scholarly journals Effect of oral clonidine premedication on hemodynamic responses during laparoscopic cholecystectomy

2017 ◽  
Vol 5 (7) ◽  
pp. 2982
Author(s):  
Anshu Mali ◽  
Unnati Asthana ◽  
Jai Prakash ◽  
Nandini Londhe ◽  
Suhail Bandey ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Age Group ◽  
Moderate Sedation ◽  
Oral Clonidine ◽  
Haemodynamic Parameters ◽  
Haemodynamic Changes ◽  
Elective Laparoscopic Cholecystectomy ◽  
Baseline Values ◽  
Double Blinded

Background: Laparoscopic cholecystectomy has rapidly revolutionized gall bladder surgeries and has now become the gold standard for the treatment of cholelithiasis. Even though it has several advantages, creation of pneumoperitoneum for the surgical procedure can have several adverse haemodynamic and respiratory consequences. Thus, the present study was designed to evaluate the type and extent of haemodynamic changes associated with laparoscopic surgery and also to find out the efficacy of oral clonidine premedication in attenuation of such haemodynamic changes.Methods: In this prospective, randomized, double blinded comparative study, 60 patients between 18-60 years age group, belonging to ASA 1 and ASA 2 categories scheduled for elective laparoscopic cholecystectomy under general anaesthesia were categorized into 2 groups as Group C and Group P with 30 patients in each group. Patients in Group C received premedication with oral clonidine 150μg and Group P received Tab. Vitamin C, 90 minutes prior to surgery. The two groups were compared with respect to haemodynamic parameters and sedation scores.Results: There was significant increase in all the haemodynamic variables in group P as compared to group C where the variables remained close to baseline values and patients in Group C had mild to moderate sedation without causing respiratory depression.Conclusions:Oral premedication with clonidine effectively attenuates the haemodynamic response to pneumoperitoneum and also provides sedation without respiratory depression, thus reducing anaesthetic requirement. 

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (05) ◽  
pp. 699-706
Author(s):  
HEMMATPOOR BEHZAD ◽  
MAHVAR TAYEBEH ◽  
MAKHSOSI BEHNAM REZA ◽  
Saeb Morteza
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Rating Scale ◽  
Controlled Study ◽  
P Value ◽  
Medical Sciences ◽  
Preoperative Administration ◽  
Elective Laparoscopic Cholecystectomy ◽  
Double Blinded ◽  
To Receive

Background: shoulder pain after laparoscopic procedure is a frequent complication encountered in surgery ward. Severaltreatments have been proposed to reduce it. This study aimed to evaluate the efficacy of preoperative administration of gabapentin inpreventing and attenuating Post Laparoscpoic Shoulder Pain (PLSP) after laparoscopic cholecystectomy. Design: In a randomised,double blinded placebo controlled study. Setting: Woman's Hospital, Kermanshah University of Medical Sciences. Period: April 2011 toMarch 2012. Material and methods: 90 patients of ASA physical status I-II undergoing elective laparoscopic cholecystectomy wererandomly allocated to receive gabapentin 600 mg or placebo ,half an hour before surgery. The presence analgesia and side effects wererecorded for 12h postoperatively in same times. Results: Incidence Verbal Rating Scale (VRS) ≥ 4 at different times after arrival to PACUwere significantly lower in gabapentin group in arrival (P Value= 0.003) and then after 30 miniute (P Value= 0.02) and 2 (P Value=0.003), 4 (P Value= 0.03) and 6 (P Value= 0.04) hours after arrival to Post Anesthesia Care Unit (PACU). But this sigificancy lost at 12hours (P Value= 0.07) after arrival to PACU. Also there was a reduction in amounts of postoperative in ward analgesic consumption. Sideeffects were not different between two groups. Conclusions: 600 mg gabapentin as premedication is effective and safe for reducing postlaparoscopicshoulder pain intensity after general laparoscopy compared with placebo.

Prospective, Double-Blinded, Randomized, Placebo-Controlled Comparison of Local Anesthetic and Nonsteroidal Anti-Inflammatory Drugs for Postoperative Pain Management after Laparoscopic Surgery

2007 ◽  
Vol 73 (6) ◽  
pp. 618-624 ◽  
Author(s):  
William Newcomb ◽  
Amy Lincourt ◽  
William Hope ◽  
Thomas Schmelzer ◽  
Ronald Sing ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Length Of Stay ◽  
Oral Administration ◽  
Local Anesthetic ◽  
Local Infiltration ◽  
Elective Laparoscopic Cholecystectomy ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Double Blinded

