Journal of the Bangladesh Society of Anaesthesiologists最新文献

{"title":"Controlled Hypotension for Functional Endoscopic Sinus Surgery: A Comparative study between Dexmedetomidine versus Esmolol","authors":"Md Shafiul Alam Shaheen, K. Sardar, A. Chowdhury, Subrata Mondal, Raju Ahmed, S. S. Alam","doi":"10.3329/jbsa.v31i2.66489","DOIUrl":"https://doi.org/10.3329/jbsa.v31i2.66489","url":null,"abstract":"Background: Functional endoscopic sinus surgery (FESS) requires effective control of bleeding forbetter visibility of the operating field and reduced risk of injury to the optic nerve or the internal carotidartery. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the bestpossible field for surgery.\u0000Objectives: Our study is undertaken to evaluate the efficacy of dexmedetomidine as a hypotensive agentin comparison to esmolol in Functional Endoscopic Sinus Surgery (FESS).\u0000Method: Sixty (60) patients 20 – 50 years of age, ASA I/II scheduled for FESS were equally randomlyassigned to two equal groups of 30 patients each. Patients of group D received dexmedetomidine 1μg/kgover 10 min before induction of anesthesia followed by 0.4 – 0.8 μg/kg/hr infusion during maintenanceand group E received esmolol loading dose 1mg/kg was infused over one min followed by 0.4 – 0.8 mg/kg/hr infusion during maintenance to maintain mean arterial blood pressure (MAP) between (55 – 65mmHg). The surgical field was assessed using Average Category Scale and average blood loss wascalculated. Hemodynamic variables (MAP, HR); intraoperative fentanyl consumption and total recoveryfrom anesthesia (Aldrete’s score e”9) were recorded. Sedation score was determined at 10, 20, 30, 40 & 60min after tracheal extubation and time to first analgesic demand was also recorded.\u0000Results: In both group D and group E reached the desired MAP (55 – 65 mmHg) with no intergroupdifference in MAP or HR. Mean intraoperative fentanyl consumption was significantly lower in group Dthan group E. Recovery time to achieved Aldrete’s score e”9 were significantly lower in group E comparedwith group D. The sedation score were significantly lower in group E compared with group D at 10minutes, 20 minutes and 30 minutes postoperatively. Time to first analgesic demand was significantlylonger in group D.\u0000Conclusion: The result of this study showed that both dexmedetomidine and esmolol can be used asagents for controlled hypotension and are effective in providing ideal surgical field during FESS. Butdexmedetomidine offers the advantage of inherent analgesic, sedative and anesthetic sparing effect.\u0000JBSA 2018; 31(2): 67-74","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85898745","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":"Ultrasound Guided Nerve Stimulation and Nerve Stimulation Alone for Supraclavicular Brachial Plexus Block – A Randomized Comparative Study","authors":"M. Hassan, A. Akhtaruzzaman, A. F. Hoque, Rezwanur Rahman, S. Yeasmeen, D. Banik","doi":"10.3329/jbsa.v31i2.66484","DOIUrl":"https://doi.org/10.3329/jbsa.v31i2.66484","url":null,"abstract":"Background: The safety of regional anaesthesia become more pronounced by the use of ultrasound andnerve stimulator. Supraclavicular nerve blocks known as ‘spinal of the arm’ are the most attractiveupper extremity blocks to perform in our practice. In this study less experienced hands try to found thebest approach for upper extremity block.\u0000Objective: To comparethe success rate when Ultrasound addedwith Peripheral nerve stimulator insupraclavicular brachial plexus block.\u0000Methods: After IRB approval and written consents from patients, total 66 patients divided into twogroups,Group USNS had supraclavicular block guided by both ultrasound and Nerve stimulator. Onthe other hand Group BNS had this block by only Nerve stimulator. All the equipments kept ready andmaintaining sterility a mixture of 0.5% Bupivacaine and 2% plain Lignocaine were prepared. The amountinjected according to the body weight without crossing the toxic dose (2mg/Kg 0.5% Bupivacaine, 5mg/Kg 2% Lignocaine). Total volumes were 25-30ml for every patient.The sensory block was assessed byobservers who unaware of the technique for every 2 minutes till the onset of block and every 10 minutesthereafter for 30 minutes. Any failure in establishing the block was converted to GA. The sensorydermatomes were assessed by alcohol swab. The motor blocks were evaluated by the same observer ineach jointfor every 2 minutes till onset than 10, 20 & at the end of 30 minutes.Successful block wasconsidered if no supplementation or conversion to general anaesthesia required.