首页 > 最新文献

Indian Journal of Clinical Anaesthesia最新文献

英文 中文
A comparative study of the efficacy of intravenous magnesium sulphate and intravenous dexmedetomidine in attenuating haemodynamic response to laryngoscopy and endotracheal intubation 静脉注射硫酸镁和静脉注射右美托咪定对减轻喉镜检查和气管插管时血流动力学反应的功效比较研究
Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.074
Anju Mohan, Gautam Saha
Both laryngoscopy and tracheal intubation elicit a sympathetic and parasympathetic response, which varies depending on the depth of anaesthesia, duration of laryngoscopy, and patient characteristics. Although different methods have been used to suppress the response, an ideal agent has yet to be discovered. This study compares and contrasts the effectiveness of intravenous dexmedetomidine and intravenous magnesium sulphate in reducing hemodynamic response during laryngoscopy and endotracheal intubation.: This 18-month prospective, randomised, double-blind, placebo-controlled comparative research was conducted in the Department of Anaesthesiology and Critical Care, Bokaro General Hospital, Bokaro Steel City, Jharkhand. One hundred twenty consenting study participants were randomly divided into three groups of forty. Before induction, Group A received IV normal saline as a placebo. Group B received 1 mcg/kg IV dexmedetomidine before induction, while Group C received 30 mg/kg IV 50% magnesium sulphate before induction.: Gender distribution was consistent and equal among 120 patients. Gender, age, weight, ASA, and type of surgery did not differ significantly across groups. The three groups had no statistically significant difference in baseline hemodynamic parameters. When compared to the Control Group (A), there were statistically significant changes in hemodynamic parameters in the Dexmedetomidine (B) and Magnesium sulphate (C) groups. There was no hypotension, bradycardia, nausea, vomiting, dry mouth, or arrhythmias.: Dexmedetomidine and magnesium sulphate efficiently reduced the hemodynamic stress response to laryngoscopy and intubation, although dexmedetomidine attenuated the sympathetic response more effectively.
喉镜检查和气管插管都会引起交感神经和副交感神经反应,这种反应因麻醉深度、喉镜检查持续时间和患者特征而异。虽然已有不同的方法用于抑制这种反应,但仍未找到理想的药剂。本研究比较并对比了静脉注射右美托咪定和静脉注射硫酸镁在喉镜检查和气管插管过程中降低血流动力学反应的效果:这项为期 18 个月的前瞻性、随机、双盲、安慰剂对照比较研究在贾坎德邦博卡罗钢城博卡罗综合医院麻醉学和重症监护部进行。经过同意的 120 名研究参与者被随机分为三组,每组 40 人。诱导前,A 组静脉注射生理盐水作为安慰剂。B 组在诱导前静脉注射 1 毫克/千克右美托咪定,C 组在诱导前静脉注射 30 毫克/千克 50%硫酸镁:120 名患者的性别分布一致且相等。各组的性别、年龄、体重、ASA 和手术类型无明显差异。三组患者的基线血流动力学参数无明显统计学差异。与对照组(A)相比,右美托咪定组(B)和硫酸镁组(C)的血液动力学参数在统计学上有显著变化。没有出现低血压、心动过缓、恶心、呕吐、口干或心律失常:右美托咪定和硫酸镁能有效减轻喉镜检查和插管时的血流动力学应激反应,但右美托咪定能更有效地减轻交感神经反应。
{"title":"A comparative study of the efficacy of intravenous magnesium sulphate and intravenous dexmedetomidine in attenuating haemodynamic response to laryngoscopy and endotracheal intubation","authors":"Anju Mohan, Gautam Saha","doi":"10.18231/j.ijca.2023.074","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.074","url":null,"abstract":"Both laryngoscopy and tracheal intubation elicit a sympathetic and parasympathetic response, which varies depending on the depth of anaesthesia, duration of laryngoscopy, and patient characteristics. Although different methods have been used to suppress the response, an ideal agent has yet to be discovered. This study compares and contrasts the effectiveness of intravenous dexmedetomidine and intravenous magnesium sulphate in reducing hemodynamic response during laryngoscopy and endotracheal intubation.: This 18-month prospective, randomised, double-blind, placebo-controlled comparative research was conducted in the Department of Anaesthesiology and Critical Care, Bokaro General Hospital, Bokaro Steel City, Jharkhand. One hundred twenty consenting study participants were randomly divided into three groups of forty. Before induction, Group A received IV normal saline as a placebo. Group B received 1 mcg/kg IV dexmedetomidine before induction, while Group C received 30 mg/kg IV 50% magnesium sulphate before induction.: Gender distribution was consistent and equal among 120 patients. Gender, age, weight, ASA, and type of surgery did not differ significantly across groups. The three groups had no statistically significant difference in baseline hemodynamic parameters. When compared to the Control Group (A), there were statistically significant changes in hemodynamic parameters in the Dexmedetomidine (B) and Magnesium sulphate (C) groups. There was no hypotension, bradycardia, nausea, vomiting, dry mouth, or arrhythmias.: Dexmedetomidine and magnesium sulphate efficiently reduced the hemodynamic stress response to laryngoscopy and intubation, although dexmedetomidine attenuated the sympathetic response more effectively.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"43 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272932","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}
引用次数: 0
