Pub Date : 2023-06-30DOI: 10.18231/j.joapr.2023.11.2.20.26
D. 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":"D. Kalyani, Savita Meena, Siddharth Sharma","doi":"10.18231/j.joapr.2023.11.2.20.26","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.20.26","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.\u0000 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.\u0000 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.\u0000 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":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74055869","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.2022.11.2.1.5
M. Harsoori, A. Tyagi, M. 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":"M. Harsoori, A. Tyagi, M. Goswami","doi":"10.18231/j.joapr.2022.11.2.1.5","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.1.5","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<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.","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":"72631266","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.2022.11.2.65.70
Dr Rajbala, Sonali Beniwal, M. Khandelwal, T. M. 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, M. Khandelwal, T. M. Thomas","doi":"10.18231/j.joapr.2022.11.2.65.70","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.65.70","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":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90423999","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.2023.11.2.6.11
Budhram Rajoria, Mahipal Singh 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 Singh Dhaka, Manisha Malik, Chetali Das","doi":"10.18231/j.joapr.2023.11.2.6.11","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.6.11","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 &lt; 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":"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":"136255022","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.2022.11.2.27.31
Kiwi Mantan, Neha Chahar, S. Kothari, D. Rakesh, G. 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, S. Kothari, D. Rakesh, G. Joshi","doi":"10.18231/j.joapr.2022.11.2.27.31","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.27.31","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":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73263625","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.2023.11.2.53.57
Dr Rajbala, Sonali Beniwal, M. Khandelwal, T. M. Thomas
Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value > 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value >0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile.
{"title":"Comparison of intracuff alkalinized 2% lignocaine versus dexamethasone for attenuation of post operative laryngotracheal morbidity: a randomized comparative study","authors":"Dr Rajbala, Sonali Beniwal, M. Khandelwal, T. M. Thomas","doi":"10.18231/j.joapr.2023.11.2.53.57","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.53.57","url":null,"abstract":"Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value > 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value >0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79485302","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.2022.11.2.58.64
M. Nadaf, S. Patil, Raghavendra Huchchannavar
Background: In a developing country like India the cost effectiveness of all polyethylene tibial components is a major boon, without compromising the functional outcome. In this study we have attempted to evaluate the functional outcome of all polyethylene tibial monoblock component in total knee arthroplasty. Methodology: The study was carried out on 86 patients who are operated for total knee arthroplasty with all polyethylene tibial monoblock component. Demographic, surgical and follow up data was collected from case sheets of patients and copied in Performa. The patients were called for five years follow up and examined in the outpatient department. Results: The mean age of study population was 62.8 years (range 50 – 72 years) with mean BMI of 27.6 kg/m2. Statistically significant improvement was seen in the range of movements in all the age groups. Both male and female patients had insignificant difference in knee scoring. Assessment of clinical functional abilities of knee scoring have observed to be higher in patients with lower BMI. Conclusion: Significant improvement in range of motion as well as knee score in all age range, emphasizes the fact that total knee arthroplasty with all polyethylene design in osteoarthritis is an excellent surgery to restore near normal life style.
{"title":"Functional assessment of all polyethylene tibial monoblock component in total knee arthroplasty","authors":"M. Nadaf, S. Patil, Raghavendra Huchchannavar","doi":"10.18231/j.joapr.2022.11.2.58.64","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.58.64","url":null,"abstract":"Background: In a developing country like India the cost effectiveness of all polyethylene tibial components is a major boon, without compromising the functional outcome. In this study we have attempted to evaluate the functional outcome of all polyethylene tibial monoblock component in total knee arthroplasty. Methodology: The study was carried out on 86 patients who are operated for total knee arthroplasty with all polyethylene tibial monoblock component. Demographic, surgical and follow up data was collected from case sheets of patients and copied in Performa. The patients were called for five years follow up and examined in the outpatient department. Results: The mean age of study population was 62.8 years (range 50 – 72 years) with mean BMI of 27.6 kg/m2. Statistically significant improvement was seen in the range of movements in all the age groups. Both male and female patients had insignificant difference in knee scoring. Assessment of clinical functional abilities of knee scoring have observed to be higher in patients with lower BMI. Conclusion: Significant improvement in range of motion as well as knee score in all age range, emphasizes the fact that total knee arthroplasty with all polyethylene design in osteoarthritis is an excellent surgery to restore near normal life style.","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"205 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77470841","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}