\u0000Results: In all demographic variables and ASA Class, there was no differences in between the USNSgroup and BNS group.In group USNS block execution time was significantly higher(P<0.05). The timerequired for both sensory and motor block was statistically significantly less in Group USNS comparedto Group BNS (P value < 0.05). Regarding quality of motor block, at wrist joint statistical significancepresent between two groups ( p value < 0.05 ). The duration of analgesia is significantly lower in GroupBNS than Group USNS (P value is 0.012).In Group USNS, only one (3.03%) patient neededsupplementation. But in Group BNS 7 (21.21%) patients needed supplementation. According to thedefinition, these cases were regarded as failed case. The success rate is significantly higher in GroupUSNS (P value is 0.024).\u0000Conclusion: Combined use of ultrasound and peripheral nerve stimulator increases success rate thanperipheral nerve stimulator alone in supraclavicular brachial plexus block. This combined method alsoreduces block execution time, early onset of both sensory and motor block, improve quality of sensory andmotor block and less incidence of complications.\u0000JBSA 2018; 31(2): 54-61\u0000 ","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86431937","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":"Troponin I, A Biomarker of Diagnosis of SIRS, Sepsis and Septic Shock","authors":"S. Afroza, Muslema Begum, I. Chowdhury, Md Mozaffer Hossain4","doi":"10.3329/jbsa.v31i1.66252","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66252","url":null,"abstract":"Background: Sepsis related troponin elevation (SRTE) has always been the demand and supply mismatchtheory. In the setting of sepsis, the cardiac metabolic requirements are high and in order to meet theserequirements an increase in the coronary blood flow is needed. Patients with underlying anemia andpreexisting subclinical CAD may develop a mismatch ischemia in this setting. It was always thought thatsepsis-related hypotension causes a decrease in coronary perfusion pressure thus leading to a decreasedblood flow to cardiac myocytes and thereby leading to SRTE.\u0000Objectives: To establish Troponin-I as a useful diagnostic marker for sepsis.\u0000Settings and Study Design: This prospective study was carried out in the department of Anesthesia,pain, palliative and intensive care medicine, Dhaka Medical College, Dhaka during July 2013 to June2015.\u0000Methods: This study was carried out in the department of Anesthesia, pain, palliative and intensive caremedicine, Dhaka Medical College, Dhaka during July 2013 to June 2015. According to Troponin-I valuepatients were divided into Troponin-I positive and negative for sepsis. Three cut off values of Troponin-I(0.05, 0.035, 0.015) were used for this study. By using Receiver operating characteristic (ROC) curve thebest sensitively, specificity, negative predictive value and positive predictive values of Troponin-I weredetermined.\u0000Results: The validity of troponin I (>0.05 ng/dl) evaluation for blood culture positive were sensitivity45.0%, specificity 53.8%, accuracy 48.5%, positive predictive values 60.0% and negative predictive values38.9%. The validity of troponin I (>0.035 ng/dl) evaluation for blood culture positive were sensitivity57.5%, specificity 23.1%, accuracy 43.9%, positive predictive values 53.5% and negative predictive values26.1%. The validity of troponin I (>0.015 ng/dl) evaluation for blood culture positive were sensitivity72.5%, specificity 15.4%, accuracy 50.0%, positive predictive values 56.9% and negative predictive values26.7%.\u0000Conclusion: The cutoff values of troponin-I (>0.035 ng/dl) observed more sensitivity of blood culture.