scholarly journals Comparison of the RAMSAY score and the Richmond Agitation Sedation Score for the measurement of sedation depth

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
R Riessen ◽  
R Pech ◽  
P Tränkle ◽  
G Blumenstock ◽  
M Haap
Keyword(s):  
Sedation Score ◽  
Ramsay Score

Effect of B-ultrasound-guided nerve block on nerve block on analgesia and sedation in patients with acute cholecystitis undergoing puncture and drainage

2021 ◽  
Vol 7 (5) ◽  
pp. 3022-3028
Author(s):  
Fei Guo ◽  
Yongjun Wang ◽  
Shenghui Liu ◽  
Junrong Cao
Keyword(s):  
Oxidative Stress ◽  
Heart Rate ◽  
Acute Cholecystitis ◽  
Nerve Block ◽  
Sedation Score ◽  
The Body ◽  
Control Group ◽  
Observation Group ◽  
Ultrasound Guided ◽  
Total Antioxidant

To investigate the effect of B-ultrasound-guided nerve block on analgesia and sedation in patients with acute cholecystitis undergoing puncture and drainage. Methods 96 patients with acute cholecystitis who underwent puncture and drainage from May 2018 to November 2020 were randomly divided into control group and observation group by random number table method, with 48 cases in each group. The patients in the control group were anesthetized by local infiltration. The patients in the observation group were anesthetized by B-ultrasound-guided nerve block. Heart rate, blood pressure, analgesia score, sedation score, and oxidative stress level were compared between the two groups. Results At the time of puncture (T2), heart rate (HR) and mean arterial pressure (MAP) in the two groups were significantly lower than those before operation (T1) (P<0.05); at the end of operation (T3), HR and MAP in the control group were significantly higher than those at T1 (P<0.05); at T2, HR and MAP in the observation group were significantly higher than those in the control group (P<0.05); at T3, HR and MAP in the observation group were significantly lower than those in the control group (P<0.05). AtT2 and T3, Ramsay sedation score in both groups was significantly lower than that at T1 (P<0.05), while Ramsay score in the observation group was significantly higher than that in control group (P<0.05); atT2 and T3, visual analog scale (VAS) pain score in both groups was significantly higher than that at T1 (P<0.05), while VAS score in the observation group was significantly lower than that in the control group (P<0.05). After operation, the levels of serum malondialdehyde (MDA) and superoxide dismutase (SOD) in the two groups were significantly higher than those before operation (P<0.05), and the levels of serum total antioxidant capacity (T-AOC) were significantly lower than those before operation (P<0.05); after operation, the levels of serum SOD and T-AOC in the observation group were significantly higher than those in the control group (P<0.05), and the levels of MDA in the observation group were significantly lower than those in the control group (P>0.05). Conclusion B-ultrasound-guided nerve block anesthesia can maintain the stable hemodynamic index of patients with acute cholecystitis undergoing puncture and drainage therapy, improve the analgesic and sedative effect and reduce the oxidative stress response of the body.

Acomparative Study between Epidural Analgesia of Levobupivacaine with Fentanyl versus Dexmedetomidine for knee replacement surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Naglaa Mohammed Ali ◽  
Ehab Hamed Abd El Mohsen ◽  
Rania Maher Hussien ◽  
Omar Abd El Gawad Kamel Massoud
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Knee Replacement ◽  
Sedation Score ◽  
Gamma Aminobutyric Acid ◽  
University Hospitals ◽  
Research Committee ◽  
Duration Of Action ◽  
Dose Dependent Decrease ◽  
Double Blinded

Abstract Background The use of epidural analgesia for the management of postoperative pain has evolved as a critical component of multimodal approach to achieve the goal of adequate analgesia with improved outcome. Epidural analgesia offers superior postoperative pain relief compared with systemic opioids. In addition to improved patient outcome. Objective To compare the effect of dexmedetomidine and fentanyl as an adjuvant to epidural levobupivacaine in knee replacement surgeries regarding duration of action and the analgesic potency of both drugs. Patients and Methods This prospective double blinded randomized clinical trial study was conducted in Maadi Military and Ain Shams University Hospitals after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent knee replacement surgeries were included in the study their ages range between 21 and 60 years old and classified as ASA I and II. The patients were randomly divided using computer generated randomization into two groups 30 patients in each (n = 30). Results As regards sedation score intraoperative and postoperative, in the present study, we found that Ramsay sedation score was significantly higher in group ‘BD’ when compared to group ‘BF’ intraoperative and postoperative. This finding may be attributed to the sedative properties of dexmedetomidine that is far superior to fentanyl acting by dose-dependent decrease in activity of noradrenergic neurons in the brain stem via post-synaptic receptor-mediated inhibition. This increases gamma-aminobutyric acid (GABA) neurone activity, which mediates central sedative effects. Conclusion Epidural levobupivacaine with dexmedetomidine provided better sedation, adequate surgical anesthesia with prolonged postoperative analgesia for lower limb surgeries. Both adjuvants reduced the epidural dose of levobupivacaine and potentiated its efficacy.

