Journal of the Bangladesh Society of Anaesthesiologists最新文献

{"title":"Management of a Patient with Sudden Onset of Intra Operative Atrial Fibrillation Posted for Emergency Evacuation of Clot Following TURP Operation Under SAB","authors":"D. Das, W. Mahmood, SM Ali, Basudeb Das, Ayub Khan","doi":"10.3329/jbsa.v30i1.65651","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65651","url":null,"abstract":"Atrial fibrillation is very common cardiac arrythmia which is encountered during the perioperative period. Atrial fibrillation in perioperative period may lead to hemodynamic impairment and thromboembolic events resulting into significant morbidity and mortality. So it is very crucial for an anesthesiologist to maintain the hemodynamic stability of the patient with atrial fibrillation and prevent furthur complications associated with it. Here we report a case of sixty year old male patient posted for emergency evacuation of clot following TURP operation.\u0000JBSA 2017; 30(1): 48-50","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"151 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80399649","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":"Comparative Study between the Laryngeal Mask Airway and Endotracheal Tube on Haemodynamic Changes for Laparoscopic Cholecystectomy Under General Anaesthesia","authors":"M. Hasan, Md. Mushfiqur Rahman, M. Ekramullah, Shafiul Alam Shaheen, A. Jabbar, Md. Rashedul Islam","doi":"10.3329/jbsa.v30i1.65840","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65840","url":null,"abstract":"Background: Evidence based data in the very recent years suggest that in spite of tremendous advances in contemporary anaesthetic practice and advances, airway management continue to be of paramount importance to anaesthesiologists and data regarding the outcomes of use of LMA (laryngeal mask airway) in contrast to ETT (endotracheal tube) are scanty in our clinical setup.\u0000Aims & Objectives: In this RCT (Randomized Control Clinical Trial), the ultimate aim was to depict the anaesthetic safety and haemodynamic changes of use of LMA in contrast to ETT for the patients of routine laparoscopic cholecystectomy (ASA II & III).\u0000Methods and Materials: This randomized control clinical trial (RCT) was conducted in BIRDEM General Hospital, Dhaka, Bangladesh with a total number of 60 patients (30 patients with endotracheal tube & 30 patients with LMA) were selected on the basis of systemic random sampling. The haemodynamic changes, oxygenation, ventilation and intraoperative and postoperative laryngopharyngeal complication (LPM) were noted.\u0000Results: The ultimate result of this study suggest that in Group A (ETT group), mean±SD of age was 48±1.9 and in Group B (LMA group), it was 52±1.7. Demographic status suggests that the average BMI in both group were 28.9 and 30.6 respectively. In ETT group, majority of patients (69%) had ASA grade II, in contrast, in LMA group, it was 52%. Average anaesthetic duration in both group were 45 & 50 minutes respectively. There found significant difference in haemodynamic parameter during Intubation and LMA insertion. There were no statistically significant differences in oxygen saturation (SpO2) between the two groups before or during peritoneal insufflation. Laryngeal complications, like coughing and vomiting following removal of tube were found in 6.7% and 3.3% patients respectively with the use of LMA. No case of tube leak, gastric insufflation, regurgitation, aspiration, trauma to lip, teeth, tongue, dysphagia, dysphonia and dysarthia was recorded. P-values suggests statistically insignificant result here (>0.05).\u0000Conclusion: The effectiveness and safety of LMA in terms of intra and postoperative haemodynamic status, SaO2 and laryngeal complications are clinically comparable to those of endotracheal tube. And LMA insertion causes less changes of haemodynamic parameters when compared with that of ET intubation. Our finding suggests that LMA can be safe and beneficial alternative to ETT.\u0000JBSA 2017; 30(1): 34-40","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80142817","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 Cardiovascular Status Between Pre- Induction Period and The Different Positions of Anaesthetized Patients in Laparoscopic Cholecystectomy","authors":"Mohammad Anisur Rahman, Moinul Hossain, A. F. Hoque, D. Banik","doi":"10.3329/jbsa.v30i1.65839","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65839","url":null,"abstract":"The laparoscopic cholecystectomy nowadays is the method of choice for treatment of patients with cholelithiasis. This surgery involves different types of positioning of the anaesthetized patient. Our study was planned to compare the haemodynamic changes between the pre-induction period with the different positions of the anaesthetized patients during laparoscopic cholecystectomy. Thirty two (32) female patients of ASA physical status - 1 & 11, aged between 18 to 55 years, scheduled for elective laparoscopic cholecystectomy under general anesthesia, were enrolled in the study. All the patients were medicated with tablet clonazepam (0.5mg) on the night before surgery. On arrival to the operation theatre, baseline heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), and arterial oxygen saturation (SpO2) were recorded. The patients were then induced with Inj. propofol (1.5 to 2mg/kg). Endotracheal intubation was facilitated with Inj. vecuronium (0.1mg/kg). Anaesthesia was maintained with halothane 0.5% and nitrous oxide 60%, in oxygen. The propofol was infused to strengthen the maintenance of anaesthesia. During operation patient was monitored for HR, NIBP, ECG, ETCO2, and SpO2. The haemodynamic tools of the patients were continuously recorded. The pre-induction mean HR, SBP, DBP, MAP were compared