scholarly journals Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study

2020 ◽  
Author(s):  
Ying Yu ◽  
Yunqian Li ◽  
Zheng Jin ◽  
Fan Chen
Keyword(s):  
Retrospective Study ◽  
Normal Saline ◽  
Saline Group ◽  
Intracranial Tumor ◽  
Tumor Surgery ◽  
Normal Saline Group ◽  
Mortality And Morbidity ◽  
Delayed Cerebral Vasospasm ◽  
Significant Difference

Abstract Background：Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery.Methods：Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge.Results：We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05).Conclusions：Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.

scholarly journals Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study

2020 ◽  
Author(s):  
Ying Yu ◽  
Yunqian Li ◽  
Zheng Jin ◽  
Shuai Zhao ◽  
Fan Chen
Keyword(s):  
Retrospective Study ◽  
Cerebral Vasospasm ◽  
Normal Saline ◽  
Saline Group ◽  
Intracranial Tumor ◽  
Tumor Surgery ◽  
Normal Saline Group ◽  
Delayed Cerebral Vasospasm ◽  
Significant Difference

Abstract Background：Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery.Methods：Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge.Results：We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05).Conclusions：Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.

scholarly journals Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery,a retrospective study

2020 ◽  
Author(s):  
Ying Yu ◽  
Yunqian Li ◽  
Zheng Jin ◽  
Fan Chen
Keyword(s):  
Retrospective Study ◽  
Cerebral Vasospasm ◽  
Normal Saline ◽  
Saline Group ◽  
Intracranial Tumor ◽  
Tumor Surgery ◽  
Normal Saline Group ◽  
Delayed Cerebral Vasospasm ◽  
Significant Difference

Abstract Background Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery. Methods Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge. Results We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4–7 days and 5 between 8–14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05). Conclusions Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.

scholarly journals Effects of prophylactic ketamine and pethidine to control postanesthetic shivering: A comparative study

2018 ◽  
Vol 5 (12) ◽  
pp. 2898-2903 ◽  
Author(s):  
Masoum Khoshfetrat ◽  
Ali Rosom Jalali ◽  
Gholamreza Komeili ◽  
Aliakbar Keykha
Keyword(s):  
Normal Saline ◽  
Pearson Correlation ◽  
Saline Group ◽  
Normal Saline Group ◽  
Chi Square ◽  
Double Blind ◽  
Postanesthetic Shivering ◽  
Significant Difference ◽  
The Mean ◽  
One Way Anova

Background: Shivering is an undesirable complication following general anesthesia and spinal anesthesia, whose early control can reduce postoperative metabolic and respiratory complications. Therefore, this study aims to compare the effects of prophylactic injection of ketamine and pethidine on postoperative shivering. Methods: This double-blind clinical trial was performed on 105 patients with short-term orthopedic and ENT surgery. The patients were randomly divided into three groups; 20 minutes before the end of the surgery, 0.4 mg/kg of pethidine was injected to the first group, 0.5 mg/kg of ketamine was injected to the second group, and normal saline was injected to the third group. After the surgery, the tympanic membrane temperature was measured at 0, 10, 20, and 30 minutes. The shivering was also measured by a four-point grading from zero (no shivering) to four (severe shivering). Data were analyzed by one-way ANOVA, Kruskal Wallis, Chi-square and Pearson correlation. Results: The mean age of patients was 35.8+/-11.45 years in the ketamine group, 34.8+/-11.64 years in the normal saline group, and 33.11+/-10.5 years in the pethidine group. The one-way ANOVA showed no significant difference in the mean age between the three groups (P=0.645). The incidence and intensity of shivering were significantly higher in the normal saline group than in the ketamine and pethidine groups (p=0.001). However, there was no significant difference in the incidence and the intensity of shivering between the ketamine and the pethidine groups (p=0.936). Conclusion: The results showed that the 0.5 mg/kg of ketamine could control the post-anesthetic shivering.  

Comparison between Nalbuphine and Ketamine as an adjuvant to Heavy Bupivacaine on Post Dural Puncture Headache

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammad A El Gendy ◽  
Gamal M Elewa ◽  
Mina Z Wadea ◽  
Ashraf M Hazem
Keyword(s):  
Spinal Anesthesia ◽  
Normal Saline ◽  
Dural Puncture ◽  
Sensory Block ◽  
Saline Group ◽  
Controlled Study ◽  
Normal Saline Group ◽  
Hyperbaric Bupivacaine ◽  
Post Dural Puncture Headache ◽  
Significant Difference

