Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.46.52
Kiwi Mantan, D. Rakesh, S. Kothari, T. Agalya, Anita Pareek, Neha Chahar, Dr Bhanupriya
Background: The Institutional Ethics Committee and patients' informed written consent were obtained before this study was carried out in the Department of Anaesthesiology at Sardar Patel Medical College in Bikaner, Rajasthan. An established method for delivering anaesthesia and analgesia during upper limb surgery is brachial plexus block. For peripheral nerve blocks, ropivacaine, a long-acting amide with a safe cardiac profile, is chosen. It has been proven that different adjuncts may be added to LA solutions to boost their effectiveness and longevity while lowering the overall dose of LA utilised and minimising any systemic side effects. Our goal was to assess the effectiveness of adjuvants such as dexmedetomidine and clonidine in comparison to 0.5% ropivacaine in an infraclavicular block for upper limb surgery under USG guidance. Method: Fifty adult patients planned for elective upperlimb surgery with an infraclavicular brachial plexus block under USG guidance were included. All research participants were split into two groups at random. In groups D and C, respectively, dexmedetomidine and clonidine were used as adjuvants with 0.5% ropivacaine. Our main goal was to compare the postoperative analgesic duration in both research groups, as well as the onset and duration of sensory and motor block. Patients were monitored for any complications connected to the medicine and procedure while hemodynamic indicators were also compared. Results: Group D's sensory and motor block action initiation time was substantially quicker than that of group C's (p 0.001). When compared to Group C, Group D's sensory and motor block and postoperative analgesia durations were considerably longer (p value 0.001). Conclusion: Dexmedetomidine is a more effective adjuvant than clonidine when given during upper limb surgery with an infraclavicular block that is guided by a USG.
{"title":"Comparison of ropivacaine 0.5% with dexmedetomidine and clonidine as adjuvants in ultrasound-guided infraclavicular brachial plexus block for upper limb surgery","authors":"Kiwi Mantan, D. Rakesh, S. Kothari, T. Agalya, Anita Pareek, Neha Chahar, Dr Bhanupriya","doi":"10.18231/j.joapr.2023.11.2.46.52","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.46.52","url":null,"abstract":"Background: The Institutional Ethics Committee and patients' informed written consent were obtained before this study was carried out in the Department of Anaesthesiology at Sardar Patel Medical College in Bikaner, Rajasthan. An established method for delivering anaesthesia and analgesia during upper limb surgery is brachial plexus block. For peripheral nerve blocks, ropivacaine, a long-acting amide with a safe cardiac profile, is chosen. It has been proven that different adjuncts may be added to LA solutions to boost their effectiveness and longevity while lowering the overall dose of LA utilised and minimising any systemic side effects. Our goal was to assess the effectiveness of adjuvants such as dexmedetomidine and clonidine in comparison to 0.5% ropivacaine in an infraclavicular block for upper limb surgery under USG guidance. Method: Fifty adult patients planned for elective upperlimb surgery with an infraclavicular brachial plexus block under USG guidance were included. All research participants were split into two groups at random. In groups D and C, respectively, dexmedetomidine and clonidine were used as adjuvants with 0.5% ropivacaine. Our main goal was to compare the postoperative analgesic duration in both research groups, as well as the onset and duration of sensory and motor block. Patients were monitored for any complications connected to the medicine and procedure while hemodynamic indicators were also compared. Results: Group D's sensory and motor block action initiation time was substantially quicker than that of group C's (p 0.001). When compared to Group C, Group D's sensory and motor block and postoperative analgesia durations were considerably longer (p value 0.001). Conclusion: Dexmedetomidine is a more effective adjuvant than clonidine when given during upper limb surgery with an infraclavicular block that is guided by a USG.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84832938","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.65.70
Dr Rajbala, Sonali Beniwal, Mamta Khandelwal, T Mirthun Thomas
Objective: To assist in the administration of spinal anesthesia for patients undergoing femur fracture procedures, we conducted comparison research to compare the analgesic efficiency of intravenous fentanyl against ultrasound-guided femoral nerve block (FNB). Material and Methods: A group of 112 patients ranging in age from 18 to 70 years old who had ASA Physical Status I and II and were having femur fracture procedures under spinal anaesthesia participated in the randomised, prospective, interventional trial. These individuals were divided into two groups through a random assignment process. Group FENT (n = 56) received Intravenous fentanyl 1 microgram/kilogram (µg/kg) and five minutes before positioning for spinal anaesthetic, group FNB (n = 56) received ultrasound-guided FNB with 20 millilitres (ml), 1.5% lignocaine and adrenaline (1:200,000). Results: Comparison of pain scores during positioning using the Visual Analog Scale (VAS) revealed that Group FENT had a score of 1.95 ± 0.585, whereas Group FNB had a score of 0.61 ± 0.562 (p-value 0.001). The FNB group demonstrated superior patient positioning quality. Patient satisfaction was similar in both groups, and no significant side effects were observed. Conclusion: FNB offers enhanced analgesia, improved patient positioning, higher patient satisfaction, reduced reliance on additional analgesia, and fewer side effects compared to intravenous fentanyl for spinal anesthesia.