with the values found after induction in trendelenburg and reverse trendelenburg position. The mean HR during pre-induction period & after induction in trendelenburg position, & reverse trendelenburg position were respectively 79.2±8.2, 76.6±9.6, and 70.1±5.9beats/min. The mean HR was statistically significant (p<0.05) between pre-induction, trendelenburg and reverse trendelenburg position. The mean SBP during pre-induction period & after induction in trendelenburg & reverse trendelenburg position were respectively 138.0±11.6, 130.3±9.9, and 119.3 ±12.7 mm Hg. The mean SBP was statistically significant (p<0.05) between pre-induction, trendelenburg and reverse trendelenburg position. The mean DBP during pre-induction period, after induction in trendelenburg & reverse trendelenburg position were respectively 75.5±10.9, 72.6±6.1, and 70.6±6.1mm Hg. The mean DBP was statistically significant (p<0.05) between pre-induction, trendelenburg and reverse trendelenburg position. The mean MAP during pre-induction period, after induction in trendelenburg & reverse trendelenburg position were respectively 96.3±10.7, 95.0±9.8, and 72.6 ±6.1mm Hg. The mean MAP was statistically significant (p<0.05) between pre-induction, trendelenburg and reverse trendelenburg position. So, it can be concluded that the cardiovascular status was significantly decreased in both trendelenburg and reverse trendelenburg position than the pre-induction values found during laparoscopic cholecystectomy.\u0000JBSA 2017; 30(1): 27-33","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83773698","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 Comparative Study of Epidural Levobupivacaine and Bupivacaine in Major Abdominal Surgeries in Type- 2 Diabetic Patient","authors":"Md Shafiul Alam Shaheen, M. Rahman, K. Sardar, Mahabubul Hasan, Md. Mushfiqur Rahman, A. Chowdhury, Raju Ahmed","doi":"10.3329/jbsa.v30i1.65309","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65309","url":null,"abstract":"Background: Major abdominal surgeries still induce neurohumoral changes responsible for postoperative pain, various organ dysfunctions, prolong hospitalization and convalescence. Insufficient pain therapy prolongs the hospital stay and rises the mortality rates. Epidural analgesia confers excellent pain relief and complete dynamic analgesia leading to a substantial reduction in the surgical stress response. Opioid and local anaesthetic infusion by an epidural catheter is widely used as a postoperative pain management method after major abdominal surgeries. Type-2 Diabetic patient has many comorbidity with cardiovascular complication and they are more vulnerable to pain.\u0000Objectives: The purpose of this study was to compare the effect of levobupivacaine and bupivacaine with fentanyl in postoperative analgesia and haemodynamic changes of type-2 Diabetic patients for major abdominal surgeries.\u0000Material and method: Sixty (60) patients were selected whose were suffering from Type-2 Diabetes mellitus and were going to be operated for major abdominal surgeries (Whipple’s procedure, FCPD, Gastrectomy, Hemi colectomy). Every patient received an epidural block in the sitting position at the T8- 9 or T9-10 level via 18 G Touhy needle. Each patient in group A received 0.125% levobupivacaine with 2 μgm. fentanyl / ml solution through epidural catheter @ 4 ml / hr. and group B were received 0.125% bupivacaine with 2 μgm. fentanyl / ml solution through epidural catheter@ 4 ml / hr\u0000Results: Mean visual analog scale (VAS) values of groups did not differ at all time. They were 6 at the end of the surgery (0.Min, p= 0.06). The VAS scores were not statistically significant in group A & group B (p > 0.05). The frequency of tachycardia was higher in group B that was bupivacaine group.\u0000Conclusion: The results of our study suggest same concentration of epidural levobupivacaine and bupivacaine with fentanyl provide stable postoperative analgesia and both were found safe for the patients undergoing major abdominal surgery, but levobupivacaine is less tachycardic and safer for Type-2 Diabetic patient.\u0000JBSA 2017; 30(1): 5-13 ","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82265703","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":"Opioids in Spinal Anaesthesia","authors":"M. K. Basu","doi":"10.3329/jbsa.v30i1.65308","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65308","url":null,"abstract":"Abstract not available\u0000JBSA 2017; 30(1): 1-3","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91287753","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 Ketamine and Fentanyl with Propofol for Procedural Sedation and Analgesia for Dilatation and Curettage","authors":"R. Ershad, Mozaffor Hossain, A. Maruf, S. Nazrina","doi":"10.3329/jbsa.v30i1.65312","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65312","url":null,"abstract":"Introduction: Dilatation and curettage (D&C) is a common procedure that generally causes considerable pain and usually done under procedural sedation and analgesia. Propofol is an ideal intravenous anaesthtic agent for short interventional procedure like D&C but lack of analgesia remains it’s main shortcoming therefore it is always combined with an analgesic. Ketamine and fentanyl are the popular analgesic in this context.\u0000Objectives: This prospective clinical study was designed to evaluate to compare propofol ketamine combination versus propofol fentanyl combination in respect of hemodynamics and recovery time for procedural sedation and analgesia in patients undergoing D&C.