Anaesthetic considerations in dextrocardia with situs inversus totalis: A reversed cardiopulmonary-abdominal landscape 右心室突出伴全瘫的麻醉注意事项:心肺-腹腔反向景观
Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.092
Ridhi Roy, K. Chaudhary, Munisha Agarwal, Nimith Prabhakar, Gunjan Manchanda, Wajaha Karim
{"title":"Anaesthetic considerations in dextrocardia with situs inversus totalis: A reversed cardiopulmonary-abdominal landscape","authors":"Ridhi Roy, K. Chaudhary, Munisha Agarwal, Nimith Prabhakar, Gunjan Manchanda, Wajaha Karim","doi":"10.18231/j.ijca.2023.092","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.092","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270874","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}
引用次数: 0
The role of vasodilators in managing chronic obstructive pulmonary disease (COPD) in ICU 血管扩张剂在重症监护病房慢性阻塞性肺病(COPD)治疗中的作用
Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.087
Ruchi Goyal, Lalit Gupta, Sherry Marak
{"title":"The role of vasodilators in managing chronic obstructive pulmonary disease (COPD) in ICU","authors":"Ruchi Goyal, Lalit Gupta, Sherry Marak","doi":"10.18231/j.ijca.2023.087","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.087","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273622","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}
引用次数: 0
A case report on anaesthetic challenges in Patau syndrome: Navigating craniofacial and cardiac defects 帕托综合征麻醉挑战的病例报告:导航颅面和心脏缺陷
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.065
Pragya Shukla, Abha Singh, Amrita Rath, Shashi Prakash, Sanjay Bhaskar
The anaesthetic management of paediatric patients with Patau syndrome presents unique challenges, particularly when combined with craniofacial and cardiac defects and limited airway resources. This case report highlights our experience in managing a syndromic child with a difficult airway in a resource-constrained environment. The inability to secure the airway adequately can pose significant perioperative risks. In this case, we successfully utilized an oesophageal bougie as an alternative technique to secure the airway. This report emphasizes the importance of adapting to limited resources and employing innovative approaches to ensure optimal patient care in challenging situations.
小儿帕托综合征患者的麻醉管理面临着独特的挑战,特别是当合并颅面和心脏缺陷以及气道资源有限时。本病例报告强调了我们在资源受限环境下处理气道困难的综合征儿童的经验。不能充分保护气道会造成重大的围手术期风险。在这个病例中,我们成功地使用了食管支架作为一种替代技术来保护气道。本报告强调了适应有限资源和采用创新方法的重要性,以确保在具有挑战性的情况下获得最佳的患者护理。
{"title":"A case report on anaesthetic challenges in Patau syndrome: Navigating craniofacial and cardiac defects","authors":"Pragya Shukla, Abha Singh, Amrita Rath, Shashi Prakash, Sanjay Bhaskar","doi":"10.18231/j.ijca.2023.065","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.065","url":null,"abstract":"The anaesthetic management of paediatric patients with Patau syndrome presents unique challenges, particularly when combined with craniofacial and cardiac defects and limited airway resources. This case report highlights our experience in managing a syndromic child with a difficult airway in a resource-constrained environment. The inability to secure the airway adequately can pose significant perioperative risks. In this case, we successfully utilized an oesophageal bougie as an alternative technique to secure the airway. This report emphasizes the importance of adapting to limited resources and employing innovative approaches to ensure optimal patient care in challenging situations.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78879488","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}
引用次数: 0
Perioperative management of thalassemia intermedia patient posted for major spine surgery – A case report 大脊柱手术中地中海贫血患者围手术期处理1例
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.060
Gobinath Jayaraman, Sruthi K
Thalassemia patients are known to have abnormal haemoglobin structure and function because of genetic suppression of chains in haemoglobin molecule. These tend to lead to abnormal coagulation pathway and can cause excessive bleeding in the intra operative period. Hence, thalassemia patients are difficult and often considered as high-risk patients. Vigilant monitoring, early diagnosis and prompt treatment plays a vital role in the management and improving patient outcomes. This case illustrates a successful T4-T8 laminectomy and excision of extradural lesion in a patient with Thalassemia intermedia, pointing out the pathophysiologic considerations and discussing the means to reduce the perioperative risk. There have only been a few reports in the literature for the same and hence this article is intended to provide an overview of the anaesthetic management for a patient with thalassemia, focussing specifically on the blood conservation strategy for major spine surgeries. The particularities described in this case report may help other anaesthesiologists choose the best strategy when facing challenging patients similar to the one described.