Compared with the open approach, laparoscopy has been shown to significantly reduce postoperative pain. Improving postoperative analgesia in laparoscopic surgery is an area of continued interest. The goal of this study was to compare the efficacy of local anesthetic infiltration with or without preoperative nonsteroidal anti-inflammatory drugs. Patients undergoing elective laparoscopic cholecystectomy were enrolled in an Institutional Review Board-approved, prospective, double-blinded, randomized, placebo-controlled comparison study. Patients were randomized into four groups: Group I, preoperative oral administration of a placebo medication and prein cision local infiltration of 40 mL of 0.5 per cent bupivicaine at trocar sites; Group II, preoperative oral administration of 50 mg of rofecoxib; Group III, preoperative oral administration of 50 mg of rofecoxib and preincision local infiltration of 40 mL of 0.5 per cent bupivicaine into skin, muscle, and peritoneum; and Group IV, preoperative oral administration of a placebo medication. Postoperative pain scores were assessed at 4 hours, 8 hours, 12 hours, and 24 hours using a visual analog scale. Postoperative analgesic use, complications, and length of stay were recorded. Statistical significance was defined as P < 0.05. Fifty-five patients (46 women and 9 men) were enrolled in this study and underwent a standardized, elective, laparoscopic cholecystectomy for mild, symptomatic cholelithiasis (96.4%) and gallbladder polyps (3.6%). No patient had pain immediately before surgery. Postoperative analgesic requests, visual analog scale results, incidence of postoperative vomiting at 4 hours, 8 hours, 12 hours, and 24 hours, in addition to length of stay, were not statistically different between the four groups. No complications occurred. The use of preoperative rofecoxib, 0.5 per cent bupivicaine infiltration, or both for postoperative analgesia did not decrease postoperative pain or decrease length of stay after laparoscopic cholecystectomy compared with placebo. Preoperative administration of an oral anti-inflammatory pain medication, infiltration of a local anesthetic, or both had no greater effect than placebo in controlling discomfort after a laparoscopic cholecystectomy. The challenge of preempting postoperative pain continues and will require further investigation.

COMPARISON OF EFFECTIVENESS AMONG ONDANSETRON, PALONOSETRON AND GRANISETRON IN PREVENTING POSTOPERATIVE NAUSEAAND VOMITING FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 65-67
Author(s):  
Amrit Ghosh ◽  
Arabinda Mazumdar ◽  
Sujan Sarkar ◽  
Ashim Mandal ◽  
Debarshi Jana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Postoperative Vomiting ◽  
Medical College ◽  
Effective Prophylaxis ◽  
Elective Laparoscopic Cholecystectomy ◽  
Comparison Of Effectiveness ◽  
Double Blinded

Postoperative nausea and vomiting (PONV) has been variously described as the “big little problem” the “nal therapeutic challenge” for anaesthesiology. The commonest cause of morbidity after anaesthesia and surgery are pain and postoperative nausea vomiting 1. To compare the incidences of PONV following laparoscopic cholecyetectomy in different groups of patients receiving ondansetron, palonosetron and Granisetron. 2. To identify the better strategy for prevention of PONV. This is a prospective randomized double blinded clinical study. Both patient and observer were blinded to the group allocation. Allocations to three groups were strictly condential and concealed. One and half year (18 months). Patients undergoing elective laparoscopic cholecystectomy under General Anaesthesia at General Surgery operation theatres of Bankura Sammilani Medical College and Hospital, Bankura The effects of palonosetron, granisetron and ondansetron in preventing PONV (postoperative nausea vomiting) were compared in patients undergoing laparoscopic cholecystectomy and it was found that palonosetron was best and granisetron better in comparison with ondansetron in preventing postoperative nausea and vomiting. Palonosetron provides more effective prophylaxis of early PON (postoperative nausea), late PON (postoperative nausea), and late POV (postoperative vomiting) compared with granisetron and ondansetron. Palonosetron could provide effective prophylactic antiemetic control to prevent PONVafter laparoscopic cholecystectomy surgery under general anesthesia.

scholarly journals Experiencia en colecistectomía laparoscópica en el Hospital Dr. Verdi Cevallos Balda, Ecuador

2018 ◽  
Vol 2 (2) ◽  
pp. 61
Author(s):  
Rudy Zambrano Morales ◽  
Giancarlos Ponce Moreno ◽  
Mónica Casanova Castillo
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Female Gender ◽  
Cross Sectional Study ◽  
International Standards ◽  
Cross Sectional ◽  
Palabras Clave ◽  
Internal Bleeding ◽  
Hospital Stays ◽  
Elective Laparoscopic Cholecystectomy

