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Palta, Sanjeev
- An Evaluation of the Comparative Efficacy of Preoperative Oral Omeprazole, Lansoprazole and Dexrabeprazole on Gastric Fluid pH and Volume in Patients undergoing Elective Surgery under General Anaesthesia
Abstract Views :316 |
PDF Views:87
Authors
Affiliations
1 Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, IN
1 Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, IN
Source
Northern Journal of ISA, Vol 1, No 2 (2016), Pagination: 54-57Abstract
Background and Aims: Aspiration of gastric contents in the lungs is one of the most feared complications of anaesthesia. Although the incidence of this complication is very low, it has high morbidity and mortality. The present study was carried out to evaluate and compare the efficacy of omeprazole, lansoprazole, and dexrabeprazole in reducing gastric volume and increasing the fasting pH in patients undergoing elective surgery. Methods: After obtaining institutional approval and written informed consent from the patients, 150 patients of ASA physical status 1 and 2, between age 18-55 years undergoing elective surgery under general anaesthesia were included in the study. The patients were randomly assigned to one of the three groups i.e. omeprazole (20 mg) group, lansoprazole (30 mg) group or dexrabeprazole (10 mg) group. Comparison of fasting interval, pH, volume and volume/weight of the aspirate was done using Kolmogorov-Smirnov test and Student Newman-Keuls test. A p-value <0.05 was considered statistically significant. Results: The mean pH was significantly lower in omeprazole group as compared to other two groups. The volume of gastric aspirate was significantly higher (p-value <0.005) in omeprazole group than in dexrabeprazole and lansoprazole group. There was no significant difference in the pH and volume of gastric contents in lansoprazole and dexrabeprazole group. Conclusion: Newer proton pump inhibitors like dexrabeprazole and lansoprazole are better than omeprazole in controlling gastric fluid environment.Keywords
Anaesthesia, Aspiration, Gastric pH, Gastric Volume.References
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- des Varannes SB, Gharib H, Bicheler V, Bost R, Bonaz B, Stanescu L, et al. Effect of low dose rabeprazole and omeprazole on gastric acidity: Results of a double blind, randomised, placebo-controlled, threeway crossover study in healthy subjects. Aliment Pharmacol Ther 2004;20(8):899–907.
- Nishina K, Mikawa K, Takao Y, Shiga M, Maekawa N, Obara H. A comparison of lansoprazole, omeprazole and ranitidine for improving preoperative gastric fluid property in adult patients undergoing elective surgery. Anesth Analg 2000;90:717–21.
- Pai V, Pai N. Randomised, double-blind, comparative study of dexrabeprazole 10 mg versus rabeprazole 20 mg in the treatment of gastroesophageal reflux disease. World J Gastroenterol 2007;13:4100–2.
- Miner PB, Mckean LA, Gibb RD, Erasala GN, Ramsey DL, Mcrories JW. Omeprazole 20 mg is superior to lansoprazole for control of gastric acid: A comparison of over the counter doses of proton pump inhibitors. Aliment Pharmacol Ther 2010;31:846–51.
- Taylor WJ, Champion MC, Barry AW, Hurtig JB. Measuring gastric contents during general anaesthesia: evaluation of blind gastric aspiration. Can J Anaesth 1989;36:51–4.
- American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures. Anesthesiology 1999;90:896–905.
- Normothermia and Kinking of PVC Tube - What is the Alternative?
Abstract Views :230 |
PDF Views:58
Authors
Affiliations
1 Government Medical College and Hospital, Chandigarh, IN
2 Government Medical College and Hospital, Chandigarh – 160030, IN
1 Government Medical College and Hospital, Chandigarh, IN
2 Government Medical College and Hospital, Chandigarh – 160030, IN
Source
Northern Journal of ISA, Vol 1, No 2 (2016), Pagination: 67-68Abstract
Discovering intraoperative airway obstruction in a prone position can be aptly described as an anesthetist's nightmare, more so when no observable and common cause can be detected. We report a case of intraoral endotracheal tube kinking in a 45-year old female patient who was undergoing removal of epidermoid cyst of the 4th ventricle in a prone position. The kink, that was intraoral, was noticed at an unusual position 2 cms beyond the inflation lumen cut off point. This case report reinforces upon anesthesiologist to be more vigilant in patients undergoing surgery in the prone position.Keywords
Endotracheal Tube, Kinking, Prone Position.References
- Campoy L, Hughes JM, McAllister H, Bellenger CR. Kinking of endotrachaeal tubes during maximum flexion of the atlanto-occipital joint in dogs. J Small Anim Pract 2003;44:3–7.
