magic of 1.5 in management of anesthesia in tonsillectomy
- 1. Dr. Tushar Chokshi Private Practicing Anesthesiologist M.D. ( Anesthesiology ) Medical College, VADODARATMC
- 2. MAGIC OF 1.5 IN ANESTHETIC MANAGEMENT OF TONSILLECTOMY ( Plus, Minus, Divided or Multiplied ) TMC
- 3. An easy method for remembering various figures in practice of anesthesia TMC
- 4. Aims & Objectives To study the magic of 1.5 in anesthesia Practice TMC
- 5. Most figures in anesthesia simplified as TOTAL DIFFERENCE MULTIPLE DIVISION Of 1.5( Based on Anesthetic Management of 1500 Tonsillectomy in last 15 years ) TMC
- 6. Methods and Materials Given around 1500 anesthesia for surgery of Tonsils & Adenoids in 3 private ENT Hospitals of Vadodara City from 1995 to 2009 (15 years) without any major complications, with all necessary protocols and standard operating procedures.TMC
- 7. Summary of Results Age Group : 3 to 45 Years ASA Group : ASA I or II (Mean 1.5) PA Check-Up : 15 minute before giving anesthesia TMC
- 8. Investigations Hb, TC, DC, ESR, BT, CT, FBS/RBS & SOS X-Ray Chest and/or ECG TMC
- 9. Nil By Mouth Clear Water up to 3 hrs before Operation Solid 6 hrs before Operation TMC
- 10. Premedication Inj. Atropine 0.03 mg / kg IM (15 minutes before) OR IV (1.5 minutes before) TMC
- 11. Infusion Ringer Lactate 15 ml / Kg weight (Total) Completed within 1.5 hours TMC
- 12. Pre-Induction Inj. Ondansetron 0.75 ml (P) / 1.5 ml (A) Inj. Diclofenac Sodium 1.5 mg/kg Most Common Antibiotics 15 mg/kg All Intravenous ( No Sedation ) TMC
- 13. Pre-Oxygenation 1.5 liters (P) or 3 liters (A) for 1.5 or 3 minutes P-Pediatric A-Adult TMC
- 14. Induction Inj. Ketamine 1.5 mg / Kg + Inj. Propofol 1.5 mg / Kg (Mix) or Inj. Thiopental Sodium 4.5 mg / kg Slowly IV For 1.5 Minutes Followed by Succinyl Choline 1.5 mg / Kg IV TMC
- 15. IPPR For 1.5 minutes with 3 liters (P) / 4.5 liters (A) of Oxygen TMC
- 16. Intubation Oral or Nasal with cuff Portex ET Tube (ET Size – Ht. in Feet + 1.5) Laryn-Pack 1.5 Feet(P)/3 Feet(A) long Cuff Pressure 3 / 6 / 9 ml TMC
- 17. Maintenance On Anaesthesia Machine 1.5 L / 3 L O2 + 1.5 L / 3 L N2O RR 15 / Minute & Tidal Volume 7.5 ml/kg with maintenance of relaxation giving Succinyl Cholene 30 mg(P) / 60 mg(A) every 3 Minutes Isoflurane at 1.5 mark or 3 markTMC
- 19. Post-Operative Analgesia Local Inj. Lidocaine 1.5 mg / kg in each tonsiller fosse or Local Inj. Bupivacaine 1.5 ml in each tonsiller fosse TMC
- 20. Outcome Pleasant with Verbal Command & Reflexes within 3 to 6 minutes of Extubation TMC
- 21. Average Anesthesia Time 30 to 45 Minutes TMC
- 22. Post operative NBM Clear water after 3 hours & Solid after 4.5 hours TMC
- 23. Discharge After 6 hrs of operation TMC
- 24. Follow Up on 3rd day TMC
- 25. TMC The Magic of 1.5 helps to give safe and efficient anesthesia with minimal strain on memory and time in Management of Tonsillectomy with respect to standard protocols of Textbooks.
- 26. TMC