scholarly journals Comparison of Ketamine and Pentazocine with Fentanyl and Propofol combination for anaesthesia during laparoscopic tubal ligation

2019 ◽  
Vol 8 (4) ◽  
pp. 1525
Author(s):  
Ovais Nazir ◽  
Asif Hussain Bhat ◽  
Hamid Yatoo ◽  
Sanjeevni Gupta ◽  
Rajesh Misra
Keyword(s):  
Side Effects ◽  
Recovery Time ◽  
Postoperative Nausea And Vomiting ◽  
Rapid Onset ◽  
Tubal Ligation ◽  
Onset Of Action ◽  
Anaesthetic Agents ◽  
Minimally Invasive Surgical ◽  
Group I ◽  
Group Ii

Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique, without risk of major haemorrhage, early postoperative ambulation and alimentation, making it suitable for ambulatory surgery. The choice of aneasthesia for laparoscopic ligation hence should consider the anaesthetic agents with a rapid onset of action and fast recovery time, with minimal problems for intraoperative control of haemodynamic, airway and pain relief as well as take consideration of the safety, quality, efficacy, and utilization of resources available to the given situation.Methods: A total of 100 patients aged from 18 to 45 years who were scheduled to undergo laparoscopic tubal ligation  were divided into Group I-  Ketamine plus pentazocine group (n=50), Group II- Propofol plus fentanyl group (n=50) and studied  for the intraoperative parameters (hemodynamic and respiratory profile), recovery time, postoperative side effects and discharge time.Results: Intraoperatively MAP and HR were consistently higher in group I as compared to group II. Incidence of apnea and need for bag and mask ventilation was significantly more in Group II than in Group I as was the incidence of Bradycardia. Postoperative nausea and vomiting, psychomimetic effects were significantly more in Group I than in Group II. The time to reach modified PADSS ≥9 (discharge time) was significantly longer in group I (140.3±12.82 min than in group II 102.2±9.2 min), P<0.01.Conclusions: Combination of ketamine and pentazocine gives good anaesthetic conditions during procedure with less incidence of airway and haemodynamic complications intraoperatively but more incidence of postoperative side effects like nausea, vomiting, psycomimetic effects, and time to meet discharge criteria, compared to propofol plus fentanyl.

scholarly journals Caudal tramadol bupivacaine combination for postoperative pain releif in subumbilical paediatric surgery

2014 ◽  
Vol 23 (2) ◽  
pp. 42-46
Author(s):  
Md Shafiqul Islam ◽  
Md Tajul Islam ◽  
Dilip Kumar Bhowmick ◽  
Moinul Hossain ◽  
AKM Akhtaruzzaman ◽  
...  
Keyword(s):  
Postoperative Nausea And Vomiting ◽  
Paediatric Population ◽  
Paediatric Surgery ◽  
Physical Status ◽  
Anaesthetic Agents ◽  
Group I ◽  
Caudal Analgesia ◽  
Group Ii ◽  
To Receive ◽  
Control Study

Background Regional anaesthesia in children provides the advantage of reduced requirements of other anaesthetic agents and of excellent analgesia introduction. Rational use of adjuvant with local anaesthetic in caudal route for prolonged optimal analgesia in paediatric population. Objectives To evaluate the quality and duration of postoperative analgesia in children undergoing subumbilical surgeries with caudally administered mixture of tramadol and bupivacaine. Methods Sixty children of ASA physical status I & II scheduled for elective subumbilical surgery were included in this prospective case-control study. Children were randomly assigned to receive caudal analgesia with plain bupivacaine (Group-I) and a mixture of tramadol-bupivacaine (Group-II) respectively. Blood pressure, heart rate, oxygen saturation and duration of analgesia were recorded postoperatively. Results Study revealed that mean duration of caudal analgesia in Group-I and Group-II were 245.67 ± 6.94 and 612.05 ± 16.49 minutes respectively which was significantly longer (P<0.001) in Group-II. Mean number of postoperative analgesics were 2.97±0.50 and 1.78±0.50 in Group-I and Group-II which was statistically highly significant (P=0.000). Postoperative nausea and vomiting was significantly high in Group-II (P=0.019). Conclusion Combination of tramadol with bupivacaine results in prolonged analgesia when administered in caudal route. In addition, tramadol is more useful in young children considering less respiratory depression than other opioids. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18172 Journal of BSA, 2009; 23(2): 42-46

scholarly journals Levobupivacaine in spinal anesthesia for primary knee and hip arthroplasty