  La colecistectomía laparoscópica actualmente es considerada el gold standard para el tratamiento de colelitiasis y colecistitis aguda. Cada vez se ha introducido en más hospitales del Ecuador. En comparación con la colecistectomía convencional tiene grandes beneficios, en cuanto a menor morbilidad y mortalidad, menor estancia hospitalaria, menor tiempo de recuperación y reinserción laboral. Por estas razones, con el objetivo de registrar la curva de aprendizaje y experiencia en colecistectomía laparoscópica por primera vez, se llevó a cabo un estudio prospectivo descriptivo de corte transversal de 23 pacientes escogidos al azar entre febrero a junio 2015 en el Hospital Verdi Cevallos Balda. Se incluyeron los pacientes mayores de 18 años programados para colecistectomía laparoscópica electivas. El género predominante fue el femenino (78,26 %) con un promedio de edad de 42,35 años.  La principal indicación fue colelitiasis (86,85 %), otros hallazgos fueron empiema, pólipo vesicular, hemangioma hepático y hematoma subcapsular hepático roto. La tasa de conversión fue de 26 % (6 casos) y la principal causa fue una disección compleja (50 %). Hubo complicaciones en un paciente por sangrado. Durante los 4 primeros meses, siendo la primera experiencia en la institución respecto a cirugías laparoscópicas, se han obtenido resultados por debajo del promedio citado en la literatura, lo cual encamina a los cirujanos abdominales a mejorar sus habilidades dentro del campo de la colecistectomía laparoscópica, con el fin de alcanzar a corto plazo estándares internacionales.   Palabras clave: Vesícula biliar, colelitiasis, cirugía laparoscópica   Abstract   Laparoscopic cholecystectomy is currently considered the gold standard for the treatment of cholelithiasis and acute cholecystitis, and each time has been introduced in most hospitals in Ecuador. Compared with conventional cholecystectomy it has great benefits in terms of reduced morbidity and mortality, shorter hospital stays, shorter recovery time and reemployment. A prospective descriptive cross-sectional study of 23 patients randomly chosen from February to June 2015 was performed patients over 18 years scheduled for elective laparoscopic cholecystectomy. We performed 23 laparoscopic cholecystectomy electives. The female gender was predominant (78.26 %) with an average age of 42.35 years. The main indication was cholelithiasis (86.85 %), other findings were empyema, gallbladder polyp, liver hemangioma and hepatic subcapsular broken hematoma. The conversion rate was 26 % (6 cases) and the main cause was a complex dissection (50%). There was a complication in a patient, internal bleeding. During the first four months, with the first experience in the institution regarding laparoscopic surgeries they have been obtained results below average cited in the literature, which directs the abdominals to improve their skills in the field of laparoscopic cholecystectomy surgeons, in order to achieve short-term international standards.   Keywords: Gallbladder, cholelithiasis, laparoscopic cholecystectomy

scholarly journals PREVALENCE OF BACTERIOBILIA IN PATIENTS UNDERGOING ELECTIVE COLECYSTECTOMY

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
Rafael Soares de OLIVEIRA1 ◽  
Paula da SILVA ◽  
Carlos Alfredo Salci QUEIROZ ◽  
Juverson Alves TERRA-JÚNIOR ◽  
Eduardo CREMA
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
The Elderly ◽  
Single Type ◽  
Anesthetic Induction ◽  
Biliary Lithiasis ◽  
Bile Culture ◽  
Elective Laparoscopic Cholecystectomy ◽  
Main Factors ◽  
A Prospective Study

ABSTRACT Background: Cholelithiasis is one of the diseases with greater surgical indication. Currently, laparoscopic cholecystectomy is the gold standard in the treatment of cholelithiasis. Aim: To analyze the culture of bile from patients with cholelithiasis, mainly in the occurrence of brown and mixed stones. Methods: Was carried out a prospective study with 246 cases with biliary lithiasis who underwent elective laparoscopic cholecystectomy. Bile culture was performed in all. During anesthetic induction the patients received a single dose of intravenous cefazolin 1 g. At the end of the surgery, the gallbladder was punctured, its contents extracted and immediately placed in a sterile 20 ml propylene flask and promptly sent to bacterioscopy with Maconkey and blood agars. Incubation at 37° C for 24 h was carried out. A protocol was elaborated to include the main factors potentially related to cholelithiasis and the possible presence of associated bacterial infection. Results: Of the 246 patients, 201 had negative bile culture and 45 positive. Of the 45 patients with bacteriobilia, 34 had growth of a single type of bacterium in bile culture and 11 more than one. Conclusions: It was observed a relationship between bacteriobilia and age, suggesting that age is a risk factor for bacteriobilia. The use of antibiotic prophylaxis in the elderly is therefore recommended.

