International Journal of Medical Anesthesiology最新文献

{"title":"Intravenous dexmedetomidine versus esmolol for attenuation of haemodynamic response to endotracheal extubation: A randomized double-blind study","authors":"P. Shah, K. Sahare, R. Bhuaarya, Falgudhara Panda","doi":"10.33545/26643766.2023.v6.i2b.396","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2b.396","url":null,"abstract":"Background and Aim: Tracheal extubation is a crucial step of general anaesthesia which is associated with intense airway and hemodynamic responses secondary to activation of mechanoreceptors in larynx. The present study aims to compare the efficacy of intravenously administered dexmedetomidine and esmolol in attenuating the hemodynamic response to endotracheal extubation. Materials and Method: This prospective, randomized, double-blind study was conducted in 80 ASA I-II patients of 18-60 years undergoing elective surgery under general anaesthesia. They were randomly divided into two groups of forty each. Anticipated ten minutes before the extubation Group D received intravenous dexmedetomidine 0.5 µg/kg diluted in 10 ml normal saline and Group E received 10 ml of normal saline. Two min before extubation Group D received 10 ml normal saline and Group E received esmolol bolus dose 1 mg/kg diluted in 10 ml normal saline. Heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, extubation and emergence time, Ramsay sedation score and adverse events were recorded. Results: Mean heart rate was significantly lower in group D from 5 min of drug administration till 20 min post extubation as compared to group E. Mean systolic blood pressure, diastolic blood pressure and mean blood pressure were significantly lower in group D as compared to group E from 8 min after administration of drug till 20 min of post extubation ( p <0.05). Emergence time, extubation time and adverse events were comparable in both the groups ( p >0.05). Delayed emergence was observed in 2 patients in group D. More number of patients in group D were sedated. Conclusion: IV dexmedetomidine is better in attenuating haemodynamic response to endotracheal extubation than esmolol because of comparatively stable haemodynamics, comparable emergence and extubation time, conscious sedation, less postoperative cough and agitation.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84630162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of single dose versus continuous infusion of dexmedetomidine for reduction in incidence of emergence agitation in adults following nasal surgeries: A randomized double-blind study","authors":"R. Bhuaarya, P. Shah, Katari Sruthi","doi":"10.33545/26643766.2023.v6.i2b.405","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2b.405","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89516452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"to study the Hemodynamic effects of intravenous clonidine as premedication for endotracheal intubation","authors":"Dr. Sherren Joseph Dsouza, Dhanashree H. Dongare, Dr. Kiran Chandrakant Valake","doi":"10.33545/26643766.2023.v6.i2a.393","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2a.393","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81643658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Block characteristics of hyperbaric bupivacaine versus hyperbaric ropivacaine in lower segment cesarean section: A randomized experimental study","authors":"P. Shah, R. Bhuaarya, Mohammed F. Sheikh","doi":"10.33545/26643766.2023.v6.i2b.401","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2b.401","url":null,"abstract":"Introduction: Bupivacaine is used most commonly for spinal anesthesia, however the major concern is longer duration and cardiotoxicity, that led us to find safe alternative with shorter duration. Hence, we compared routinely used hyperbaric bupivacaine with recently available hyperbaric ropivacaine in terms of block characteristics in caesarean section (CS). Objective: To compare the efficacy and safety of hyperbaric ropivacaine and bupivacaine in spinal anesthesia for elective CS with primary outcome as onset of sensory block at T 10 level & secondary outcomes as onset of motor block, grading & duration of sensory and motor block, duration of analgesia, hemodynamic changes & side effects. Methodology: Eighty parturients with ASA grade ІІ undergoing elective CS were allocated into two groups (n=40): group R (2 ml hyperbaric ropivacaine 0.75%) and group B (2 ml hyperbaric bupivacaine 0.5%). Result: Though onset of sensory block (group B 3.40±0.63 min & in group R 4.13±0.79min) & motor block (group B 5.28±0.82 min & group R 7.10±0.84min) (p<0.001) were significantly shorter in group B, but duration of sensory & motor block and duration of analgesia was significantly shorter in group R (p<0.001). Incidence of side effects (i.e. hypotension, nausea & vomiting, shivering) was comparable in both the groups. Conclusion: Ropivacaine can be preferred as an alternative to bupivacaine for spinal anesthesia in cesarean section because of early recovery & lesser side effects.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84783354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of post-operative shivering, nausea and vomiting between pre-intubation and pre-extubation intravenous paracetamol in percutaneous nephrolithotripsy under general anaesthesia","authors":"Dr. Shalaka S Nellore, Dr. Ankesh Jhunjhunwala, Dr. Mrunalini Kasod, Dr. Geeta Patkar","doi":"10.33545/26643766.2023.v6.i2b.397","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2b.397","url":null,"abstract":"Background: Post-operative shivering, nausea and vomiting is frequently observed in patients undergoing percutaneous nephrolithotripsy [PCNL] under general anaesthesia. It is not only distressing to patients but can also be detrimental because of the increased oxygen consumption, coagulopathies, delayed recovery and increased blood pressure. Prophylactic paracetamol administration has shown to be effective in reducing post-operative shivering by decreasing the hypothalamic temperature set point. When paracetamol is administered prior to extubation, it can reduce