2020 ◽  
Vol 27 (1) ◽  
pp. 31-35
Author(s):  
K. Yu. Ukolov ◽  
V. L. Ayzenberg ◽  
M. V. Kapirina ◽  
M. E. Mikitina
Keyword(s):  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Postoperative Nausea And Vomiting ◽  
Anaesthetic Agents ◽  
Group I ◽  
Primary Knee Arthroplasty ◽  
Group Ii ◽  
Knee And Hip Arthroplasty

Introduction. Spinal anesthesia is widely used in major orthopedic. Primary hip and knee arthroplasty are major surgical procedures associated with significant potential morbidity in elderly patients. This increases requirement to surgical and anesthetic procedures. Some studies provide evidence that levobupivacaine when used as an alternative to bupivacaine in spinal anesthesia is less cardiotoxic and neurotoxic. Aim: To compare the efficacy and safety of these two spinal anaesthetic agents in elderly patients undergoing primary hip or knee replacement. Patients and methods. The study included 90 patients performed arthroplasty with spinal anesthesia. I group patients received spinal anesthesia bupivacaine 0,5%, II group patients received intrathecal levobupicavaine 0.5%. Group I (n=60), 22 (37%) underwent primary hip arthroplasty, and 38 (63%) patients that underwent primary knee arthroplasty with mean age (65,4 + 6,5). Group II (n=30), 18 (60%) patients that underwent primary total hip arthroplasty and 12 (40%) patients that underwent primary knee arthroplasty with mean age (65,5 + 8,1). Anesthesia algorithm did not differ for both groups. Results. Vital parameters and adverse effects in relation to spinal anesthesia were observed. Decrease of heart rate was more significant in group II. Blood pressure parameters were comparable to both groups though, 10% of Group I patients received infusion of norepinephrine for treatment of hypotension. The two groups were comparable with glucose and lactate variations as well as the duration of analgesia and postoperative nausea and vomiting. No postoperative delirium was noted in both groups. Conclusion. Spinal anesthesia with levobupivacaine is more safe for elderly patients undergoing knee and hip arthroplasty.

scholarly journals Comparative Effects of Total Intravenous Anesthesia with Propofol and Remifentanil Versus Inhalational Sevoflurane with Dexmedetomidine on Emergence Delirium in Children Undergoing Strabismus Surgery

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohamed E Oriby ◽  
Ayman Elrashidy
Keyword(s):  
Recovery Time ◽  
Pediatric Anesthesia ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Emergence Delirium ◽  
Group I ◽  
Group Ii ◽  
Postanesthetic Care Unit

Background: Emergence delirium (ED) is common after strabismus surgery due to postoperative visual disturbance, vomiting, and pain. Total intravenous anesthesia (TIVA) has many advantages like smooth emergence from anesthesia, decreased incidence of postoperative nausea and vomiting (PONV), and postoperative analgesia. Objectives: Our study aimed to compare the incidence of ED using inhalational sevoflurane with dexmedetomidine (DEX) versus TIVA with remifentanil. Methods: Eighty-four patients aged 3 - 11 years scheduled for strabismus surgery under general anesthesia were randomly allocated into two groups. Patients in group I received sevoflurane and DEX (group I, n = 42), while group II patients received TIVA with propofol and remifentanil infusion (group II, n = 42). Mean arterial pressure (MAP), heart rate (HR), and pulse oximetry (SpO2) were monitored before induction, at induction, and every 10 minutes during the surgery. In the postanesthetic care unit (PACU), pediatric anesthesia emergence delirium (PAED), face, legs, activity, cry, and consolability (FLACC), need for rescue analgesics, recovery time, level of parents’ satisfaction, and PONV were recorded. Results: Based on the results, HR and MAP significantly decreased 10 and 20 min after induction compared to baseline in group I after infusion of DEX. The incidence of PONV was significantly lower in group II than in group I, while the recovery time was significantly shorter in group I. The incidence of emergence delirium decreased in both groups. Conclusions: The use of either total intravenous anesthesia with propofol and remifentanil or sevoflurane inhalational anesthesia with dexmedetomidine resulted in a lower incidence of emergence delirium, although dexmedetomidine resulted in hypotension, bradycardia, and PONV.