{"title":"A comparative study of intravenous fentanyl and ultrasound-guided femoral nerve block for positioning during spinal anaesthesia in femur fracture surgeries","authors":"Dr Rajbala, Sonali Beniwal, Mamta Khandelwal, T Mirthun Thomas","doi":"10.18231/j.joapr.2023.11.2.65.70","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.65.70","url":null,"abstract":"Objective: To assist in the administration of spinal anesthesia for patients undergoing femur fracture procedures, we conducted comparison research to compare the analgesic efficiency of intravenous fentanyl against ultrasound-guided femoral nerve block (FNB). Material and Methods: A group of 112 patients ranging in age from 18 to 70 years old who had ASA Physical Status I and II and were having femur fracture procedures under spinal anaesthesia participated in the randomised, prospective, interventional trial. These individuals were divided into two groups through a random assignment process. Group FENT (n = 56) received Intravenous fentanyl 1 microgram/kilogram (µg/kg) and five minutes before positioning for spinal anaesthetic, group FNB (n = 56) received ultrasound-guided FNB with 20 millilitres (ml), 1.5% lignocaine and adrenaline (1:200,000). Results: Comparison of pain scores during positioning using the Visual Analog Scale (VAS) revealed that Group FENT had a score of 1.95 ± 0.585, whereas Group FNB had a score of 0.61 ± 0.562 (p-value 0.001). The FNB group demonstrated superior patient positioning quality. Patient satisfaction was similar in both groups, and no significant side effects were observed. Conclusion: FNB offers enhanced analgesia, improved patient positioning, higher patient satisfaction, reduced reliance on additional analgesia, and fewer side effects compared to intravenous fentanyl for spinal anesthesia.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255025","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2022.11.2.20.26
Dr Kalyani, Savita Meena, Siddharth Sharma
Background: Effective airway management is vital in anesthesiology for preserving patient lives. Laryngoscopy and endotracheal intubation, commonly used procedures, can lead to undesirable outcomes due to vagal activation and sympathoadrenal reaction. This double-blind, randomized interventional study aimed to assess the impact of two different doses of dexmedetomidine on heart rate and blood pressure during laryngoscopy and intubation, which often induce tachycardia and hypertension, particularly risky for patients with hypertension, myocardial insufficiency, and cerebrovascular disease. Methods: Seventy-six participants, aged 20-60 years and classified as American Society of Anesthesiologists (ASA) Grade I & II, were enrolled after Institutional Ethics Committee approval. Random allocation assigned them to two groups: Group A (0.5 µg/kg dexmedetomidine) and Group B (1.0 µg/kg dexmedetomidine) before anesthesia induction. Hemodynamic measurements were recorded at various time points: pre- and post-drug administration, before intubation, and at intervals thereafter. Results: Both groups exhibited similar age, weight, and gender distribution. Group B consistently demonstrated lower hemodynamic variables compared to Group A after laryngoscopy and intubation. Additionally, Group B required a smaller induction dose of propofol than Group A. No significant adverse effects were reported in either group during the study. Conclusion: The study suggests that intravenous administration of dexmedetomidine at a rate of 1 µg/kg is more effective than 0.5 µg/kg in attenuating the physiological response to laryngoscopy and intubation. Moreover, it reduces the required propofol dose for anesthesia induction. These findings highlight the potential benefits of higher dexmedetomidine doses in mitigating adverse physiological effects during airway management procedures