nausea and vomiting by reducing the post-operative pain. We aimed to compare the effects of prophylactic pre-induction and pre-extubation intravenous paracetamol on post-operative shivering, nausea and vomiting. Correlation of severe post-operative shivering with patient’s age, BMI, and amount o f irrigation fluid used were also evaluated. Methods: This prospective observational study was carried out on 72 patients undergoing PCNL under GA. Patients receiving intravenous 1gm paracetamol 20 minutes prior to intubation were grouped as PI-PCM while those receiving it 20 minutes prior to extubation over 20 minutes were grouped as PE-PCM. We recorded age, BMI, core body temperature (Pre-induction, before giving muscle relaxant and then 30 minutes thereafter, after extubation and just before shifting to the post-operative recovery), duration of PCNL, amount of irrigation fluid, post-operative shivering using Crossley & Mahajan score and PONV using the Afpel score every 10 minutes for 2 hours. Results: Demographic data such were comparable between the PI-PCM and PE-PCM groups. The occurrence of severe post-operative shivering (Crossley-Mahajan grade >II) was significantly higher (p 0.033) in the PE-PCM group as compared to the PI-PCM group. Post-operative shivering had statistically highly significant negative correlation with BMI and positive correlation with the amount of irrigation volume used. Incidence of PONV was statistically higher (p0.023) in the PI-PCM group as compared to the PE-PCM group. Conclusion: Prophylactic intravenous parcetamol administration can significantly reduce post-operative shivering in PCNL patients under GA. Similarly, it’s administration prior to extubating can significantly decrease the post-operative nausea and vomiting.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89879063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long-term effectiveness of ultrasound guided cervical medial branch radiofrequency ablation in treatment of chronic neck pain of zygapophysial joints origin","authors":"Mahmoud Gamal Arakeeb, A. A. El-Hafez, H. El-Gendy, Mohamed Ahmed Lofty","doi":"10.33545/26643766.2023.v6.i2a.394","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2a.394","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76443401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthesia management for aneurysm clipping surgery in patients with severe aortic stenosis with regurgitation: A case report","authors":"Dr. Ankhila D Hamand, Dr. Hemangi Karnik","doi":"10.33545/26643766.2023.v6.i2a.386","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2a.386","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"184 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80477693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"to compare the efficacy of propofol with ketamine versus propofol with fentanyl for procedural sedation for patients undergoing endoscopic retrograde cholangiopancreatography","authors":"Dr. Keerthichandra Reddy K, D. Kv","doi":"10.33545/26643766.2023.v6.i2a.389","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2a.389","url":null,"abstract":"Objective: This study was conducted to compare the efficacy of Propofol with Ketamine versus Propofol with Fentanyl for procedural sedation for patients undergoing ERCP to evaluate Propofol consumption, recovery score, patient satisfaction and sedation related adverse events. Materials and Methods: Sixty patients aged 18-60 years, ASA Class I and II were randomly allocated to one of two groups; Propofol/Ketamine (Ketofol) group KP (n=30) and Propofol/Fentanyl group FP (n=30). The level of sedation was adjusted to achieve a Ramsay Sedation Scale (RSS) score of 5. Results: The total amount of Propofol consumed was significantly higher in FP group (109.883±11.3871 mg) compared to KP group (89.867±9.8942 mg). Time to reach acceptable recovery score was slightly longer in KP group compared to FP (Aldrete scores 9.5±0.509, 9.8±0.407 respectively at 30 min). Patient satisfaction was comparable in both the groups and sedation related side effects like hypotension, bradycardia, desaturation was more significant in FP group compared to KP group. Conclusion: Propofol-Ketamine combination provided sedation quality similar to Propofol-Fentanyl combination with better hemodynamic profile and fewer side effects. Hence Propofol-Ketamine combination can be safely used in patients undergoing ERCP.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79848302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective study of incidence and risk factors of post-operative delirium following hip/femur surgery in elder patients (age > 60years) in tertiary care hospital","authors":"Dr. Bhakti Gaude, Dr. Surekha Sudhir Chavan, Dr. Sujit Kshirsagar, Dr. Shital Rathod, Dr. Ankita Kaparboina, Dr. Priya Chavre","doi":"10.33545/26643766.2023.v6.i2b.404","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2b.404","url":null,"abstract":"","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80553686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pericapsular Nerve Group block (PENG) and total hip arthroplasty","authors":"Rania Gamal Hegab, T. Mostafa, Rehab Said El Kalla, A. Hamed","doi":"10.33545/26643766.2023.v6.i2b.400","DOIUrl":"https://doi.org/10.33545/26643766.2023.v6.i2b.400","url":null,"abstract":"A new method of regional anaesthetic called Pericapsular Nerve Group block (PENG) blocks these nerves in order to target the hip's anterior capsule. PENG Block applications include medial thigh lesions, hip fractures, and vascular operations. Only ultrasonic guidance is used when performing the PENG Block, and two methods — out-of-plane method and in-plane method — are used with the low-frequency probe. When employed in a multimodal manner, ultrasound guided peripheral nerve blocks were shown to be more effective and to have less adverse effects. Infection, bleeding, nerve injury, and local anaesthetic toxicity are some of the consequences. PENG is useful in complete hip replacement","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86019578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}