scholarly journals The Efficacy and Safety of Nabufen and Sufentanil in the Prevention of Visceral Pain After Gynecological Laparoscopic Surgery: A Randomised Controlled Trial

2020 ◽  
Author(s):  
Xiaoxia Gu ◽  
Jingjing Wang ◽  
Huihua Liao ◽  
Jian Mo ◽  
Weiming Huang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Adverse Reactions ◽  
Visceral Pain ◽  
Sedation Score ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Ramsay Sedation Score

Abstract Background: To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery. Methods: from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by visual analogue scale (VAS). The total amount of analgesic pump used, the total number of times of pressing and the effective times of pressing were recorded. The adverse reactions included respiratory depression, nausea and vomiting, drowsiness, restlessness and skin The skin itches. Results: the analgesic effect of group B was similar to that of group A, and there was no significant difference in the number of invalid pressing, total pressing times and rescue analgesia rate (P > 0.05), while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A (P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia (P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A (P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D, which indicated that the incidence of adverse reactions was higher in group D than group B and group C.Conclusion: the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.Trial registration: http://www.chictr.org.cn/showproj.aspx?proj=40635Registration number：ChiCTR1900025076 . Prospectively registered on 10 August 2019.

scholarly journals Controlled Hypotension for Functional Endoscopic Sinus Surgery: A Comparative study of Dexmedetomidine and Esmolol

2020 ◽  
Vol 24 (1) ◽  
pp. 37-49
Author(s):  
Md Shafiul Alam Shaheen ◽  
AKM Nurnobi Chowdhury ◽  
Kawsar Sardar ◽  
Mushfiqur Rahman ◽  
Sudhangshu Shekhar Biswas ◽  
...  
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sedation Score ◽  
Sinus Surgery ◽  
Effective Control ◽  
Controlled Hypotension ◽  
Fentanyl Consumption ◽  
Surgical Field ◽  
Group D

Background: Functional endoscopic sinus surgery (FESS) requires effective control of bleeding for better visibility of the operating field and reduced risk of injury to the optic nerve or the internal carotid artery. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objectives: Our study is undertaken to evaluate the efficacy of dexmedetomidine as a hypotensive agent in comparison to esmolol in Functional Endoscopic Sinus Surgery (FESS). Methods: Sixty (60) patients 20 – 50 years of age, ASA I/II scheduled for FESS were randomly assigned to two equal groups of 30 patients each. Patients of group D received dexmedetomidine 1µg/kg over 10 min before induction of anesthesia followed by 0.4 – 0.8 µg/kg/hr infusion during maintenance and group E received esmolol loading dose 1mg/kg was infused over one min followed by 0.4 – 0.8 mg/kg/hr infusion during maintenance to maintain mean arterial blood pressure (MAP) between (55 – 65 mmHg). The surgical field was assessed using Average Category Scale and average blood loss was calculated. Hemodynamic variables (MAP, HR); intraoperative fentanyl consumption and total recovery from anesthesia (Aldrete’s score ≥9) were recorded. Sedation score was determined at 10, 20, 30, 40 & 60 min after tracheal extubation and time to first analgesic demand was also recorded. Results:In both group D and group E reached the desired MAP (55–65 mmHg) with no inter group difference in MAP or HR. Mean intraoperative fentanyl consumption was significantly lower in group D than group E. Recovery time to achieved Aldrete’s score ≥9 were significantly lower in group E compared with group D.The sedation score were significantly lower in group E compared with group D at 10 minutes, 20 minutes and 30 minutes postoperatively. Time to first analgesic demand was significantly longer in group D. Conclusion: The result of this study showed that both dexmedetomidine and esmolol can be used as agents for controlled hypotension and are effective in providing ideal surgical field during FESS. But dexmedetomidine offers the advantage of inherent analgesic, sedative and anesthetic sparing effect. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 37-49

RELIABILITY OF A SEDATION SCORE IN ASSESSING RESPONSES TO PREINDUCTION AGENTS IN PEDIATRIC PATIENTS

1989 ◽  
Vol 71 (Supplement) ◽  
pp. A932
Author(s):  
H. W. Karl ◽  
J. L. Rosenberger ◽  
N. E. Heyneman ◽  
A. T. Keifer
Keyword(s):  
Pediatric Patients ◽  
Sedation Score

Comparative Study Between Dexmedetomidine and Fentanyl as Sedatives in Awake Fiberoptic Intubation in Cervical Spine Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Waleed Mohamed Abd El Mageed ◽  
Ahmad Kamal Mohamed Ali ◽  
Eeman Aboubakr ElSiddik Ahmed Bayoumi ◽  
Haitham Sabry Mahmoud Omar
Keyword(s):  
Cervical Spine ◽  
Sedation Score ◽  
Fiberoptic Intubation ◽  
Intubation Time ◽  
Hemodynamic Stability ◽  
Double Blind ◽  
Hemodynamic Variables ◽  
Group A ◽  
Group B ◽  
Awake Fiberoptic Intubation