{"title":"Effects of different dexmedetomidine doses on haemodynamic variability during laryngoscopy and intubation: A randomized double-blind study","authors":"Dr Kalyani, Savita Meena, Siddharth Sharma","doi":"10.18231/j.joapr.2022.11.2.20.26","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.20.26","url":null,"abstract":"Background: Effective airway management is vital in anesthesiology for preserving patient lives. Laryngoscopy and endotracheal intubation, commonly used procedures, can lead to undesirable outcomes due to vagal activation and sympathoadrenal reaction. This double-blind, randomized interventional study aimed to assess the impact of two different doses of dexmedetomidine on heart rate and blood pressure during laryngoscopy and intubation, which often induce tachycardia and hypertension, particularly risky for patients with hypertension, myocardial insufficiency, and cerebrovascular disease. Methods: Seventy-six participants, aged 20-60 years and classified as American Society of Anesthesiologists (ASA) Grade I & II, were enrolled after Institutional Ethics Committee approval. Random allocation assigned them to two groups: Group A (0.5 µg/kg dexmedetomidine) and Group B (1.0 µg/kg dexmedetomidine) before anesthesia induction. Hemodynamic measurements were recorded at various time points: pre- and post-drug administration, before intubation, and at intervals thereafter. Results: Both groups exhibited similar age, weight, and gender distribution. Group B consistently demonstrated lower hemodynamic variables compared to Group A after laryngoscopy and intubation. Additionally, Group B required a smaller induction dose of propofol than Group A. No significant adverse effects were reported in either group during the study. Conclusion: The study suggests that intravenous administration of dexmedetomidine at a rate of 1 µg/kg is more effective than 0.5 µg/kg in attenuating the physiological response to laryngoscopy and intubation. Moreover, it reduces the required propofol dose for anesthesia induction. These findings highlight the potential benefits of higher dexmedetomidine doses in mitigating adverse physiological effects during airway management procedures","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255158","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.27.31
Kiwi Mantan, Neha Chahar, Sandeep Kothari, Dr Rakesh, Gaurav Joshi
The Department of Anaesthesia at SPMC Bikaner approved the trial and it was carried out during laparoscopic surgery OT with proper informed written permission. The study was a double-blind, randomised, prospective interventional trial. The study comprised 60 (ASA) Classes I and II patients between the ages of 18 and 60 who were scheduled for elective laparoscopic cholecystectomy. Using a computer-generated random number sequence, patients were divided into two groups of 30 each: Group A received 1.5 mg/kg of clonidine, whereas Group B received.2 mg/kg of nalbuphine in a 50 ml NS solution. Prior to administering the study drug, five minutes after premedication, hemodynamic parameters were recorded. Double-blind administration of the study medication occurred more than 10 minutes before anaesthesia onset. Hemodynamic parameters were recorded following the administration of the study medication, 1 and 5 minutes after intubation, prior to pneumoperitoneum, 5 minutes, 10 minutes, 20 minutes, 30 minutes, and 40 minutes after pneumoperitoneum, and finally following extubation. following 1 minute and 5 minutes after intubation (and following pneumoperitoneum at 5 minutes, 10 minutes, 20 minutes, and post extubation), it was discovered that there was a substantial difference in heart rate, SBP, DBP, and MAP between Group A and Group B. In our investigation, hemodynamics related to heart rate were improved with clonidine. Based on the results of our study and other earlier research conducted by different authors, we came to the conclusion that both clonidine and nalbuphine, when administered 5 minutes prior to intubation in patients undergoing laparoscopic surgery, attenuated the hemodynamic response to intubation and pneumoperitoneum during the surgery. The difference in heart rate, systolic and diastolic blood pressure, and mean arterial pressure is much less with clonidine than with nalbuphine, which leads us to the conclusion that clonidine produced greater hemodynamic response than nalbuphine.