\u0000JBSA 2018; 31(1): 3-11","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81747933","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":"Prognostic Value of Serum Troponin I in Sepsis Patients","authors":"S. Reza, S. N. Jahan, Akm Ferdous Rahman, M. Asaduzzaman, Parvin Akhter, Rabeya Begum, Abdur Rahman","doi":"10.3329/jbsa.v31i1.66253","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66253","url":null,"abstract":"Background: Sepsis is one of the leading causes of admission in ICU with high mortality and morbidity.Intensivists face challenges to manage sepsis in their practices particularly in a limited resource setting.The diagnosis of sepsis and its evaluation of severity are not easy because of its complex pathophysiologyand variable nature of presentation. So, researchers identified biomarkers including troponin I for potentialuse in sepsis. Of them troponin I is a useful biomarker with prognostic significance.\u0000Materials and methods: This prospective observational study was conducted among purposively selected110 patients diagnosed as sepsis at intensive care unit (ICU) in Dhaka Medical College & Hospital. Afterfulfilling the inclusion and exclusion criteria, ECG was done to exclude MI. Then troponin I was measuredwith a cut of value of 0.6 ng/ml. the patients were followed up for a period upto 30 days. Statisticalassociations between categorical variables were tested using chi-square test and mean difference ofcontinuous variables by independent t-test. Correlation between troponin I value length of ICU stays andventilator days were calculated.\u0000Results:Among 110 patients diagnosed as sepsis 56.4% had normal troponin I and 43.6% had elevatedtroponin I. Distribution of elevated troponin I was higher among male patients (77.1% vs 64.5%) thanfemale. Mean duration of ICU stay was prolonged in elevated troponin I group as like ventilator support.Positive relationship was found between troponin level I and duration of ventilator support as well aslength of ICU stay (r=0.225, 0.279). There was significantly increased mortality rate in elevated troponingroup of patients compared to normal troponin group (72.9% vs 35.5%) in sepsis patients (p<0.001) followedby in severe sepsis 67.5% vs 35.48% (p=0.001) and 92.9% vs 57.1%) in septic shock (p<0.029).\u0000Conclusion: This study showed that mortality and morbidity increases when troponin I value elevatedin sepsis.\u0000JBSA 2018; 31(1): 12-19","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83587947","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":"A Comparative study of Albumin-Creatinine Ratio and APACHE-II in Prediction of Outcome in Critically ill Patients in Intensive Care Units","authors":"Suraya Akter, Akm Habibullah Bahar, Md Tanveer Alam, Subrata Mondal, Mozaffer Hossain, Md. Abdur Rahman","doi":"10.3329/jbsa.v31i1.66254","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66254","url":null,"abstract":"Background: Simple, sensitive, and dynamic markersfor prediction of outcome, which generate rapidand reliable results, are desirable in critical care units.\u0000Aim: Evaluation of prediction of outcome in critically ill patients by the Albumin Creatinine Ratio (ACR)on admission (ACR-1) and after 24hours of admission (ACR-2) & making a comparison between AcutePhysiology & Chronic Health Evaluation-II(APACHE-II), ACR-1 & ACR-2 in terms of outcome prediction.\u0000Settings and Study design: The prospective, observational study was carried out in the 20 bed mixedMedical-Surgical ICU of Dhaka Medical College Hospital.\u0000Materials and Methods A total 60 critically ill patient were purposively recruited. Adult patient withICU stay of more than 24 hours were included &patients with pregnancy, menstruation, a macroscopichematuria, pre-existing kidney diseases, were excluded in this study. For disease severity scoring, APACHEIIscores & the percentage (%) of prediction of mortality by APACHE-II scores were calculated from datacollected during the first 24 hours following ICU admission. Spot urine samples were collected within 6hrs of admission (ACR1) and again at 24 hrs(ACR2), for quantification of Albumin Creatinine Ratio.Patients were followed up throughout their ICU stay for a maximum of 15 days and the following outcomedata were obtained: ICU length of the stay and ICU mortality.