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, Satveer Singh Gurjar, Deepak Choudhary","doi":"10.18231/j.joapr.2023.11.2.71.75","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.71.75","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":"244 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":"136255021","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.2022.11.2.46.52
Kiwi Mantan, Dr Rakesh, Sandeep 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, Dr Rakesh, Sandeep Kothari, T. Agalya, Anita Pareek, Neha Chahar, Dr Bhanupriya","doi":"10.18231/j.joapr.2022.11.2.46.52","DOIUrl":"https://doi.org/10.18231/j.joapr.2022.11.2.46.52","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":"37 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":"136255024","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.2023.11.2.12.19
Sunil Chauhan, Sandeep Kothari, Nitish Chaudhary, Kiwi Mantan
The Anaesthesiology Department at Sawai Man Singh Medical College carried out this study. For this, 60 ASA grade I and II patients undergoing planned general surgery were randomly assigned into two groups of 30 each, with Group KP (n=30) receiving injections of ketamine at 0.3 mg/kg and Group MP receiving injections of midozolam at 0.03 mg/kg and Propofol I.V. The main goal of the study was to find the best induction by analysing changes in hemodynamic indicators from baseline to various time points after induction. On the basis of the necessary induction dose and hemodynamic characteristics, the groups were contrasted. The strategy used was to present the categorical data as percentages and compare them between groups using the Chi square test. The mean and standard deviation of the quantitative data were displayed, and students' t-tests were used to compare them. According to the study described above, group MP saw a greater fluctuation in heart rate than did group KP, whose heart rate remained more constant during the anaesthetic time. Group MP's blood pressure dropped more quickly after induction compared to group KP. The ketamine group's blood pressure remained the most stable out of all the groups. Apnea, pain upon injection, and uncontrollable movements were absent in the KP group. Of all the groups, the ketamine-propofol group required the least induction dose. As a result, we came to the conclusion that pretreatment with ketamine at a dose of 0.3 mg/kg results in better hemodynamic stability and requires less propofol for induction than midazolam does. The ketamine-propofol group is therefore the best of the two groups, making it the optimum induction agent
Sawai Man Singh医学院麻醉科进行了这项研究。为此，将60例ASA I级和II级计划行普外科手术的患者随机分为两组，每组30例，KP组(n=30)注射氯胺酮0.3 mg/kg, MP组(n=30)注射咪多唑仑0.03 mg/kg并静脉注射异丙酚。本研究的主要目的是通过分析诱导后血液动力学指标从基线到各时间点的变化，寻找最佳诱导方式。根据必要的诱导剂量和血流动力学特性，对两组进行对比。使用的策略是将分类数据以百分比表示，并使用卡方检验在组间进行比较。显示定量数据的均值和标准差，并采用学生t检验进行比较。根据上述研究，MP组的心率波动比KP组更大，KP组的心率在麻醉时间内保持不变。与KP组相比，MP组诱导后血压下降更快。氯胺酮组的血压是所有组中最稳定的。KP组无呼吸暂停、注射时疼痛、无法控制的运动。在所有组中，氯胺酮-异丙酚组需要最少的诱导剂量。因此，我们得出结论，与咪达唑仑相比，0.3 mg/kg剂量的氯胺酮预处理具有更好的血流动力学稳定性，并且需要更少的异丙酚诱导。因此，氯胺酮-异丙酚组是两组中最好的，使其成为最佳的诱导剂
{"title":"Comparison of hemodynamic response of small dose ketamine versus midazolam as co- induction agent to propofol: a randomized double blind interventional study","authors":"Sunil Chauhan, Sandeep Kothari, Nitish Chaudhary, Kiwi Mantan","doi":"10.18231/j.joapr.2023.11.2.12.19","DOIUrl":"https://doi.org/10.18231/j.joapr.2023.11.2.12.19","url":null,"abstract":"The Anaesthesiology Department at Sawai Man Singh Medical College carried out this study. For this, 60 ASA grade I and II patients undergoing planned general surgery were randomly assigned into two groups of 30 each, with Group KP (n=30) receiving injections of ketamine at 0.3 mg/kg and Group MP receiving injections of midozolam at 0.03 mg/kg and Propofol I.V. The main goal of the study was to find the best induction by analysing changes in hemodynamic indicators from baseline to various time points after induction. On the basis of the necessary induction dose and hemodynamic characteristics, the groups were contrasted. The strategy used was to present the categorical data as percentages and compare them between groups using the Chi square test. The mean and standard deviation of the quantitative data were displayed, and students' t-tests were used to compare them. According to the study described above, group MP saw a greater fluctuation in heart rate than did group KP, whose heart rate remained more constant during the anaesthetic time. Group MP's blood pressure dropped more quickly after induction compared to group KP. The ketamine group's blood pressure remained the most stable out of all the groups. Apnea, pain upon injection, and uncontrollable movements were absent in the KP group. Of all the groups, the ketamine-propofol group required the least induction dose. As a result, we came to the conclusion that pretreatment with ketamine at a dose of 0.3 mg/kg results in better hemodynamic stability and requires less propofol for induction than midazolam does. The ketamine-propofol group is therefore the best of the two groups, making it the optimum induction agent","PeriodicalId":15232,"journal":{"name":"Journal of Applied Pharmaceutical Research","volume":"126 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":"136255160","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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