{"title":"Comparing intravenous clonidine and nalbuphine for attenuating hemodynamic response to laryngoscopy and improving perioperative outcomes in laparoscopic surgeries","authors":"Kiwi Mantan, Neha Chahar, Sandeep Kothari, Dr Rakesh, Gaurav Joshi","doi":"10.18231/j.joapr.2023.11.2.27.31","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.27.31","url":null,"abstract":"The Department of Anaesthesia at SPMC Bikaner approved the trial and it was carried out during laparoscopic surgery OT with proper informed written permission. The study was a double-blind, randomised, prospective interventional trial. The study comprised 60 (ASA) Classes I and II patients between the ages of 18 and 60 who were scheduled for elective laparoscopic cholecystectomy. Using a computer-generated random number sequence, patients were divided into two groups of 30 each: Group A received 1.5 mg/kg of clonidine, whereas Group B received.2 mg/kg of nalbuphine in a 50 ml NS solution. Prior to administering the study drug, five minutes after premedication, hemodynamic parameters were recorded. Double-blind administration of the study medication occurred more than 10 minutes before anaesthesia onset. Hemodynamic parameters were recorded following the administration of the study medication, 1 and 5 minutes after intubation, prior to pneumoperitoneum, 5 minutes, 10 minutes, 20 minutes, 30 minutes, and 40 minutes after pneumoperitoneum, and finally following extubation. following 1 minute and 5 minutes after intubation (and following pneumoperitoneum at 5 minutes, 10 minutes, 20 minutes, and post extubation), it was discovered that there was a substantial difference in heart rate, SBP, DBP, and MAP between Group A and Group B. In our investigation, hemodynamics related to heart rate were improved with clonidine. Based on the results of our study and other earlier research conducted by different authors, we came to the conclusion that both clonidine and nalbuphine, when administered 5 minutes prior to intubation in patients undergoing laparoscopic surgery, attenuated the hemodynamic response to intubation and pneumoperitoneum during the surgery. The difference in heart rate, systolic and diastolic blood pressure, and mean arterial pressure is much less with clonidine than with nalbuphine, which leads us to the conclusion that clonidine produced greater hemodynamic response than nalbuphine.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255159","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.1.5
Mohammed Minhajuddin Harsoori, Arvind Kumar Tyagi, Mayukh Kamal Goswami
Background: Head injury causes accumulation of blood between the rigid skull and the outer endosteal layer of the dura mater. If the volume of extradural hematoma is less than 30 ml volume, it may not require surgery based on neurological examination. Objectives: To study the various causes, factors influencing and outcome of conservatively management in Extra Dural Hematomas. Materials and Methods: A total of 23 Extra Dural Hematoma cases requiring conservative management were included in the study. All the patients were subjected to complete neurological examination including and various imaging techniques like CT brain and chest X-ray. The patients with volume<30ml, thickness<5 mm, midline shift<5 mm, GCS >8, were subjected to conservative management by admitting the patients in Intensive Care Units (ICU). Results: Among 23 EDH cases, 17 (74%) cases were males and 6(26%) cases were females. The mean age of patients was 26.7years. Road traffic accident was the common mode of injury in 47.8% (11 cases) of patients. Mean volume of hematoma was 20.5ml and GCS Score was mild to moderate group.The majority of the patients (34.7%) presented with frontal EDH. Among 23 cases, 91.3% of the patients were discharged with good recovery. Conclusion: Extra Dural Hematoma (EDH) with low volume can be considered for conservative therapy by close observation, yet a risk of sudden neurological deterioration. However, surgical evacuation is the definitive treatment of EDH but craniotomy can be avoided in many patients with keen observation and repeated neurological assessments.