A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA

2021 ◽  
pp. 48-50
Author(s):  
Niraj Kumar Mishra ◽  
Sushil Kumar
Keyword(s):  
Side Effects ◽  
Fetal Distress ◽  
Labour Pain ◽  
Sampling Procedure ◽  
Chi Square ◽  
Double Blind ◽  
Motor Weakness ◽  
Group I ◽  
Group Ii ◽  
Fetal Oxygenation

Introduction: Labour pain is among the most severe pain a woman can experience in her lifetime. Painful labour has decrimental effects on both mother and fetus leads to severe physical and psychological stress. Maternal hyperventilation in response to pain reduces fetal oxygenation and hypoventilation between contractions combined with decreased blood ow worsens fetal hypoxemia. It has been suggested that conning women to bed during labour may cause the labour to be longer and more painful with increase in abnormal presentation, instrumental deliveries and fetal distress. Aims And Objectives:The onset, quality and duration of their analgesic action. Incidence of unwanted effects like muscle weakness, hypotension, pruritus, nausea/vomiting, fetal bradycardia by the individual drugs. Materials And Methods: The study was conducted in the department of anesthesia, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Methods of collection of data (including sampling procedure if any) : After institutional committee approval and written informed consent from parturients and their relatives for the procedure the study was conducted and data were collected. Results: Duration of analgesia was found varying widely. It was 55±12.34 minutes in Group I whereas 75 ±14.36 minutes in Group II. The incidence of pruritus almost mild or negligible in both groups. The incidence of motor weakness in group II was 24 (80%) whereas in group I it was 10(33%). There was signicant statistics difference in motor weakness between two groups (p< 0.001) by Chi square test 9 with yate's correction. Other side effects differences between two groups were not statistically signicant. Summary And Conclusion:Both the drugs provided excellent quality of analgesia to the parturient in pain. The difference in duration of analgesia was signicant between the two groups statistically. Mean duration of analgesia lasted for 55 minutes in group I whereas in group II, it lasted for 75 minutes. Main side effects encountered in this study were motor weakness of longer duration in group II than in group I. Other side effects like nausea-vomiting were comparable to each other and were minimal in nature.

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

Comparison of the effectiveness of antibacterial therapy regimens in the treatment of asymptomatic bacteriuria during pregnancy

2018 ◽  
pp. 57-60
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Bacterial Infection ◽  
Asymptomatic Bacteriuria ◽  
Urine Specimen ◽  
Cultural Research ◽  
Group I ◽  
Group Ii ◽  
American Society ◽  
Practical Recommendations

The objective: to evaluate the effectiveness of the proposed therapy in pregnant women with asymptomatic bacteriuria. Materials and methods. All patients were divided into two groups. І group – 38 patients received the course of amoxicillin with clavulanic acid 625 mg per os twice a day for 7 days, group II – 33 patients received D-mannose (1.2 g), powder of 5.8 g in a sachet 2 times a day for 7 days. Diagnostic criteria for asymptomatic bacteriuria were based on practical recommendations of the American Society of Infectious Diseases. Results. In the first cultural research of the urine specimen (immediately after the end of the course of therapy), the percentage of microorganism’s persistence in the urinary tract of a woman was determined, in case of its detection, an additional course of treatment was prescribed. In the second and subsequent control urine samples, the percentage of relapsing bacteriuria was determined. Percentage of the persistence of the pathogen in the urinary tract among the treated women with bacteriuria remained rather low – 10.5% (4 patients) in group I, but higher than in group II 3.1% (1 patient). The percentage of sterile first urine sample was high and probably did not differ between groups – 31 (81.6%) and 32 (96.9%) women respectively in I and II groups. In the first group, the percentage of relapses during gestation after the diagnosed and treated bacteriuria remained rather high and amounted to 23.7% (9 patients), and in the second group, the relapse was not recorded. Conclusions. The 7-day course of therapy with the D-mannose drug is associated with fewer cases of persistent pathogenic pathogens in urine, no recurrence of bacterial infection, and no side effects. Key words: asymptomatic bacteriuria, D-mannose, urinary tract, pregnancy.