地中海贫血患者由于血红蛋白分子链的基因抑制而具有异常的血红蛋白结构和功能。这些易导致凝血途径异常,并可引起术中出血过多。因此,地中海贫血患者很困难,通常被认为是高危患者。警惕监测、早期诊断和及时治疗在管理和改善患者预后方面起着至关重要的作用。本病例描述了一例中地中海贫血患者成功的T4-T8椎板切除术和硬膜外病变切除术,指出了病理生理方面的考虑,并讨论了降低围手术期风险的方法。文献中只有少数报道,因此本文旨在概述地中海贫血患者的麻醉管理,特别关注大脊柱手术的血液保护策略。在本病例报告中描述的特殊性可以帮助其他麻醉师在面对类似于所描述的具有挑战性的患者时选择最佳策略。
{"title":"Perioperative management of thalassemia intermedia patient posted for major spine surgery – A case report","authors":"Gobinath Jayaraman, Sruthi K","doi":"10.18231/j.ijca.2023.060","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.060","url":null,"abstract":"Thalassemia patients are known to have abnormal haemoglobin structure and function because of genetic suppression of chains in haemoglobin molecule. These tend to lead to abnormal coagulation pathway and can cause excessive bleeding in the intra operative period. Hence, thalassemia patients are difficult and often considered as high-risk patients. Vigilant monitoring, early diagnosis and prompt treatment plays a vital role in the management and improving patient outcomes. This case illustrates a successful T4-T8 laminectomy and excision of extradural lesion in a patient with Thalassemia intermedia, pointing out the pathophysiologic considerations and discussing the means to reduce the perioperative risk. There have only been a few reports in the literature for the same and hence this article is intended to provide an overview of the anaesthetic management for a patient with thalassemia, focussing specifically on the blood conservation strategy for major spine surgeries. The particularities described in this case report may help other anaesthesiologists choose the best strategy when facing challenging patients similar to the one described.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90944256","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}
引用次数: 0
Multimodal analgesia regime for open spine fixation surgery: A case series 开放式脊柱固定手术的多模式镇痛方案:一个病例系列
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.058
Anshul Yadav, Nikhil Swarnkar
Postoperative pain is a common and significant problem that affects millions of patients worldwide. Inadequate pain control can lead to a range of negative outcomes, including prolonged hospital stays, delayed recovery, increased healthcare costs, and decreased patient satisfaction. Therefore, effective management of postoperative pain is essential for improving patient outcomes and reducing healthcare utilization. While progress has been made in improving postoperative pain management, there are still significant gaps in our understanding of the mechanisms underlying postoperative pain and the most effective interventions for its management. Further research is needed to optimize pain management strategies and reduce the burden of postoperative pain on patients and healthcare systems.Multimodal analgesia is an approach to pain management that uses a combination of medications and other interventions to effectively manage pain while minimizing side effects. The goal is to target pain at different points in the pain pathway, using different mechanisms of action, to achieve better pain control than could be achieved with a single medication alone. By using multiple medications that work through different mechanisms, a lower dose of each medication can be used, reducing the risk of side effects. The approach is often tailored to the individual patient, taking into account their medical history, the type of surgery or injury, and their level of pain. Overall, multimodal analgesia aims to improve pain control and patient outcomes while reducing the risk of adverse effects.