{"title":"A clinical study of patients with conservatively managed extra dural hematoma at a tertiary care hospital","authors":"Mohammed Minhajuddin Harsoori, Arvind Kumar Tyagi, Mayukh Kamal Goswami","doi":"10.18231/j.joapr.2023.11.2.1.5","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.1.5","url":null,"abstract":"Background: Head injury causes accumulation of blood between the rigid skull and the outer endosteal layer of the dura mater. If the volume of extradural hematoma is less than 30 ml volume, it may not require surgery based on neurological examination. Objectives: To study the various causes, factors influencing and outcome of conservatively management in Extra Dural Hematomas. Materials and Methods: A total of 23 Extra Dural Hematoma cases requiring conservative management were included in the study. All the patients were subjected to complete neurological examination including and various imaging techniques like CT brain and chest X-ray. The patients with volume&lt;30ml, thickness&lt;5 mm, midline shift&lt;5 mm, GCS >8, were subjected to conservative management by admitting the patients in Intensive Care Units (ICU). Results: Among 23 EDH cases, 17 (74%) cases were males and 6(26%) cases were females. The mean age of patients was 26.7years. Road traffic accident was the common mode of injury in 47.8% (11 cases) of patients. Mean volume of hematoma was 20.5ml and GCS Score was mild to moderate group.The majority of the patients (34.7%) presented with frontal EDH. Among 23 cases, 91.3% of the patients were discharged with good recovery. Conclusion: Extra Dural Hematoma (EDH) with low volume can be considered for conservative therapy by close observation, yet a risk of sudden neurological deterioration. However, surgical evacuation is the definitive treatment of EDH but craniotomy can be avoided in many patients with keen observation and repeated neurological assessments.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255161","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2022.11.2.71.75
Poonam Kalra, Gursevak Maan, S. Gurjar, Deepak Choudhary
Background: The relationship between the common carotid artery (CCA) and the internal jugular vein (IJV) plays a crucial role in the process of internal jugular vein (IJV) cannulation, and this relationship often undergoes changes with head rotation. Methods: In this analytical, observational study, we aimed to compare the effect of 15-degree and 45-degree head rotation on the visualization of the IJV and CCA among 30 patients undergoing IJV cannulation for central venous access. Ultrasound guidance was used during the cannulation procedure. Results: Our findings revealed that greater overlapping of the IJV, specifically at the 12 o'clock position, was observed in cases with a 45-degree head rotation, whereas a lesser degree of overlapping (IJV at the 10 o'clock position) was observed with head in the neutral position. Conclusion: Based on our observations, we conclude that maintaining a head neutral position during IJV central line insertion under ultrasound guidance is safer compared to a 45-degree neck rotation. This information can contribute to improved safety and efficacy during IJV cannulation procedures
{"title":"Effect of head rotation on visualisation of carotid artery and jugular vein in ijv cannulation: an observational analytical study","authors":"Poonam Kalra, Gursevak Maan, S. Gurjar, Deepak Choudhary","doi":"10.18231/j.joapr.2022.11.2.71.75","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.71.75","url":null,"abstract":"Background: The relationship between the common carotid artery (CCA) and the internal jugular vein (IJV) plays a crucial role in the process of internal jugular vein (IJV) cannulation, and this relationship often undergoes changes with head rotation. Methods: In this analytical, observational study, we aimed to compare the effect of 15-degree and 45-degree head rotation on the visualization of the IJV and CCA among 30 patients undergoing IJV cannulation for central venous access. Ultrasound guidance was used during the cannulation procedure. Results: Our findings revealed that greater overlapping of the IJV, specifically at the 12 o'clock position, was observed in cases with a 45-degree head rotation, whereas a lesser degree of overlapping (IJV at the 10 o'clock position) was observed with head in the neutral position. Conclusion: Based on our observations, we conclude that maintaining a head neutral position during IJV central line insertion under ultrasound guidance is safer compared to a 45-degree neck rotation. This information can contribute to improved safety and efficacy during IJV cannulation procedures","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88051915","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}
Introduction: Regional anaesthesia is widely used and safe anaesthetic technique. It leads to Intra/ post-operative shivering. There are various methods available to control. Tramadol is one of the most widely used to control shivering, however it is also associated with nausea and vomiting. Objective: To compare the efficacy of dexmedetomidine and tramadol in the treatment of post‑spinal anesthesia (SA) shivering as well as to compare their side‑effect profile. Methodology: This hospital based, prospective, randomized, double blinded, Superiority type of interventional study included 60 patients undergoing elective spinal anesthesia aged 20-60 years, ASA grade I and II, weighing 40-80 kilograms. Subjects were randomly allocated into two groups, to receive either 0.5 mcg/kg Dexmedetomidine (Group D) or 05 mg/kg Tramadol (or grpup T). The grade of shivering was assessed as per wrench (Grade 0: no shivering, Grade 1: One or more of the following: piloerection, peripheral vasoconstriction, peripheral cyanosis, but without visible muscles activity, Grade 2: Visible muscle activity confined to one muscle group, Grade 3: Visible muscle activity in more than one muscle group and Grade 4: Gross muscle activity involving the whole body). Result: Shivering was eliminated in all the patients who received either dexmedetomidine or tramadol. Time for unset of shivering and grade of shivering is quite similar in both study groups. Time to cessation of shivering was significantly earlier with dexmedetomidine (174.3±12.5) as compare with tramadol (279.6±15.9). Nausea and vomiting is found significantly higher (P value = 0.024) with tramadol.