Effects of Propofol, Ketamine and their Combination (ketofol) as Total Intravenous Anesthesia (TIVA) on Haematological, Serum Biochemical and Hormonal Profile in the Surgical Management of Canine Patients

2021 ◽  
Author(s):  
Basanta Saikia ◽  
Kushal Konwar Sarma ◽  
Kalyan Sarma
Keyword(s):  
Body Weight ◽  
Anaesthetic Agent ◽  
Anaesthetic Machine ◽  
Hormonal Profile ◽  
Group Iii ◽  
Anaesthetic Agents ◽  
Group I ◽  
Biochemical Evaluation ◽  
Serum Biochemical ◽  
Group Ii

Background: The non-availability of the sophisticated anaesthetic machine and the necessary equipment to administer inhalant anaesthetic in the field hospitals make their use practically unfeasible for the field veterinarians. Therefore, the present study was undertaken to evaluate the effect of propofol, ketamine and their combination ‘Ketofol’ as a TIVA on certain haematological, serum biochemical and hormonal profiles in atropine and xylazine premedicated dogs. Methods: The study was conducted in eighteen clinical cases of dogs of either sex. The animals were randomly divided into three groups with six animals in each group. All the three groups were premedicated with Atropine sulphate @ 0.04mg/kg body weight and xylazine HCl @ 0.5mg/kg body weight intramuscularly. In group-I, propofol @ 5mg/kg body weight, in group-II, ketamine @ 5mg/kg body weight and in group-III, ketofol @ 4mg/kg body weight was administered intravenously for induction after 15 minutes of pre-anesthetic administration. Surgical anaesthesia was maintained for 90 minutes in all three groups viz. group-I, group-II and group-III with propofol @ 2.5mg/kg. b.w., ketamine @ 2.5mg/kg b.wt. and ketofol @ 2mg/kg b.wt. respectively by intermittent bolus injection (IBI) technique. Haematological, serum biochemical and hormonal profile were evaluated before administration of the anaesthetic agent (0 minutes) then at 15, 30, 60 and 90 minutes during and after administration of anaesthetic agents. Result: The study revealed that Hb, PCV and TEC were significantly decreased in all the groups at 60 mints and 30 mints respectively. The biochemical evaluation revealed that blood glucose level was significantly increased in all the groups until the end of the experiment. BUN and creatinine value was a significant increase in group-I and group-II than group-III at different time intervals up to the end of the experiment. In all the groups’ alanine aminotransferase (ALT) values significantly increased up to 60th minutes during TIVA whereas AST value was significantly increased in group-II at 30th and 60th minute of the experiment in compare to group-I and group-III. A higher level of cortisol values was recorded in group-I animals for the entire period of observation. There were no changes observed in the case of T3. Transient variables of haemato-biochemical have been reported following propofol, ketamine and their combination (ketofol) as total intravenous anaesthesia (TIVA). Thus, it has been concluded that diligent monitorization and electrolyte support are essential during the period of anaesthesia. 

scholarly journals A comparative clinical study of intrathecal hyperbaric bupivacaine with and without fentanyl for hysterectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 59-63
Author(s):  
Hari Poudel ◽  
Surinder Nath Bawa ◽  
Surendra Mohan Sharma
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Maximum Height ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Spinal anaesthesia has been widely used for lower abdominal surgeries like hysterectomy.Hyperbaric bupivacaine is the most extensively used local anesthetic. Addition of fentanyl can allow the reduction in the dose of bupivacaine, increase the height and duration of sensory blockade, and reduces complications of spinal anesthesia. Aims and Objective: The aim of the study was to examine whether adding fentanyl to hyperbaric bupivacaine would increase the height of sensory blockade, accelerate the onset of sensory blockade and increase the duration of the sensory blockade. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal that included hundred patients who underwent total abdominal hysterectomy. The patients were randomly allocated in two groups; Group I: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus normal saline 0.5 ml. Group II: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus 0.5 ml fentanyl (25 μg). Hemodynamic variables, onset of motor and sensory blockade, duration of sensory and motor blockade and any side effects were observed and recorded. Results: The highest and lowest sensory block in Group I was T-7 and T-9 whereas in Group II was T-5 and T-9 respectively. In group I, the mean onset till maximum height of sensory blockade was 7.04 min whereas in group II it was 5.96 min (P<0.00).There was no significant statistical difference in the incidence of side effects in both the groups. Conclusion: Intrathecal fentanyl with hyperbaric bupivacaine for spinal anesthesia significantly accelerated the onset of sensory blockade and increased its maximum height and duration.

