Tranexamic acid

 Postpartum haemorrhage has been a nightmare for obstetricians as well as the Anaesthesiologists since ages. Active management of the 3rd stage, in the form of intramuscular ergometrine at delivery of the anterior shoulder or 10-20 units of oxytocin infusion in 500 ml of normal saline and a controlled cord traction are practised routinely. Uterine atony, retained placentae and ruptured uteri are very often the real cause. But I also feel sincerely that morbidity in such cases do happen due to the late arrival at the hospital.As a last resort to control bleeding, major surgical interventions such as hysterectomy and bilateral uterine artery ligation are also required occasionally. In my experience, one drug which should not be forgotten in such cases is Tranexamic acid...Tranexamic acid is cheap, heat-resistant, easy to store  and it is proven to save lives. Col Pradeep Pendyala

Intralipid

 Maximum dose of lidocaine (plain, without vasoconstrictor)  is 4.5 mg/kg (not to exceed 300 mg) and similarly for Bupivacaine it's 2.5 mg /kg not to exceed 175 mg in a single dose. These figures could be read in almost all the standard text books of Anaesthesiology. But interestingly, nowhere it's written what's the safe dose of each of them when they're mixed together. As we're aware we always mix these two drugs when we give blocks. Wonder why no author has ever bothered to write about the safe dose when they're mixed. Accidental intravascular injection is the major cause of systemic toxicity, for example, regional anesthesia of the neck (interscalene block ) can cause direct intra-arterial injection and cause rapid toxicity from early entry to the cerebral circulation. Epidural anesthesia holds a risk of intravenous injection into the engorged epidural venous plexus of the parturient. The accidental overdose of local anaesthetics may prove fatal. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anaesthetic for  cardiotoxicity. Hence I would request all  Anaesthesiologists to keep intralipid always available in the operation theatre fridge. Col Pradeep Pendyala.

New Year Resolutions

 Started the new year with Garam Garam Puri as breakfast. I do hope sincerely that I would achieve the following resolutions for this year 2021. Read more of Anaesthesiology. Get better results for my final year post graduate students. Eat more veggies rather than chicken. Create better songs and mimicry videos. Learn more new things. Create a bigger friendship circle and above all today being the first day of the year...wish as many people as possible...A Happy New Year 2021. Col Pradeep Pendyala Professor of Anaesthesiology at ASRAM Medical College Eluru

How to prepare for the exams

 I always tell my students to read atleast one page a day... because, I know too very well that it's impossible to read only one page. The moment you complete one page, you feel the desire to read one more page and the process goes on. Well, frankly, it's always better to plan your studies spread over one month. Understanding the concept and deeper understanding of the topic is essential rather than cramming it and trying to memorize it verbatim. If you try to memorize everything without understanding, it's a huge stress generating exercise. Try to entertain yourself while reading...eg listen to your favourite song after completing a difficult chapter or present yourself a Cadbury after writing down all the important points. Easier way to learn is reading a PPT or understanding a diagram or a table connected to the concerned topic. And yes, if you want to memorize it for a lifetime, simplest thing is to teach someone... your junior or your classmate, the things you've learned already... Col Pradeep Pendyala, Professor of Anaesthesiology at ASRAM Medical College

हम निश्चेतक हैं।

 सभी के लिए अज्ञात

हम आपको जीवित रखते हैं

हम आपको सुरक्षित रखते हैं

हम आपको जगाते हैं

हम आपको घर भेजते हैं

हम जोखिम उठाते हैं

हम निश्चेतक हैं

हमारे पास केवल एक आदर्श वाक्य है

हम आपके जीवन को महत्व देते हैं

हमारे से ज्यादा

हम आपकी सांस की निगरानी करते हैं

हम आपके दिल की धड़कन को मापते हैं

हम निश्चेतक हैं।

हम आपकी नब्ज देखते हैं

हम आपको कीमती मानते हैं

हम आपको नींद से वापस लाते हैं

घंटे, और उम्र के लिए

हम वहाँ स्थिर रहते हैं

दुनिया के सर्वश्रेष्ठ सैनिकों की तरह

हम निश्चेतक हैं। 

कर्नल प्रदीप l

An Anthem

 Invisible to you 

Unknown to all

We put you to sleep

We keep you alive

We keep you safe

We wake you up

We send you home

We take the risks

We call the shots

We hold your life, praying

In the palm of our hands

We do not gamble 

With its price

We take the blame

In case we fail

We let others take the credit

When we succeed

Which is most of the time

We are the anaesthetists

We have only one motto

We value your life

More than ours

We monitor your breath

We measure your heartbeat

We master machines

Save countless lives

We are the anesthetists.

We watch your pulse

The rise and fall of your chests

We hold you precious 

Remember your loved ones

We bring you back from slumber 

Stupor and drugged states

We stand for care and value

And e-quality

We cannot have a gap 

Between our words and actions

Name and reality

Unlike  other professions

Such a slip would be costly

We stand at our post 

For hours, and ages

We remain there steadfast

To the end, as needed

Forsaking food and drink

And sleep and loved ones, if need be

Like the world's best soldiers

Concentrated, focussed

We are the anaesthetists.

Peace of mind...