- Never be in a hurry to send the patient back to the ward if the procedure was done under a muscle relaxant. If in doubt try IPPR; if permitted the patient needs reintubation or IPPR with mask till he is completely reversed.
- Rising BP; not the colour or consciousness, indicate inadequate reversal. Transfer only if the BP is steady and the patient is conscious.
- All patients who have received muscle relaxant (long acting) must be reversed with at least 0.5 to 1 mg. Prostigmin for even a small dose of muscle relaxant.
- Patients having long acting spinal anaesthetic drugs must be under observation with written instructions for maintenance of BP in post-operative period.
- In patients with known full stomach or even expected full stomach induce with head up tilt, remove the Ryle’s tube after proper suction in different positions. Oxygenate with 100% oxygen. Do not ventilate after Scoline. Ask the surgeon to give tracheal pressure, introduce the laryngoscope blade only when the patient is fully relaxed and intubate. Study your position for intubation (take a flat stool to stand on if necessary) with head up tilt.
#21-25: Private Practice Anesthesia- Do’s and Dont’s