\u0000Results: There were 32(53.3%) patients were non-survivors and 28(46.7%) patients were survivors.Non-survivors had a significantly higher median Albumin Creatinine Ratio 1(ACR1) =285.00 mg/g &higher median Albumin Creatinine Ratio 2(ACR2) =393.30 mg/g in comparison to the survivors. Therewere significant differences between the mean and Standard Deviation of the APACHE-II scores, theAlbumin Creatinine Ratio 1(ACR1),the Albumin Creatinine Ratio 2(ACR2)&ACR2-ACR1 between thenon survivors (p=<0.001,p=<0.001,p=<0.001, p=<0.001 respectively). In, multiplelogistic regressionsanalysis female sex scored high odds of 361 for mortality compared to males followed by 15% highermortality by high ACR2.The strength of agreement among APACHEII, ACR1, and ACR2 by kappastatistics revealed a very good agreement (1.000) by the degree of change of ACR2 in comparison toACR1 and APACHE-II Score in predicting outcome in critical ill patients. A good agreement revealedbetween ACR1 and the APACHEII Score (0.802), and The APACHEII Score revealed a fair agreement(0.798) in predicting outcome. Results of all the variables were highly significant.\u0000Conclusion: Theraised Albumin- Creatinine Ratio at 24 hours of ICU admission(ACR2) is a predictor of poor outcomein critically ill patients.\u0000JBSA 2018; 31(1): 20-28","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79613080","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":"Role of Intravenous Dexmedetomidine Premedication on Intra-operative Hemodynamics and PONV in Laparoscopic Cholecystectomy","authors":"A. Jabbar, M. Hasan, M. Rahman, S. Alam, Naima Tahsim, Subrata Mondal","doi":"10.3329/jbsa.v31i1.66255","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66255","url":null,"abstract":"Background: Laparoscopic cholecystectomy is a gold standard surgical procedure for gallbladderoperation. It causes altered hemodynamic responses due to pneumoperitoneum and surgical procedurealso causes high incidence of postoperative nausea & vomiting (PONV). Dexmedetomidine has beenshown to reduce intraoperative hemodynamic instability and PONV.\u0000Objective: This study was designed to evaluate the efficacy of intravenous dexmedetomidine premedicationfor attenuation of hemodynamic responses associated with pneumoperitoneum & its effect on postoperativenausea &vomiting.\u0000Methods: Sixty adult patients of ASA physical status I & II scheduled for elective laparoscopiccholecystectomy were enlisted for a prospective randomized double blind study. They were selectedrandomized into two equal groups, thirty in each group. Group A received 0.9% normal saline 100 ml &Group B received dexmedetomidine (100μgm) in 100 ml 0.9% normal saline intravenously for 10 minutesbefore induction of anaesthesia. Pulse rate, mean arterial pressure were recorded prior to induction, 2minutes after endotracheal intubation, before pneumoperitoneum,10 minutes & 20 minutes afterpneumoperitoneum, 10 minutes after release of carbon dioxide(CO2) & 10 minutes after extubation. Inpost anaesthetic care unit patient were observed on 2,6,12,24 hour for PONV.\u0000Results: Patients in Group B (dexmedetomidine) maintained greater hemodynamic stability compare toGroup A after intubation, during pneumoperitoneum and also extubation. Pulse rate & mean arterialpressure significantly varies in Group A compare with Group B at different times of intraoperative period(p <0.05). Postoperative nausea & vomiting was significantly less in Group B (dexmedetomidine).\u0000Conclusion: Premedication with intravenous dexmedetomidine (100 μgm) attenuates the hemodynamicresponses produced by pneumoperitoneum during laparoscopic cholecystectomy and also significantlyreduces nausea and vomiting.\u0000JBSA 2018; 31(1): 29-37","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88934373","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":"Labour Analgesia in a Patient with Dengue Fever - Case Report","authors":"Morshed Khandoker, L. A. Banu","doi":"10.3329/jbsa.v31i1.66259","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66259","url":null,"abstract":"Abstract not available. \u0000JBSA 2018; 31(1): 48-49","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74850182","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":"Perioperative Anaesthetics Management of a Girl with Byars-Jurkiewicz Syndrome for Mammoplasty","authors":"S. Yeasmeen, A. F. Haque, Montosh Kumar Mondol, Arifuddin, Debasish