术后疼痛是一个普遍而重要的问题,影响着全世界数百万患者。疼痛控制不足会导致一系列负面结果,包括延长住院时间、延迟恢复、增加医疗成本和降低患者满意度。因此,有效管理术后疼痛对于改善患者预后和减少医疗保健利用率至关重要。虽然在改善术后疼痛管理方面取得了进展,但我们对术后疼痛的机制和最有效的管理干预措施的理解仍然存在重大差距。需要进一步的研究来优化疼痛管理策略,减轻术后疼痛对患者和医疗保健系统的负担。多模式镇痛是一种疼痛管理方法,它使用药物和其他干预措施的组合来有效地控制疼痛,同时最大限度地减少副作用。目标是针对疼痛通路中不同的疼痛点,使用不同的作用机制,以达到比单一药物更好的疼痛控制效果。通过使用通过不同机制起作用的多种药物,可以使用较低剂量的每种药物,减少副作用的风险。这种方法通常是根据病人的个人情况量身定制的,考虑到他们的病史、手术或损伤的类型以及他们的疼痛程度。总体而言,多模式镇痛旨在改善疼痛控制和患者预后,同时降低不良反应的风险。
{"title":"Multimodal analgesia regime for open spine fixation surgery: A case series","authors":"Anshul Yadav, Nikhil Swarnkar","doi":"10.18231/j.ijca.2023.058","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.058","url":null,"abstract":"Postoperative pain is a common and significant problem that affects millions of patients worldwide. Inadequate pain control can lead to a range of negative outcomes, including prolonged hospital stays, delayed recovery, increased healthcare costs, and decreased patient satisfaction. Therefore, effective management of postoperative pain is essential for improving patient outcomes and reducing healthcare utilization. While progress has been made in improving postoperative pain management, there are still significant gaps in our understanding of the mechanisms underlying postoperative pain and the most effective interventions for its management. Further research is needed to optimize pain management strategies and reduce the burden of postoperative pain on patients and healthcare systems.Multimodal analgesia is an approach to pain management that uses a combination of medications and other interventions to effectively manage pain while minimizing side effects. The goal is to target pain at different points in the pain pathway, using different mechanisms of action, to achieve better pain control than could be achieved with a single medication alone. By using multiple medications that work through different mechanisms, a lower dose of each medication can be used, reducing the risk of side effects. The approach is often tailored to the individual patient, taking into account their medical history, the type of surgery or injury, and their level of pain. Overall, multimodal analgesia aims to improve pain control and patient outcomes while reducing the risk of adverse effects.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74084118","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}
引用次数: 0
Study of the effect of timing of pre-operative administration of dexamethasone and ondansetron on post-operative nausea and vomiting follow laparoscopic cholecystectomy: A prospective randomized control trial 术前给药地塞米松和昂丹司琼对腹腔镜胆囊切除术后恶心呕吐影响的前瞻性随机对照研究
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.052
S. Mahajan, Manjula Garg, Surinder Singh
: Post-operative nausea and vomiting (PONV) is potential complication in patients after laparoscopic cholecystectomy. The incidence rate of PONV after laparoscopic cholecystectomy (LC) is 46-75% which is higher than that after other types of surgery. The present study was aimed to compare the effect of timing of dexamethasone and ondansetron alone when given 45 minutes before induction or given just before induction of anaesthesia for control of PONV in laparoscopic cholecystectomy. : Tocompare the effect of timing of dexamethasone and ondansetron each when given 45 minutes before induction or given just before induction for control of PONV in laparoscopic cholecystectomy.: After approval by the institutional ethics committee, this study was carried out on 200 patients of both sexes in the age group of 20-60 years. It was a randomized controlled trial. And after obtaining the consent, the patients were allocated in four groups randomly. Group A: 8 mg dexamethasone 45 minutes before induction, Group B: 4 mg ondansetron 45 minutes before induction, Group C: 8 mg dexamethasone just before induction and Group D:4 mg ondansetron just before induction. Patients were observed for 24 hours after surgery for any episode of nausea and vomiting for 24 hours. Patient satisfaction with the management of PONV symptoms using 10 points verbal rating scale was accessed (VRS, 0=not satisfied, 10 = fully satisfied).: Incidence of nausea and vomiting was significantly higher in group B was 68% and D 50% in comparison to group A 28%and C 36% (P=0.003). PONV score was highly significant when ondansetron was administered 45 minutes before induction as compare to dexamethasone when administered 45minutes before induction. The effect of ondansetron was also significant in PONV score of 24 hrs in comparison to dexamethasone.: The ondansetron appears to have a shorter duration of action in comparison to dexamethasone. Timing of administration of ondansetron is important in laparoscopic cholecystectomy before surgery as it has bearing on the incidence of vomiting and rescue antiemetic required. It was found that administration of ondansetron just before induction still delays the onset of PONV in comparison to when given 45 minutes before induction.
