title: Anaesthesia at remote location: use of modified Bain circuit (Mapleson D) at Kunri Christian Hospital (KCH).
abstract: OBJECTIVE
  To develop a safe general anaesthesia technique for remote areas with lack of facilities.
  
  
  METHODS
  Four types of anaesthesia techniques using TIVA and modified Bain circuit were planned. Monitoring facility was limited to manual sphygmomanometer, palpation of radial pulse and monitoring of colour of skin and blood. Depth of anaesthesia was assessed using EVANs, RPST scoring system. Patients were asked in recovery room for awareness.
  
  
  RESULTS
  Surgeries done were cesarean sections, laparotomies, gynaecological, urological, hernia and burn contractures. Six patients had RPST score of 5 or more and three patients in recovery room complained of awareness. Cost per Anaesthesia was Rs225.
  
  
  CONCLUSIONS
  TIVA with modified Bain circuit provided effective anaesthesia in remote area at low cost.
authors: Department of Anaesthesia & Intensive Care, The Aga Khan University Hospital, Karachi.
authors: Ehtesham Izhar
authors: EI
authors: Khan
authors: Hameed
authors: H
authors: Ullah
authors: Rehana
authors: R
authors: Kamal
mesh_terms: D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000776:Anesthesiology; D006761:Hospitals; D006801:Humans