scholarly journals COMPARISON OF SINGLE BOLUS DOSE OF DEXMEDETOMIDINE WITH BOLUS PLUS CONTINUOUS INFUSION OF DEXMEDETOMIDINE ON CHARACTERISTIC OF SPINAL ANAESTHESIA WITH HYPERBARIC BUPIVACAINE

2016 ◽  
Vol 3 (85) ◽  
pp. 4609-4616
Author(s):  
Jigar Ashokkumar Rupareliya ◽  
Rajesh Vitthalrao Nagmothe
2020 ◽  
Vol 5 (1) ◽  
pp. 970-975
Author(s):  
Bandana Paudel ◽  
Pramod Rai ◽  
Robins Tiwari ◽  
Sanjay Gautam ◽  
Sumitra Paudel ◽  
...  

Introduction: The use of intrathecal adjuvants in spinal anaesthesia in enhancing and prolonging it’s action has been well established and is widely used for surgery below the umbilicus. Dexmedetomidine, a selective α2A receptor agonist is a suitable adjuvant due to its selective activity. Objectives: To evaluate the effect of a single bolus dose of intravenous dexmedetomidine as an adjuvant in cases undergoing lower limb surgeries under spinal anaesthesia. Methodology: One hundred patients posted for lower limb surgery under spinal anaesthesia with hyperbaric bupivacaine, were equally divided into two groups. In group D, in addition to spinal, intravenous dexmedetomidine 0.5mcg/kg over 10 min was given whereas group C patients received spinal and intravenous normal saline . Results: The onset of sensory and motor block was faster in group D (2.09 ± 0.71 min, 3.18 ± 1min)compared to group C (3.5 ± 0.82 min, 6.19 ± 1.87 min) which was statistically significant . The duration of sensory and motor block was also significantly prolonged in Group D (174.5 ± 14.04 min, 133.4 ± 10.42 min) as compared to Group C(138.2 ± 11.51 min, 120.4 ± 8.8 min).The duration of analgesia in Group D (225.3 ±20.11 min)was prolonged when compared to Group C (168.3 ± 15.11). Conclusion: Intravenous dexmedetomidine as a single bolus dose before spinal anaesthesia can fasten the onset of sensory and motor block, prolongs the duration of sensory and motor block and also increased the duration of analgesia.


2016 ◽  
Vol 3 (1) ◽  
pp. 8-12
Author(s):  
Manjunath Reddy ◽  
Archana Byadarahalli Narayanappa ◽  
Sreenivasa Babu

Background: To prolong the effect of spinal anaesthesia into the postoperative period many pharmacological agents are being used intrathecally and intravenously. The present study was designed to assess the effects of single bolus dose of intravenous Dexmedetomidine on spinal anaesthesia and analgesia in patients undergoing lower abdominal surgeries under spinal anaesthesia with 0.5% Hyperbaric Bupivacaine.Methods: One hundred patients posted for lower abdominal surgeries under spinal anaesthesia were randomly allocated to two groups. Group D (study group) patients received single bolus dose of 0.5mcg/kg of intravenous Dexmedetomidine and Group C (control group) received 10ml of normal saline. Variation in the onset, duration of sensory and motor level, duration of analgesia, effect on sedation and side effects were recorded.Results: The duration of sensory block and two segment regression was significantly prolonged in Group D (189.90±7.66 minutes, 104±20.6 minutes) as compared to Group C (145.60±11.98 minutes, 75±22.5 minutes). The onset of sensory block was earlier in Group D then compared to Group C which was statistically significant. The duration of analgesia in Group D (218.8 ± 11.36 minutes) was prolonged when compared to Group C (178.6±17.96 minutes). Sedation score and incidence of bradycardia was high in Group D when compared to Group C.Conclusion: Single bolus dose of IV Dexmedetomidine prior to spinal anaesthesia prolongs the duration of sensory block and duration of analgesia with satisfactory arousable sedation and acceptable side effects.


2019 ◽  
Vol 22 (1) ◽  
pp. 4-9
Author(s):  
Liudmila A. Suplotova ◽  
Valeria A. Avdeeva ◽  
Ekaterina A. Pigarova ◽  
Liudmila Y. Rozhinskaya

Background: The lack of a unified approach to the treatment of deficiency and vitamin D deficiency stimulated a detailed study of the dynamics of indicators of phosphorus-calcium metabolism, parathyroid hormone, 25(OH)D (calcidiol). Aim: To evaluate the pharmacokinetic properties of colecalciferol at a dosage of 150 000 IU, from the standpoint of its efficacy and safety in clinical practice. Materials and methods: Observational, single-center, prospective, selective, uncontrolled study of a comprehensive assessment of the pharmacokinetic properties of a single saturating dose of 150 000 IU of colecalciferol. To assess the pharmacokinetic properties of colecalciferol at a dosage of 150 000 IU, we set efficacy and safety criteria. The criterion for the effectiveness of treatment was to achieve an adequate level of vitamin D (more than 30 ng / ml at the initial insufficient level and more than 20 ng / ml for patients with vitamin D deficiency). The safety criteria for the correction of vitamin D deficiency or deficiency were the absence of patient complaints, adverse events and / or serious adverse events, as well as the preservation of the main laboratory parameters of phosphorus-calcium metabolism within the reference values. Results: When studying the efficacy of a dose of 150 000 IU in patients with vitamin D deficiency and insufficiency, it was found that the level of calcidiol was significantly higher in the group after treatment with colecalciferol compared with the group before treatment (p 0.05). The peak of the maximum value for patients with deficiency was established on the 14 day from the moment of administration of colecalciferol and was 37.1 6.28 ng / ml, and for patients with initial vitamin D deficiency 40.1 3.71 ng / ml. In the study of the safety of colecalciferol in a bolus dose of 150 000 IU, there were no statistically significant differences in the laboratory parameters of calcium-phosphorus metabolism, both in the group before treatment and after correction of deficiency and vitamin D insufficiency in both groups. Conclusion: Colecalciferol in the form of a single bolus dose of 150 000 IU demonstrated its efficacy and safety in real clinical practice.


Author(s):  
Sun-Joon Bai ◽  
Ki-Young Lee ◽  
Sung Soo Kim ◽  
Jung Hwa Hong ◽  
Hoon Jae Nam ◽  
...  

There is a lack of data comparing sugammadex with anticholinesterase for the quality of anaesthesia recovery, especially following a single bolus dose of rocuronium. Thus, we evaluated the influence of reversal with sugammadex or neostigmine on post-operative quality of recovery by using the Post-operative Quality Recovery Scale (PQRS). A total of 86 patients undergoing trans-pars plana vitrectomy (TPPV) under general anaesthesia were intubated following a single bolus dose of rocuronium (0.6 mg/kg). At the end of surgery, patients were received either neostigmine or sugammadex. The quality of recovery was assessed using the PQRS at 15 minutes and 40 minutes after surgery, and on post-operative day 1. The recovery rate in the physiological domain was higher in the sugammadex group at 15 minutes after surgery (P = 0.02). Though there were no significant differences in the overall cognitive recovery domain, patients in the sugammadex group could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the PQRS. The use of sugammadex may increase the quality of the post-operative physiological recovery at early post-operative periods compared with neostigmine use following a single bolus dose of rocuronium in patients undergoing TPPV with general anaesthesia.


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