Banik, D. Banik","doi":"10.3329/jbsa.v31i1.66258","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66258","url":null,"abstract":"Byars-Jurkiewicz syndrome is a cutaneous- facial -genital disorder characterized by sporadic congenitalmacrogengivae hypertrichosis, massive bilateral enlargement of breast after puberty and Kyposis. It isan extremely rare condition as only four to five patients diagnosed throughout the world till now. MissBithi, aged 12 years was admitted in plastic surgery in BSMMU with hypertrichosis on the face frombirth, huge gingival fibromatosis and bilateral excessive rapid enlargement of breast since last year whichis almost half of her 38 kg body weight. She was scheduled for mammoplasty. No abnormalities detectedin all routine tests. Small mouth opening with hypertrophied gum obscured visibility of the posteriorpharyngeal wall, thyromental distance and cervical spine mobility was found normal. General anesthesiawas planned with anticipation of profuse blood loss during procedure and ICU bed was booked for prolongedsurgery, .Difficult airway trolley was kept ready, two wide bore canula were inserted and all routinemonitoring were applied before induction. Laryngoscopic view was equivalent to Cormac Lehan grade 2.Surgery was completed uneventfully except huge bleeding and prolonged duration (8 hours). She wastransferred to ICU, mechanically ventilated overnight and extubated in the next morning and sent thepatient to the ward.\u0000JBSA 2018; 31(1): 45-47","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79407934","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":"Anaesthesiologist today is multimodality specialist.","authors":"Md. Abdur Rahman","doi":"10.3329/jbsa.v31i1.66251","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66251","url":null,"abstract":"Abstract not available\u0000JBSA 2018; 31(1) 1-2","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81572900","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":"Use of Proseal Laryngeal Mask Airway (PLMA) and Endotracheal Tube (ETT) in Cardiac Compromise Patients with LVEF <45% Undergoing Laparoscopic Cholecystectomy : A Comparison of Hemodynamic Parameters","authors":"Md. Mushfiqur Rahman, Mahbubul Hasan Munir, K. Sardar, Md. Abdus, Salam Khan, A. Chowdhury, M. K. Rahman, S. K. Mondal, S. S. Alam","doi":"10.3329/jbsa.v31i1.66256","DOIUrl":"https://doi.org/10.3329/jbsa.v31i1.66256","url":null,"abstract":"Background: The major cause of sympatho-adrenal response to tracheal intubation is due to thestimulation of supraglottic region by tissue irritation induced by direct laryngoscopy. Direct laryngoscopyby activating proprioceptors, induces arterial hypertension, tachycardia and increased catecholamineconcentrationproportional to the intensity of stimulus exerted against the base of the tongue. Incardiac compromised patient, use of endotracheal tube (ETT) is associated with various hemodynamiccomplications, which are minimally affected during ProSeal laryngeal mask airway (PLMA) use.\u0000Objective: This prospective study was conducted with the objective of demonstrating the advantages ofPLMA over ETT in the patients undergoing laparoscopic cholecystectomy surgeries.\u0000Methodology: This prospective, interventional study was carried out in 60 patients who underwentlaparoscopic cholecystectomy surgeries. Patients were randomized in equal numbers to either ETTgroup or PLMA group, and various hemodynamic changes were observed at different time points.\u0000Results: Patients in PLMA group had mean systolic blood pressure 134.785±03.765 mm Hg comparedto the patients of ETT group 146.675±05.764 mmHg. Pulse rate in the PLMA group was less (94.267 ±05.678per min) (P < 0.05) compared to ETT group (115.34±10.236).Thus, hemodynamic changes weresignificantly lower (P < 0.05) in PLMA than in ETT group. The incidence of adverse events was alsolower in PLMA group.\u0000Conclusion: PLMA offers advantages over the ETT in airway management in the patients undergoinglaparoscopic cholecystectomy surgeries in cardiac compromise patients.\u0000JBSA 2018; 31(1): 38-44","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"246 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79086625","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}