tolerates tube better once he comes out of relaxant
we use atracurium....as recovery is complete and safe of recurarization for short procedures.
and we do give fliuds for tonsillectomies...........adequate hydration is necessary to prevent ponv.

hi,
some peadiatricians advice using banocide syrup for 5 days and then take up the case in elective surgeries, although we dont have anything of the sort in our text books

as an anesthetist ,our problem is probabaly high incidence of bronchospasm- so propofol or ketamine induction,pre operative bronchodialator inhalation and be prepared as for hyper reactive airway diseases

some points i feel very useful for nasal intubation,apart from one size smaller ETT are
  1. red rubber endotracheal tubes cause less damage as there is no murphy's eye and mucosal damage from cuff during insertion in the nostril is also less
  2.bevel should be away from septum during insertion in the nostril.so our tubes with left sided bevel r more useful for left nostril.if for the right nostril then we have to turn the tube so that bevel faces right side during insertion
  3.never force the tube in case of resistance.just roatate with screwing movements with gentle pressure
  4.i personally do a direct laryngoscopy view the larynx and then insert the nasal tube,so any complication i can still secure the airway very fast with oral intubation

does high eosinophil count warrant use of avil before induction.in elective cases does a course of DEC help.

i also find this slight head up position useful while intubating obese patients with big breasts when the introduction of laryngoscope is difficult.i find this slight head up position with chin above the level of breast very useful.waiting for comments from senior people.

i would like  to know how u anaesthetised this old lady.
did u have a plan A,a plan B in case plan A fails.what all are the problems u anticipated and what all were ur preparations to deal with them.

i am a new member of this forum and find the site very useful and interesting.i must at first thank all the members for sharing their experiences and giving suggestions without any restrictions. i am quite young to this field and have lots of questions to be answered .this forum will be very helpful to me.

sir,for administering NTG,i follow a simple calculation . one ampule -25 mg,in 500 ml of dextose gives 50 mcg per ml.so start with 10 drops per minute and adjust depending on response.the iv sets we use is generally 1ml=20 drops.
sir ,i would like to know a simple calculation for esmolol infusion.