- Hubler M, Petrasch F. Intraoperative kinking of polyvinyl endotracheal tubes. Anesth Analg 2006;103:1601–2.
- Lee YW, Lee TS, Chan KC, Sun WZ, Lu CW. Intratracheal kink of endotracheal tube. Can J Anesth 2003;50:311–2.
- Ogden LL, Bradway JA. Manoeuvre to relieve kinking of the endotracheal tube in a prone patient. Anesthesiology 2008;109:159.
- Rao GS, Ali Z, Ramkiran S, Chandrasekhar HS. The dissection of a reinforced endotracheal tube causing nearfatal intraoperative airway obstruction. Anesth Analg 2006;103:1624–5.
- Spinal Anesthesia for Laparoscopic Cholecystectomy:Is it a Feasible Alternative?
Abstract Views :184 |
PDF Views:67
Authors
Affiliations
1 Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Sector – 32, Chandigarh, IN
1 Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Sector – 32, Chandigarh, IN
Source
Northern Journal of ISA, Vol 2, No 1 (2017), Pagination: 21-28Abstract
Background and Aims: Although mostly performed under general anesthesia, regional anesthesia has been sparingly employed in patients undergoing laparoscopic cholecystectomy. Recent evidence labels regional anesthetic techniques to be safe and highly acceptable for laparoscopic cholecystectomy. The present study was undertaken to evaluate and compare the effects of general or regional anaesthesia on haemodynamics, blood gases, postoperative pain and recovery scores, rescue analgesic consumption, and side effects in patients undergoing elective laparoscopic cholecystectomy. Methods: 80 patients were randomized in two groups of 40 each to receive either general or spinal anaesthesia for pain, hemodynamic variables, respiratory rate and cumulative rescue analgesic consumption. Intraoperative shoulder pain, oxygen saturation and arterial blood gas parameters were compared in both the groups. Intraoperative consumption of vasopressors was also observed. Modified Aldrete scoring was used to evaluate the recovery characteristics of both the techniques. Patient and surgeon feedback was assessed by the use of preformed questionnaire. At the end of study, data was compiled and analysed with appropriate statistical tests. Results: Spinal anaesthesia provided better postoperative analgesia in patients undergoing laparoscopic cholecystectomy as evident by lower VAS scores and lesser total analgesic consumption. There were more incidences of bradycardia, hypotension, and significant arterial blood gas changes under spinal anaesthesia. Patients in spinal anaesthesia group demonstrated better recovery score as well as lesser incidence of PONV IN PACU. Conclusion: Spinal anesthesia can be used as sole anesthetic technique in patients undergoing elective laparoscopic cholecystectomy especially in patients where general anesthesia carries its own inherent risks.Keywords
Laparoscopic Cholecystectomy, General Anaesthesia, Spinal Anaesthesia.References
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- Sinha R, Gurwara AK, Gupta SC. Laparoscopic surgery using spinal anaesthesia. Journal of the Society of Laparoscopic Surgeries. 2008; 12:133–8.
- Bessa SS, El-Sayes IA, El-Saiedi MK, Abdel Baki NA, Abdel-Maksoud MM. Laparoscopic cholecystectomy under spinal versus general anaesthesia: A prospective, randomizedstudy. J Laparoendosc Adv Surg Tech. 2010; 20(6):515–20. Crossref PMid:20578922
- Turkstani A, Ibraheim O, Khairy G, Alseif A, Khalil N. Spinal versus general anaesthesia for laparoscopic cholecystectomy: A cost effectiveness and side effects study. Anaesthesia, Pain & Intensive care. 2009: 13(1):9–14.
- Gautam B.Spinal anaesthesia for laparoscopic cholecystectomy: A feasibility and safety study. Kathmandu Univ Med J. 2009; 7(4):360–8.
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