\u0000Methods: This prospective randomized study was performed on 100 patients who underwent elective D&C procedure. Patients were randomly allocated into two groups of fifty each: group PK received propofol 2mg/kg + ketamine 1mg/kg for induction and propofol 4mg/kg/hr + ketamine 1 mg/kg/hr for maintenance anesthesia, group PF received propofol 2 mg/kg + fentanyl 2 ìg/kg for induction and propofol 4 mg/kg/hr + fentanyl 1ìg/kg/hr for maintenance of anesthesia. The pulse rate, systolic and diastolic arterial blood pressures and peripheral oxygen saturation were recorded. Recovery times, side effects of sedation were also recorded.\u0000Results: Demographic data were found similar in two groups. There were no significant differences in heart rate, systolic and diastolic arterial blood pressure in all time intervals among groups except there was statistically significant fall in systolic blood pressure after induction in PF group (P=0.005). Recovery time was statistically significant increase in Group PK compared to Group PF (p=0.004). There were no significant differences among groups in regard to side effects.\u0000Conclusion: Propofol ketamine and propofol fentanyl had similar hemodynamic stability without any important side effects for procedural sedation and analgesia in patients underwent D&C but propofol ketamine had longer recovery time.\u0000 JBSA 2017; 30(1): 14-20","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90364392","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":"Monitored Anaesthesia Care in An One Hundred Years Old Man in NIO&H","authors":"R. Yasmin, Kanijun Nahar Quadir, S. S. Alam","doi":"10.3329/JBSA.V27I1.29000","DOIUrl":"https://doi.org/10.3329/JBSA.V27I1.29000","url":null,"abstract":"A hundred years old man was admitted in NIO&H with the diagnosis of cataract in right eye.He was scheduled for operation under local anaesthesia, but on the O.T. table he became restless, non cooperative. So, the surgical team planned to do the operation under general anaesthesia. Necessary investigations for GA done and the patient was found nondiabetic but had anterolateral ischaemia and had cardiomegaly in X-ray chest. Our anaesthetic plan was to do the surgery under sedation with local anaesthetic block (MAC). We provided the patient monitored anaesthesia care (MAC) by giving Inj. Fentanyl, Inj.Midazolam and Inj. Propofol. The operation took twenty five minutes. Initially after the administration of drugs,his SPO2 fell down.Oxygen given and SPO2 increased to 99% within 90 seconds. Throughout the peroperative period patient remained haemodynamically stable. Within 10 minutes,he opened his eyes,responded to vocal command and after one hour, he was shifted from postoperative ward to general ward.","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"163 1","pages":"36-38"},"PeriodicalIF":0.0,"publicationDate":"2016-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73148739","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 Challenge of Multi Drug Resistant Bacteria in Intensive Care Patient Management in Bangladesh","authors":"D. Banik, S. Banik, Montosh Kumar Mondal","doi":"10.3329/JBSA.V27I1.28995","DOIUrl":"https://doi.org/10.3329/JBSA.V27I1.28995","url":null,"abstract":"Abstract not available Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 24-26","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"1 1","pages":"24-26"},"PeriodicalIF":0.0,"publicationDate":"2016-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83149540","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":"Medication Error in Anaesthesia – A Review","authors":"Montosh Kumar Mondal, Beauty Rani Roy, S. Banik, D. Banik","doi":"10.3329/JBSA.V27I1.28999","DOIUrl":"https://doi.org/10.3329/JBSA.V27I1.28999","url":null,"abstract":"Medication error is a major cause of morbidity and mortality in medical profession . There is an increasing recognition that medication errors are causing a substantial global public health problem, as many result in harm to patients and increased costs to health providers.Anaesthesia is now safe and routine, yet anaesthetists are not immune from making medication errors and the consequences of their mistakes may be more serious than those of doctors in other specialties. Steps are being taken to determine the extent of the problem of medication error in anaesthesia. In this review, incidence, types, risk factors and preventive measures of the medication errors are discussed in detail. Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 31-35","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"51 1","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2016-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88645270","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":"Emergency Cesarean Delivery in a Guillain- Barre Syndrome Patient","authors":"Abdur Rahman, M. Hossain, Subrata Mondal, A. Islam, Mohiuddin Shoman, Muslema Begum, Akm Shamsul Bari, Mahmuda Khanom","doi":"10.3329/JBSA.V27I1.29001","DOIUrl":"https://doi.org/10.3329/JBSA.V27I1.29001","url":null,"abstract":"Guillain-Barre syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weaknes, areflexia, and ascending paralysis. Guillain-Barre syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods. We report an emergency Cesarean delivery in the case of a 25-year old woman who was diagnosed as Guillain-Barre syndrome at her 26 weeks gestation. Tracheostomy was performed as prolonged ventilatory support was required in the intensive care unit. The respiratory difficulty was exacerbated by the growth of the fetus, necessitating emergency Cesarean delivery. The delivery was successfully performed under general anesthesia, and the patient recovered without neurological sequelae. Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 39-42","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"45 1","pages":"39-42"},"PeriodicalIF":0.0,"publicationDate":"2016-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86677910","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}