SOCIO-DEMOGRAPHIC PROFILE OF PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Suneet Katoch ◽  
Mukesh Kumar Jamwal ◽  
Sanjay Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Age Group ◽  
Female Ratio ◽  
Demographic Profile ◽  
Elective Laparoscopic Cholecystectomy ◽  
Male To Female

Background: In this study we evaluate the socio-demographic profile of patients undergoing elective laparoscopic cholecystectomy Methods: The present study was conducted at Department of Surgery, Dr RPGMC Kangra at Tanda. The 50 patients admitted for elective laparoscopic cholecystectomy, aging less than 75  years of both the genders were included Results: In the present study, mean age of the patients was 44.12±11.56 years B.In our study, majority of the patients (30%) were in age-group of 41-50 years followed by patients in age-group of 31-40 years (26%). 14% of the study subjects were aged more than 60 years while only 4% patients aged less than 20 years. 40% of the patients were male while 60% of the patients were female. Male to female ratio in the present study was 0.75:1. Conclusion: We concluded that a maximum patient in our study was 41-50 yrs age group female. Keywords: Age, sex, Cholelithiasis,  Cholecystectomy.

scholarly journals ORAL CLONIDINE AND ANAESTHESIA: EFFECT OF ORAL CLONIDINE PREMEDICATION ON HEMODYNAMIC CHANGES DURING LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 1-3
Author(s):  
Shyam Kishor Thakur ◽  
Satyeshwar Jha ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Cardiac Arrhythmias ◽  
Hemodynamic Changes ◽  
Hemodynamic Responses ◽  
Oral Clonidine ◽  
Adrenal Response ◽  
Elective Laparoscopic Cholecystectomy ◽  
Carbon Dioxide Co2

Background: Laryngoscopy and intubation are mandatory for patients undergoing general anesthesia. Direct laryngoscopy and intubation along with pneumoperitoneum with carbon dioxide (CO2) insufflation for laparoscopic surgery cause afferent sympatho-adrenal response, this causes increase in blood pressure (BP), heart rate (HR) and cardiac arrhythmias in some patients Oral Clonidine premedication has been recently shown to have a potential to prevent such harmful responses. Aim: To evaluate the efficacy of administration of oral Clonidine premedication to attenuate hemodynamic responses due to laryngoscopy, intubation and pneumoperitoneum during laparoscopic surgery. Methods: After taking informed consent, 200 patients were systematically randomised into two groups of 100 each. Patients were kept NPO 8 hours, after proper preanesthetic checkup before surgery. On morning of surgery Group C received Oral Clonidine150mcg premedication 90 minutes prior to induction in the preoperative room and Group P ,oral ranitidine150mg (Pacebo) premedication 90 minutes before shifting the patient immediately afterwards to the operation room. Results: Oral Clonidine premedication in a dose of 150 mcg orally before laryngoscopy and intubation effectively attenuates hemodynamic responses during intubation and pneumoperitoneum during elective laparoscopic cholecystectomy. Conclusion: Oral Clonidine150mcg premedication effectively attenuates hemodynamic responses during intubation and pneumoperitoneum during laparoscopic cholecystectomy.

scholarly journals Oral Clonidine in reduction of postoperative nausea and vomiting after laparoscopic cholecystectomy: A double blinded placebo controlled trial

2015 ◽  
Vol 1 (2) ◽  
pp. 76-79
Author(s):  
Sandip Bhandari ◽  
Madindra Basnet ◽  
Gentle Sunder Shrestha ◽  
Modh Nath Marhatta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Placebo Group ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Oral Clonidine ◽  
Prophylactic Use ◽  
Post Operative Nausea ◽  
Double Blinded

Background: The common adverse effects of laparoscopic cholecystectomy include nausea and vomiting. Surgical pneumoperitoneum can stimulate vagal response and induce the release of various emetogenic substances such as 5-hydroxytryptamine and acetylcholine. We hypothesized that oral Clonidine administered preoperatively reduces the post operative nausea and vomiting following laparoscopic cholecystectomy.Methodology: In a randomized, double-blinded placebo controlled study, seventy patients undergoing laparoscopic cholecystectomy were assigned to receive either oral Pyridoxine (placebo) or oral Clonidine 200?g 20-30 minutes before conduction of general anaesthesia. We assessed post operative nausea and vomiting and compared its incidence following laparoscopic cholecystectomy with prophylactic use of oral Clonidine or placebo. We also found out the requirements of rescue antiemetic medication (Ondansetron and Promethazine) for post operative nausea and vomiting after prophylactic use of oral Clonidine or Placebo.Results: Three patients in Clonidine group and 12 patients in Placebo group vomited in first two hours. Likewise, 11 and 22 patients vomited in Clonidine and Placebo group over 24 hours respectively. In group Clonidine, 18 patients had nausea in first two hours and 20 patients had nausea over 24 hours. In group Placebo, 33 patients developed nausea in first two hours and over 24 hours. Ten patients in Clonidine group and 19 patients in Placebo group required Ondansetron as rescue antiemetics over 24 hours.Conclusion: Oral Clonidine given pre-operative to patients undergoing laparoscopic cholecystectomy decrease the incidence of post operative nausea and vomiting.Journal of Society of Anesthesiologists 2014 1(2): 76-79

Sign in / Sign up

Export Citation Format

Share Document