术后恶心呕吐(PONV)是腹腔镜胆囊切除术后患者的潜在并发症。腹腔镜胆囊切除术(LC)后PONV的发生率为46-75%,高于其他类型手术后。本研究旨在比较地塞米松和昂丹司琼在麻醉诱导前45分钟或在麻醉诱导前单独给药对腹腔镜胆囊切除术中PONV控制的影响。目的:比较诱导前45分钟给药地塞米松和昂丹司琼控制腹腔镜胆囊切除术PONV的效果。:经机构伦理委员会批准,本研究纳入年龄在20-60岁的男女患者200例。这是一项随机对照试验。在征得同意后,将患者随机分为四组。A组诱导前45分钟:地塞米松8mg, B组诱导前45分钟:昂丹司琼4mg, C组诱导前:地塞米松8mg, D组诱导前:昂丹司琼4mg。术后24小时观察患者是否出现恶心和呕吐。采用10分口头评定量表评估患者对PONV症状处理的满意度(VRS, 0=不满意,10 =完全满意)。: B组恶心呕吐发生率为68%,D组为50%,明显高于A组28%,C组36% (P=0.003)。诱导前45分钟给予昂丹司琼的PONV评分显著高于诱导前45分钟给予地塞米松的PONV评分。与地塞米松相比,昂丹司琼对24小时PONV评分的影响也显著。与地塞米松相比,昂丹司琼的作用时间似乎更短。在腹腔镜胆囊切除术中,术前给予昂丹司琼的时机很重要,因为它关系到呕吐的发生率和所需的抢救止吐药。研究发现,与诱导前45分钟给药相比,在诱导前给药昂丹司琼仍可延迟PONV的发生。
{"title":"Study of the effect of timing of pre-operative administration of dexamethasone and ondansetron on post-operative nausea and vomiting follow laparoscopic cholecystectomy: A prospective randomized control trial","authors":"S. Mahajan, Manjula Garg, Surinder Singh","doi":"10.18231/j.ijca.2023.052","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.052","url":null,"abstract":": Post-operative nausea and vomiting (PONV) is potential complication in patients after laparoscopic cholecystectomy. The incidence rate of PONV after laparoscopic cholecystectomy (LC) is 46-75% which is higher than that after other types of surgery. The present study was aimed to compare the effect of timing of dexamethasone and ondansetron alone when given 45 minutes before induction or given just before induction of anaesthesia for control of PONV in laparoscopic cholecystectomy. : Tocompare the effect of timing of dexamethasone and ondansetron each when given 45 minutes before induction or given just before induction for control of PONV in laparoscopic cholecystectomy.: After approval by the institutional ethics committee, this study was carried out on 200 patients of both sexes in the age group of 20-60 years. It was a randomized controlled trial. And after obtaining the consent, the patients were allocated in four groups randomly. Group A: 8 mg dexamethasone 45 minutes before induction, Group B: 4 mg ondansetron 45 minutes before induction, Group C: 8 mg dexamethasone just before induction and Group D:4 mg ondansetron just before induction. Patients were observed for 24 hours after surgery for any episode of nausea and vomiting for 24 hours. Patient satisfaction with the management of PONV symptoms using 10 points verbal rating scale was accessed (VRS, 0=not satisfied, 10 = fully satisfied).: Incidence of nausea and vomiting was significantly higher in group B was 68% and D 50% in comparison to group A 28%and C 36% (P=0.003). PONV score was highly significant when ondansetron was administered 45 minutes before induction as compare to dexamethasone when administered 45minutes before induction. The effect of ondansetron was also significant in PONV score of 24 hrs in comparison to dexamethasone.: The ondansetron appears to have a shorter duration of action in comparison to dexamethasone. Timing of administration of ondansetron is important in laparoscopic cholecystectomy before surgery as it has bearing on the incidence of vomiting and rescue antiemetic required. It was found that administration of ondansetron just before induction still delays the onset of PONV in comparison to when given 45 minutes before induction.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82025010","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}
引用次数: 0
Anesthesia management of superobese pregnant patient under spinal anesthesia in cesarean section 超肥胖孕妇腰麻剖宫产术的麻醉处理
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.062
Sumedha Mehta, Dhanshree Dongare, N. Sadafule, Kirti Surendra Pawar
Morbidly obese parturient requires specialized anesthetic care for safe labour and delivery. Regional anesthesia is considered safer than general anesthesia for cesarean section in super morbid obese parturient. We present this case to discuss anesthetic challenges associated with regional anesthesia and our approach in successful management of cesarean section in super morbid obese parturient.