{"title":"Intravenous dexmedetomidine v/s tramadol on post spinal anaesthesia shivering: A randomized, double blind and interventional study","authors":"Pooja Bharti, Yogesh Chand Modi, Subhita Marodia, Pushpendra Bairwa","doi":"10.18231/j.joapr.2023.11.2.40.45","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.40.45","url":null,"abstract":"Introduction: Regional anaesthesia is widely used and safe anaesthetic technique. It leads to Intra/ post-operative shivering. There are various methods available to control. Tramadol is one of the most widely used to control shivering, however it is also associated with nausea and vomiting. Objective: To compare the efficacy of dexmedetomidine and tramadol in the treatment of post‑spinal anesthesia (SA) shivering as well as to compare their side‑effect profile. Methodology: This hospital based, prospective, randomized, double blinded, Superiority type of interventional study included 60 patients undergoing elective spinal anesthesia aged 20-60 years, ASA grade I and II, weighing 40-80 kilograms. Subjects were randomly allocated into two groups, to receive either 0.5 mcg/kg Dexmedetomidine (Group D) or 05 mg/kg Tramadol (or grpup T). The grade of shivering was assessed as per wrench (Grade 0: no shivering, Grade 1: One or more of the following: piloerection, peripheral vasoconstriction, peripheral cyanosis, but without visible muscles activity, Grade 2: Visible muscle activity confined to one muscle group, Grade 3: Visible muscle activity in more than one muscle group and Grade 4: Gross muscle activity involving the whole body). Result: Shivering was eliminated in all the patients who received either dexmedetomidine or tramadol. Time for unset of shivering and grade of shivering is quite similar in both study groups. Time to cessation of shivering was significantly earlier with dexmedetomidine (174.3±12.5) as compare with tramadol (279.6±15.9). Nausea and vomiting is found significantly higher (P value = 0.024) with tramadol.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"173 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82666853","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}
Introduction: Regional anaesthesia is widely used and safe anaesthetic technique. It leads to Intra/ post-operative shivering. There are various methods available to control. Tramadol is one of the most widely used to control shivering, however it is also associated with nausea and vomiting. Objective: To compare the efficacy of dexmedetomidine and tramadol in the treatment of post‑spinal anesthesia (SA) shivering as well as to compare their side‑effect profile. Methodology: This hospital based, prospective, randomized, double blinded, Superiority type of interventional study included 60 patients undergoing elective spinal anesthesia aged 20-60 years, ASA grade I and II, weighing 40-80 kilograms. Subjects were randomly allocated into two groups, to receive either 0.5 mcg/kg Dexmedetomidine (Group D) or 05 mg/kg Tramadol (or grpup T). The grade of shivering was assessed as per wrench (Grade 0: no shivering, Grade 1: One or more of the following: piloerection, peripheral vasoconstriction, peripheral cyanosis, but without visible muscles activity, Grade 2: Visible muscle activity confined to one muscle group, Grade 3: Visible muscle activity in more than one muscle group and Grade 4: Gross muscle activity involving the whole body). Result: Shivering was eliminated in all the patients who received either dexmedetomidine or tramadol. Time for unset of shivering and grade of shivering is quite similar in both study groups. Time to cessation of shivering was significantly earlier with dexmedetomidine (174.3±12.5) as compare with tramadol (279.6±15.9). Nausea and vomiting is found significantly higher (P value = 0.024) with tramadol.
