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Pawar, Hemant
- Comparison of Haemodynamic Response among Patients Posted for Laparoscopic Cholecystectomy with or without Oral Clonidine as Premedication- A Prospective Comparative Study
Abstract Views :119 |
PDF Views:93
Authors
Affiliations
1 Professor and Head, Department of Anaesthesiology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
2 Former PG Resident, Department of Anaesthesiology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Associate Professor, Department of Anaesthesiology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
1 Professor and Head, Department of Anaesthesiology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
2 Former PG Resident, Department of Anaesthesiology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Associate Professor, Department of Anaesthesiology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 1 (2021), Pagination: 54-59Abstract
Background: Laparoscopic cholecystectomy is one of the most commonly performed surgeries and has now being recognized as the gold standard for the treatment of cholelithiasis. It is known fact that laparoscopy has several advantages due to creation of pneumoperitoneum during the surgical procedure which is responsible for several deleterious haemodynamic and cardiorespiratory changes. Thus, our present study was designed tostudy of haemodynamic response to oral clonidine as pre medication in laparoscopic cholecystectomy. Methods: In this prospective comparative study, 128 patients between the age group of 18-60 years, belonging to ASA 1 and ASA 2 categories scheduled for elective laparoscopic cholecystectomy under general anaesthesia were categorized into 2 groups as Group C and Group NC with 64 patients in each group. Patients in Group C received premedication with oral clonidine 150μg 90 minutes prior to surgery and Group NC did not receive oral clonidine 150μg. The two groups were compared with respect to heart rate, systolic and diastolic blood pressure and post operative complications. Results: There was significant increase in all the haemodynamic variables in group C as compared to group NC where the variables remained close to baseline while the patients in Group C showed less post operative complications as compared to NC group. Conclusion: Oral premedication with clonidine helps in blunting the haemodynamic response to pneumoperitoneum and also has less post operative complications.Keywords
Clonidine, General Anaesthesia, Haemodynamic Response, Laparoscopic CholecystectomyFull Text
References
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- Singh S, Arora K. Effect of oral clonidine premedication on perioperative haemodynamic response and post operative analgesic requirement for patients undergoing laparoscopic cholecystectomy. Indian J Anaesth. 2011 Jan- Feb: 55(1):26-30 https://doi.org/10.4103/0019-5049.76583 PMid:21431049 PMCid:PMC3057241
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- Singhal SK, Kaur K, Arora P. Oral clonidine versus gabapentin as premedicant for obtunding hemodynamic response to laryngoscopy and tracheal intubation. Saudi J Anaesth. 2014; 8(2):172-177. https://doi.org/10.4103/1658- 354X.130692 PMid:24843327 PMCid:PMC4024671
- Kalra NK, Verma A, Agarwal A, Pandey HD. Comparative study of intravenously administered clonidine and magnesium sulfate on haemodynamic responses during laparoscopic cholecystectomy. J Anaesthesiol ClinPharmacol. 2011; 27:344-8. https://doi. org/10.4103/0970-9185.83679 PMid: 21897505 PMCid: PMC3161459.
- Chandrashekaraiah MM, Upadya M, Jayachandran SP, Wali M. Effects of clonidine premedication on haemodynamic changes during laproscopic cholecystectomy- A randomized control study. Applied Cardiopulmonary Pathophysiology. 2011; 15: 91-98.