病态肥胖的产妇需要专门的麻醉护理,以确保安全生产和分娩。区域麻醉被认为比全身麻醉更安全用于超病态肥胖产妇剖宫产术。我们提出这个病例来讨论与区域麻醉相关的麻醉挑战,以及我们在成功处理超病态肥胖产妇剖宫产手术中的方法。
{"title":"Anesthesia management of superobese pregnant patient under spinal anesthesia in cesarean section","authors":"Sumedha Mehta, Dhanshree Dongare, N. Sadafule, Kirti Surendra Pawar","doi":"10.18231/j.ijca.2023.062","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.062","url":null,"abstract":"Morbidly obese parturient requires specialized anesthetic care for safe labour and delivery. Regional anesthesia is considered safer than general anesthesia for cesarean section in super morbid obese parturient. We present this case to discuss anesthetic challenges associated with regional anesthesia and our approach in successful management of cesarean section in super morbid obese parturient.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81310982","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}
引用次数: 0
Role of lung ultrasonography for diagnosing atelectasis in robotic pelvic surgeries 肺超声在机器人盆腔手术中诊断肺不张的作用
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.055
Anita Chandrashekhar Kulkarni, Anurag Sharma
Patients undergoing robotic pelvic surgery were included in prospective observational study, they are at increased risk of atelectasis and postoperative pulmonary complications.Lung ultrasonography in basal six zones and arterial gas analysis was performed as baseline after induction of GA and on de-docking robotic arms to detect incidence and severity of atelectasis and its effect on arterial oxygenation.Total fifty patients were recruited in the study with age 61.88 ± 8.49 years, BMI 25.97±4.03, intraoperative with steep trendelenburg position, average duration of docking was 155.32 ± 47.44 minutes, VCV provided to 29 and PCV to 21 patients. [Lung aeration score 0] was noted for all patients in Right anterior basal –Zone I, 50-60% of patients developed mild atelectasis [Lung Aeration score1] in Posterior basal zones III and VI. Total 10% patients developed moderate atelectasis [Lung Aeration score 2] and 4% developed severe atelectasis [Lung Aeration score 3] in zones III and VI. The incidence and severity of atelectasis was not affected by duration of robotic arms docking and mode of ventilation. For both VCV and PCV group statistically significant (p>0.05) decrease in Arterial Oxygen Pressure (Pao2) and Alveolar-arterial (A-a)o gradient difference was detected after completion of robotic surgery compared to baselines values. Atelectasis was detected in 60% patients in bilateral basal posterior zones in patients undergoing robotic pelvic surgeries causing statistically significant decrease in PaO2 compared to baseline values. Early detection of atelectasis by Lung Ultrasonography in the OR and applying optimal PEEP is recommended.