{"title":"Intravenous dexmedetomidine v/s tramadol on post spinal anaesthesia shivering: A randomized, double blind and interventional study","authors":"Pooja Bharti, Yogesh Chand Modi, Subhita Marodia, Pushpendra Bairwa","doi":"10.18231/j.joapr.2022.11.2.40.45","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.40.45","url":null,"abstract":"Introduction: Regional anaesthesia is widely used and safe anaesthetic technique. It leads to Intra/ post-operative shivering. There are various methods available to control. Tramadol is one of the most widely used to control shivering, however it is also associated with nausea and vomiting. Objective: To compare the efficacy of dexmedetomidine and tramadol in the treatment of post‑spinal anesthesia (SA) shivering as well as to compare their side‑effect profile. Methodology: This hospital based, prospective, randomized, double blinded, Superiority type of interventional study included 60 patients undergoing elective spinal anesthesia aged 20-60 years, ASA grade I and II, weighing 40-80 kilograms. Subjects were randomly allocated into two groups, to receive either 0.5 mcg/kg Dexmedetomidine (Group D) or 05 mg/kg Tramadol (or grpup T). The grade of shivering was assessed as per wrench (Grade 0: no shivering, Grade 1: One or more of the following: piloerection, peripheral vasoconstriction, peripheral cyanosis, but without visible muscles activity, Grade 2: Visible muscle activity confined to one muscle group, Grade 3: Visible muscle activity in more than one muscle group and Grade 4: Gross muscle activity involving the whole body). Result: Shivering was eliminated in all the patients who received either dexmedetomidine or tramadol. Time for unset of shivering and grade of shivering is quite similar in both study groups. Time to cessation of shivering was significantly earlier with dexmedetomidine (174.3±12.5) as compare with tramadol (279.6±15.9). Nausea and vomiting is found significantly higher (P value = 0.024) with tramadol.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136255023","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2022.11.2.6.11
Budhram Rajoria, Mahipal Dhaka, Manisha Malik, Chetali Das
Background: Preemptive analgesia is pain control before inciting a noxious stimulus. Upper abdominal and shoulder tip pain after laparoscopy is probably caused by gas retained in the peritoneal cavity. Pain relievers were given before the incision. Aim: The study was planned to compare the Analgesic effect of pre-operative intravenous Paracetamol versus Ketorolac in laparoscopic cholecystectomy under general anesthesia. The difference in the need for first rescue analgesia and total dose of rescue analgesics in 24 hours postoperative period in both groups was assessed. Methods: This Hospital Based Double Blinded Randomized Interventional Study was carried out in ASA I and II, aged 18 to 60 years in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Group A received an Intravenous infusion of paracetamol 1gm (100ml) and Group B received an intravenous infusion of ketorolac 30mg (1ml) diluted in 99 ml 0.9% normal saline. In both groups, analgesic was given over a period of 30 minutes, 30 min before induction of general anesthesia. The chi-square test and Student’s t-test were used for the statistical analysis. Results: The time for the demand of the first rescue analgesia was219±81.0 min in group A and 350±175.1min in group B, with a p-value < 0.001. The demand for rescue analgesics was more in Group A in contrast to Group B. Conclusion: We concluded with our study, pre-emptive analgesia with 30mg ketorolac is better than 1 gm paracetamol. The time for rescue analgesia is prolonged, the number of rescue analgesics demanded is reduced, VAS score was significantly lower when ketorolac was used.