Abstract Background Various drugs are used for providing favorable intubation conditions during awake fiberoptic intubation (AFOI). However, most of them have various side effects. Aim The aim of this study was to compare the effects of dexmedetomedine and fentanyl as regards sedative effects, hemodynamic stability, intubation time and intubation attempts success during awake fiberoptic intubation. Material and Methods A randomized double-blind prospective study was conducted on a total of 40 patients scheduled for elective cervical spine surgeries who were randomly allocated into two equal groups (n 20): (group A) patients received a bolus dose of dexmedetomidine of 1 mcg/kg over 10 min followed by a continuous infusion of dexmedetomidine at 0.5 mcg/kg/h. and fentanyl group (group B) received dose of 1 μg/kg over 10 min followed by 0.5 μg/kg/hr. Sedation score (Ramsy sedation score), hemodynamic variables, oxygen saturation, intubation time and intubation attempts were noted and compared between the two groups. Results Ramsy Sedation Score was significantly favorable (P &lt; 0.001) in group A in comparison to group B, moreover better hemodynamic stability during intubation (P &lt; 0.05) and less intubation attempts were observed in group A in comparison to group B. Conclusion The results of our study showed that dexmedetomidine provides optimum sedation without compromising airway or hemodynamic stability and with favorable intubation time and less intubation attempts during AFOI in comparison to fentanyl.

THE DIFFERENT TIMING OF ORAL CLONIDINE PREMEDICATION EFFECT ON SEDATION SCORE IN SPINE SURGERY

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Satish Kumar ◽  
Sanjay Kumar
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Ethics Committee ◽  
Sedation Score ◽  
Oral Clonidine ◽  
Adequate Sedation ◽  
Group 2 ◽  
American Society ◽  
Oral Premedication ◽  
Group 1

Background: Premedication is the administration of medication before anaesthesia. It is used to prepare the patient for anaesthesia and to provideoptimal conditions for surgery. Methods: The study of oral premedication dose of clonidine in spinal surgery at different time was conducted on sixty ASA grade-1 patients of eithersex between 20 to 60 years of age undergoing elective spine surgery. This study was performed after approval from ethics committee of the institute.Informed consent was obtained from each patient. Results: Sedation score was recorded preoperatively in both the groups when the patient were shifted to the operation theater according to score givenby American Society of Anaesthesia. In group-1, 25 patients (83.3%) had sedation score of 0 and 5 patients (16.7%) had score of 1. Similarly in group-2, 29 patients (96.7) had a sedation score 0 and only 1 patient (3.3%) had sedation score1. Conclusion: In conclusion this study establishes that the premedication with tab. clonidine 200µg (As tab. clonidine is available in 100µg) 90 minutebefore the surgery or 3.5 hour before the surgery produced adequate sedation Keywords: Clonidine, Sedation, Spine

scholarly journals A Comparative Study of Oral Dexmedetomidine versus Oral Midazolam As preanesthesia Medication in Pediatric Patients to Reduce anxiety

2019 ◽  
Vol 4 (2) ◽  
pp. 724-728
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa ◽  
Abha Prasai
Keyword(s):  
General Anesthesia ◽  
Separation Anxiety ◽  
Elective Surgery ◽  
Sedation Score ◽  
Preoperative Anxiety ◽  
Parental Separation ◽  
Emergence Agitation ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Group D

Introduction: Preoperative period is a stressful period. In children the preoperative anxiety is expressed as difficult separation from parents and difficult mask induction. The level of preoperative anxiety also affects postoperative outcomes. To overcome anxiety premedication is often used by pediatric anesthesiologist. Objective: The objective of this study was to compare the effect of oral midazolam 0.5mg/kg and oral dexmedetomidine 4μg/kg on parental separation, mask induction and postoperative emergence agitation in children undergoing elective surgery under general anesthesia. Methodology: 120 children aged 2-8years undergoing elective surgery under general anesthesia were divided into two groups: Group M and Group D. Patients in group M received oral midazolam 0.5mg/kg and patients in group D received oral dexmedetomidine 4μg/kg. After 45min of premedication sedation score was assessed in both the groups. Ease of parental separation and mask acceptance was compared in both the groups. In the postoperative period occurrence of emergence agitation was compared in both the groups. Results: There was no statistically significant difference in preoperative sedation score in both the groups. Parent separation anxiety score and mask acceptance score were statistically similar in both the groups. But emergence agitation was significantly lesser in patients who received dexmedetomidine premedication. Conclusions: Premedication with oral midazolam as well as oral dexmedetomidine effectively reduces parental separation anxiety and produces satisfactory mask induction in pediatric age group. However, dexmedetomidine is more effective in reducing emergence delirium in comparison to midazolam.

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