Effects of the dopamine agonist cabergoline in patients with prolactinoma intolerant or resistant to bromocriptine

1996 ◽  
Vol 134 (4) ◽  
pp. 454-456 ◽  
Author(s):  
Etienne Delgrange ◽  
Dominique Maiter ◽  
Julian Donckier
Keyword(s):  
Internal Medicine ◽  
Side Effects ◽  
Dopamine Agonist ◽  
Side Effect ◽  
University Hospital ◽  
The Third ◽  
Group I ◽  
Resistant Group ◽  
Group Ii ◽  
Long Acting

Delgrange E, Maiter D, Donckier J. Effects of the dopamine agonist cabergoline in patients with prolactinoma intolerant or resistant to bromocriptine. Eur J Endocrinol 1996;134:454–6. ISSN 0804–4643 Cabergoline is a new long-acting ergoline derivative used to treat hyperprolactinaemia. Its effect was assessed in 10 patients (eight women and two men) with prolactinoma who were intolerant (group I; N = 7) or resistant (group II; N = 3) to bromocriptine. In group I, no side effect was observed on cabergoline therapy; two patients became pregnant and normoprolactinaemia was achieved in the five others. In group II, cabergoline was active and well-tolerated in two out of the three patients: one woman had three consecutive pregnancies; in another patient normoprolactinaemia was restored and the tumour shrank by 60%; in the third patient cabergoline was discontinued because of side effects and inefficacy. Thus, cabergoline appears to be an alternative of choice as treatment of hyper-prolactinaemic patients who are intolerant or resistant to bromocriptine. Julian Donckier, Internal Medicine and Endocrinology, University Hospital UCL of Mont-Godinne, B-5530 Yvoir, Belgium

Low-dose Gabapentin for Intractable Hiccups in a Heart Transplant Recipient

2011 ◽  
Vol 21 (4) ◽  
pp. 340-343 ◽  
Author(s):  
Robert L. Page ◽  
Megan Luna ◽  
Andreas Brieke ◽  
JoAnn Lindenfeld
Keyword(s):  
Side Effects ◽  
Transplant Recipient ◽  
Drug Interactions ◽  
Heart Transplant ◽  
Heart Transplant Recipient ◽  
Rapid Onset ◽  
Transplant Recipients ◽  
Onset Of Action ◽  
One Year ◽  
Intractable Hiccups

Intractable hiccups can be a serious complication in transplant recipients. Unfortunately, many of the pharmacotherapies used to stop hiccups are associated with severe side effects as well as drug-drug interactions with immunosuppressants. We report a case of a heart transplant recipient who had had intractable hiccups for 2 months, resulting in severe insomnia, diminished appetite, and weight loss. To treat the hiccups, treatment with oral baclofen (5–10 mg 3 times daily) was started. After 6 weeks of therapy, the baclofen was titrated down and discontinued because it had not stopped the hiccups and was causing severe central nervous system side effects. Gabapentin (100 mg twice daily) was then prescribed and within 24 hours of the start of that treatment, the hiccups had resolved completely. After 3 weeks of therapy, the patient had no side effects and the gabapentin was subsequently discontinued. One year after stopping the gabapentin, the patient remains free of hiccups. Gabapentin appears to be a promising medication for the treatment of intractable hiccups in thoracic transplant recipients because of its lack of serious side effects at low doses, rapid onset of action, and lack of drug-drug interactions with transplant medications.

Sign in / Sign up

Export Citation Format

Share Document