{"title":"Comparison of analgesic effect of preoperative intravenous paracetamol v/s ketorolac in laparoscopic cholecystectomy under general anesthesia","authors":"Budhram Rajoria, Mahipal Dhaka, Manisha Malik, Chetali Das","doi":"10.18231/j.joapr.2022.11.2.6.11","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.6.11","url":null,"abstract":"Background: Preemptive analgesia is pain control before inciting a noxious stimulus. Upper abdominal and shoulder tip pain after laparoscopy is probably caused by gas retained in the peritoneal cavity. Pain relievers were given before the incision. Aim: The study was planned to compare the Analgesic effect of pre-operative intravenous Paracetamol versus Ketorolac in laparoscopic cholecystectomy under general anesthesia. The difference in the need for first rescue analgesia and total dose of rescue analgesics in 24 hours postoperative period in both groups was assessed. Methods: This Hospital Based Double Blinded Randomized Interventional Study was carried out in ASA I and II, aged 18 to 60 years in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Group A received an Intravenous infusion of paracetamol 1gm (100ml) and Group B received an intravenous infusion of ketorolac 30mg (1ml) diluted in 99 ml 0.9% normal saline. In both groups, analgesic was given over a period of 30 minutes, 30 min before induction of general anesthesia. The chi-square test and Student’s t-test were used for the statistical analysis. Results: The time for the demand of the first rescue analgesia was219±81.0 min in group A and 350±175.1min in group B, with a p-value < 0.001. The demand for rescue analgesics was more in Group A in contrast to Group B. Conclusion: We concluded with our study, pre-emptive analgesia with 30mg ketorolac is better than 1 gm paracetamol. The time for rescue analgesia is prolonged, the number of rescue analgesics demanded is reduced, VAS score was significantly lower when ketorolac was used.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80170032","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}
Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.32.39
A. Kaur, Amandeep Singh, A. Varma
Background: A chronic, symmetrical & inflammatory disease, which affects small joints and later progresses to involve large joints. To promote remission and control further joint destruction, disease modifying ant rheumatic drugs are used. The role of low Vitamin D3 and High BMI have been found in pathogenesis of RA. Methodology: The study was designed by Department of pharmacology and patients were enrolled from department of medicine. This was an open label; prospective study. After obtaining, informed written consent, the subjects were randomized in three groups, Group 1-Methotrexate 7.5-15mg once a week, Group 2 - Hydroxychloroquine 200mg BD and Group 3-Methotrexate 7.5mg once a week Plus HCQ 200mg OD. The Vitamin D3 levels and Body mass index was assessed at first visit. The quality of life was assessed using DAS-28/CRP, RAPID-3 Score. Average cost-effective ratio was also calculated. The adverse effects were also assessed using WHO-UMC causality assessment. The statistical analysis of the data Graph pad insta version 3.1 was used, p-value <0.05 was considered statistically significant. Results: The mean changes in DAS28/CRP and RAPID-3 between baseline & 16 weeks was highly significant (p<0.0001) in all groups. Vitamin D3 levels at baseline was 19.14±0.42, 19.86±0.67 and 19.52±0.98 in all groups respectively. Conclusion: The vitamin D3 levels were in the lower limit and BMI was raised in almost all the patients at first visit. The efficacy of combination therapy is found to be better when given at initial stages of RA patients
{"title":"Assessing the impact of methotrexate, hydroxychloroquine, and their combination in rheumatoid arthritis: efficacy, safety, and cost analysis with vitamin D3 and BMI","authors":"A. Kaur, Amandeep Singh, A. Varma","doi":"10.18231/j.joapr.2023.11.2.32.39","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.32.39","url":null,"abstract":"Background: A chronic, symmetrical & inflammatory disease, which affects small joints and later progresses to involve large joints. To promote remission and control further joint destruction, disease modifying ant rheumatic drugs are used. The role of low Vitamin D3 and High BMI have been found in pathogenesis of RA. Methodology: The study was designed by Department of pharmacology and patients were enrolled from department of medicine. This was an open label; prospective study. After obtaining, informed written consent, the subjects were randomized in three groups, Group 1-Methotrexate 7.5-15mg once a week, Group 2 - Hydroxychloroquine 200mg BD and Group 3-Methotrexate 7.5mg once a week Plus HCQ 200mg OD. The Vitamin D3 levels and Body mass index was assessed at first visit. The quality of life was assessed using DAS-28/CRP, RAPID-3 Score. Average cost-effective ratio was also calculated. The adverse effects were also assessed using WHO-UMC causality assessment. The statistical analysis of the data Graph pad insta version 3.1 was used, p-value <0.05 was considered statistically significant. Results: The mean changes in DAS28/CRP and RAPID-3 between baseline & 16 weeks was highly significant (p<0.0001) in all groups. Vitamin D3 levels at baseline was 19.14±0.42, 19.86±0.67 and 19.52±0.98 in all groups respectively. Conclusion: The vitamin D3 levels were in the lower limit and BMI was raised in almost all the patients at first visit. The efficacy of combination therapy is found to be better when given at initial stages of RA patients","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74940416","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}
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