- Nicolaou G, Chen AA, Johnston CE, Kenny GP, Bristrow GK, Giesbrecth GG. Clonidine produces a dose dependant increase in the sweating threshold and dose dependant decrease in vasoconstriction and shivering threshold. Canadian Journal of Anesthesia. 1997 Jun; 44(6):636-42. https://doi.org/10.1007/BF03015448 PMid:9187784
- Comparison Between Propofol and Etomidate in General Anaesthesia as Induction Agents at a Tertiary Care Centre
Abstract Views :158 |
PDF Views:96
Authors
Affiliations
1 Professor and Head, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Former PG Resident, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
1 Professor and Head, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Former PG Resident, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 2 (2021), Pagination: 179-182Abstract
Aims: To compare hemodynamic changes occurring due to Propofol and Etomidate during general anesthesia as induction agents at a Tertiary Care Centre. Materials and Methods: 68 Adult ASA1 and ASA 2 Patients undergoing elective surgeries under gender anaesthesia in the department of Anaesthesia, Medical college and tertiary health care Centre after considering and satisfying the inclusion and exclusion criteria were selected and divided in two equal groups. They were given Propofol (2mg/kg) and Etomidate (0.3mg/kg) and hemodynamics were compared. Results: Etomidate was having more stable hemodynamic conditions as compared to Propofol induced anaesthesia. There was significant reduction in heart rate and blood pressure leading to hypotension in propofol group while etomidate group had stable hemodynamics. Conclusion: This study concludes that etomidate is a better agent for induction than propofol in view of hemodynamic stability.Keywords
Induction Agents, Hemodynamic Changes, Propofol, EtomidateFull Text
References
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- Comparison of Intubating Conditions in Patients Induced with Succinylcholine, Atracurium and Priming with Atracurium
Abstract Views :166 |
PDF Views:100
Authors
Affiliations
1 Associate Professor, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, IN
2 Former PG Resident, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, IN
1 Associate Professor, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, IN
2 Former PG Resident, Department of Anaesthesia, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 2 (2021), Pagination: 183-190Abstract
Background: This was a comparative observational study to compare the intubating conditions in patients posted for elective surgeries under general anaesthesia using succinylcholine, atracurium or priming with atracurium. Depolarizing muscle relaxant, frequently used for rapid sequence endotracheal intubation, has serious complications that occur intermittently, such as, hyperkalemia, increased intraoccular pressure and sudden cardiac arrest. So the priming principle, i.e., the administration of a subparalyzing dose of a nondepolarizing muscle relaxant (priming dose) prior to the intubating dose, was developed for rapid sequence endotracheal intubation with nondepolarizing muscle relaxant. This study compares the intubating conditions using a depolarizing muscle relaxant, a nondepolarizing muscle relaxant and priming with a nondepolarizing muscle relaxant. Methodology: Total 114 patients scheduled for elective surgeries were allocated into 3 groups. We assessed the intubating conditions with jaw relaxation, position of vocal cords, response to intubation (coughing, straining or muscular movements), haemodynamic response to intubation and number and strength of twitches to train of four stimuli just before intubation. Results: All the patients in different study groups were comparable in terms of age, sex, ASA status. The mean SBP, DBP was statistically significantly higher in Group B as compared to Group C group and Group A from 1 minute after intubation till after extubation. Good jaw relaxation was most commonly observed in group A (100%) as compared to group C (31%) and group B (17.5%) and the difference was statistically significant. Open vocal cord was most commonly observed in group A (100%) as compared to group C (75%) and group B (23%) and the difference was statistically significant. Severe coughing was most commonly observed in group B (17.5%) as compared to group C (0%) and group A (0%) and the difference was statistically significant. Severe muscular movements was most commonly observed in group B (21%) as compared to group C (0%) and group A (0%) and the difference was statistically significant.1,2,3 twitch was most commonly observed in group B (100%) as compared to group C (77.5%) and group A (56%) and the difference was statistically significant. Increase in BP and pulse > 20% of basal values was most commonly observed in group B (42%) as compared to group C (0%) and group A (0%) and the difference was statistically significant. Excellent to good scoring was most commonly observed in group A (100%) as compared to group C (92.5%) and group B (25%) and the difference was statistically significant. Conclusion: Succinylcholine is still the ideal choice for rapid sequence induction. Priming with atracurium can be used as an efficient alternative when succinylcholine is contraindicated.Keywords
Succinylcholine, Atracurium, Intubation, Muscle Relaxant, Elective SurgeryFull Text
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