接受机器人骨盆手术的患者被纳入前瞻性观察研究,他们的肺不张和术后肺部并发症的风险增加。在GA诱导和离对接机械臂上进行肺基础六区超声检查和动脉气体分析作为基线,检测肺不张的发生率、严重程度及其对动脉氧合的影响。共纳入50例患者,年龄61.88±8.49岁,BMI 25.97±4.03,术中trendelenburg体位陡,平均对接时间155.32±47.44 min,提供VCV 29例,提供PCV 21例。右前基底- I区所有患者均为[肺通气评分0],后基底III区和VI区有50-60%的患者出现轻度肺不张[肺通气评分1],III区和VI区有10%的患者出现中度肺不张[肺通气评分2],4%的患者出现重度肺不张[肺通气评分3]。肺不张的发生率和严重程度不受机械臂接触时间和通气方式的影响。与基线值相比,VCV组和PCV组完成机器人手术后动脉氧压(Pao2)和肺泡-动脉(A-a)o梯度差均有统计学意义(p>0.05)。在接受骨盆机器人手术的患者中,60%的患者在双侧基底后区发现肺不张,导致PaO2与基线值相比有统计学意义的下降。建议在手术室早期通过肺超声检查发现肺不张并应用最佳PEEP。
{"title":"Role of lung ultrasonography for diagnosing atelectasis in robotic pelvic surgeries","authors":"Anita Chandrashekhar Kulkarni, Anurag Sharma","doi":"10.18231/j.ijca.2023.055","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.055","url":null,"abstract":"Patients undergoing robotic pelvic surgery were included in prospective observational study, they are at increased risk of atelectasis and postoperative pulmonary complications.Lung ultrasonography in basal six zones and arterial gas analysis was performed as baseline after induction of GA and on de-docking robotic arms to detect incidence and severity of atelectasis and its effect on arterial oxygenation.Total fifty patients were recruited in the study with age 61.88 ± 8.49 years, BMI 25.97±4.03, intraoperative with steep trendelenburg position, average duration of docking was 155.32 ± 47.44 minutes, VCV provided to 29 and PCV to 21 patients. [Lung aeration score 0] was noted for all patients in Right anterior basal –Zone I, 50-60% of patients developed mild atelectasis [Lung Aeration score1] in Posterior basal zones III and VI. Total 10% patients developed moderate atelectasis [Lung Aeration score 2] and 4% developed severe atelectasis [Lung Aeration score 3] in zones III and VI. The incidence and severity of atelectasis was not affected by duration of robotic arms docking and mode of ventilation. For both VCV and PCV group statistically significant (p>0.05) decrease in Arterial Oxygen Pressure (Pao2) and Alveolar-arterial (A-a)o gradient difference was detected after completion of robotic surgery compared to baselines values. Atelectasis was detected in 60% patients in bilateral basal posterior zones in patients undergoing robotic pelvic surgeries causing statistically significant decrease in PaO2 compared to baseline values. Early detection of atelectasis by Lung Ultrasonography in the OR and applying optimal PEEP is recommended.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84192107","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}
引用次数: 0
Anaesthetic management of a case of Ebstein’s anomaly undergoing a non cardiac surgery 非心脏手术Ebstein异常1例的麻醉处理
Pub Date : 2023-09-15 DOI: 10.18231/j.ijca.2023.066
Aakash Agarwal, Mohit Gupta, Nupur Gupta
Ebstein’s anomaly is a rare congenital heart disease characterized by apical displacement of the Tricuspid valve leaflets leading to Tricuspid Regurgitation. Here we report the successful management of a case of a patient with Ebstein’s anomaly who underwent Defunctioning Tranverse Colostomy. Given the complexity of Ebstein's anomaly and the potential for associated cardiac abnormalities, it is crucial to have a multidisciplinary team involved in the patient's care.
Ebstein畸形是一种罕见的先天性心脏病,其特征是三尖瓣小叶顶端移位导致三尖瓣反流。在这里,我们报告了一例成功的管理病人的Ebstein的异常谁接受功能障碍的横向结肠造口术。考虑到Ebstein异常的复杂性和潜在的相关心脏异常,让一个多学科团队参与患者的护理是至关重要的。
{"title":"Anaesthetic management of a case of Ebstein’s anomaly undergoing a non cardiac surgery","authors":"Aakash Agarwal, Mohit Gupta, Nupur Gupta","doi":"10.18231/j.ijca.2023.066","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.066","url":null,"abstract":"Ebstein’s anomaly is a rare congenital heart disease characterized by apical displacement of the Tricuspid valve leaflets leading to Tricuspid Regurgitation. Here we report the successful management of a case of a patient with Ebstein’s anomaly who underwent Defunctioning Tranverse Colostomy. Given the complexity of Ebstein's anomaly and the potential for associated cardiac abnormalities, it is crucial to have a multidisciplinary team involved in the patient's care.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78921885","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}
引用次数: 0
期刊
Indian Journal of Clinical Anaesthesia
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1