Abstract Background Incidence of post dural puncture headache (PDPH) is relatively high, and many methods have been tried to prevent or treat it, but results are not satisfactory. Both Nalbuphine and Ketamine have analgesic effects, and have been used intrathecally with local anesthetics, but their effects on PDPH were not studied. Objective To study the incidence and severity of PDPH when nalbuphine or ketamine was added as an adjuvant to hyperbaric bupivacaine in spinal anesthesia (primary outcome). Secondary outcomes were the effects of adding nalbuphine or ketamine as an adjuvant to hyperbaric bupivacaine on motor and sensory effects, duration of analgesia, hemodynamics and side effects of both of them. Patients and Methods This prospective double-blind, randomized controlled study was conducted on 320 patients, aged 21–60 years of both sexes, ASA physical status I and II, and allocated for lower abdominal, pelvic, or lower limb surgeries under spinal anesthesia, after approval from ethical committee (Assurance No. FWA 000017585) of Faculty of Medicine, Ain, Shams University, Cairo, Egypt. Contact with 17 patients was lost. So, 303 patients completed the study. Patients were divided into 3 equal groups (101 each) according to drugs injected intrayhecally. Group (N): 3 ml of 0.5% hyperbaric bupivacaine with 0.5 mg nalbuphine hydrochloride diluted in 0.5 ml normal saline. Group (K): 3 ml of 0.5% hyperbaric bupivacaine with 25 mg ketamine hydrochloride diluted in 0.5 ml normal saline. Group (C): 3 ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline. Results Incidence of PDPH was statistically significantly less in group N in comparison to Groups K and C, in the first day. But, no statistically significant difference was found between the three groups at 2nd and 3rd days. There was no statistically significant difference between groups according to severity of PDPH by visual analog score (VAS). Group N has the most rapid onset and long duration of sensory block in comparison with groups K and C. There was no statistically significant difference between groups according to onset and duration of motor block and hemodynamic changes. Conclusion Adding nalbuphine, and not ketamine, with hyperbaric bupivacaine in spinal anesthesia decreased incidence of post dural puncture headache, and prolonged the duration of sensory block. Both groups provided adequate anesthesia and analgesia with good hemodynamic stability.

scholarly journals The Effect of Preparing Dialysis Machine Using Normal Saline-Heparin on the Dialysis Adequacy of Hemodialysis Patients: A Crossover, Two-Group, and Randomized Clinical Trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Seyed Reza Borzou ◽  
Hiva Azami ◽  
Mahmood Gholyaf ◽  
Leili Tapak ◽  
Tayebeh Nazari Doust
Keyword(s):  
Normal Saline ◽  
Saline Group ◽  
Hemodialysis Patients ◽  
Normal Saline Group ◽  
Heparin Group ◽  
Dialysis Adequacy ◽  
Significant Difference ◽  
Before And After ◽  
Stage Renal Disease ◽  
Hemodialysis Machine

Background: Patients with end-stage renal disease (ESRD) need adequate dialysis. Thus, identification of the ways to enhance dialysis adequacy is very important. Objectives: The present study was conducted to examine the effect of preparing a dialysis machine using a normal saline heparin method on the dialysis adequacy of hemodialysis patients. Methods: This study was conducted in Hamadan in 2019. A total of 36 patients with hemodialysis were selected using convenience sampling who were assigned to the control and intervention groups. The hemodialysis machine was primed for one month using a routine method (control) and one month using a normal saline-heparin method (intervention). Urea reduction ratio (URR) and Kt/V indices were calculated at the beginning and end of each month in the intervention and control groups. Data were analyzed using paired and independent t-test. Results: In the normal saline-heparin group, KT/V showed a statistically significant difference before and after the treatment (P = 0.013), as well as an increase in the KT/V. The URR as the mean dialysis adequacy showed a statistically significant difference (P = 0.004) between the normal saline group and the normal saline-heparin group before and after the treatment. Moreover, URR in the normal saline-heparin group increased after the treatment. In the normal saline treatment group, KT/V and URR decreased after the treatment. In the normal saline group, URR decreased after the treatment. Conclusions: Applying the hemodialysis machine preparation with a normal saline-heparin method increased dialysis adequacy in the patients who underwent hemodialysis.

scholarly journals Prevention of Succinylcholine Induced Postoperative Myalgia by Pretreatment with Lignocaine: A Randomized Controlled Study

2020 ◽  
Vol 14 (1) ◽  
pp. 13-15
Author(s):  
Muhammad Sazzad Hossain ◽  
Lipika Sanjowal ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Devashis Saha
Keyword(s):  
Normal Saline ◽  
Muscle Relaxant ◽  
Isotonic Saline ◽  
Saline Group ◽  
Controlled Study ◽  
Double Blind Study ◽  
Normal Saline Group ◽  
Duration Of Action ◽  
Randomized Controlled ◽  
Significant Difference

Succinylcholine, a depolarizing muscle relaxant possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects such as fasciculation and myalgia. The aim of this study was to investigate the prophylactic effect of intravenous lignocaine on the incidence and severity of succinylcholine-induced postoperative myalgia. This was a randomized controlled double blind study conducted at National Institute of ENT Dhaka, during September to December 2017. Eighty adult patients of American Society of Anesthesiologists status I and II of both sexes for elective surgery under general anesthesia were randomly allocated into two equal groups, lignocaine group and normal saline group. The patients of lignocaine group were pretreated with lignocaine 1.5 mg/kg body weight in 5 ml volume, while patients of normal saline group were given isotonic saline 0.9% in the same volume (5 ml) intravenously. Thereafter, anesthesia was induced in all patients, by injecting 1.5 mg/kg of fentanyl and 2 mg/kg of propofol intravenously. Following the loss of eyelid reflex, 1.5 mg/kg of succinylcholine was injected intravenously as a muscle relaxant and then the patients were intubated. The incidence and severity of myalgia were assessed by a blinded observer 24 hours after surgery. In terms of demographic data, the results of this study showed that there is no significant difference between patients in both groups (P>0.05). Overall, the incidence and severity of succinylcholine-induced myalgia in lignocaine group was significantly less, when compared with normal saline group (P<0.05). Pretreatment with intravenous lignocaine is effective in prevention of postoperative succinylcholine induced myalgia. Faridpur Med. Coll. J. Jan 2019;14(1): 13-15

scholarly journals Effect of topical furosemide on sinonasal polyposis relapse after endoscopic sinus surgery

2020 ◽  
Vol 7 (1) ◽  
pp. 101
Author(s):  
Souvagini Acharya ◽  
Alka Kapil ◽  
Kamalini Bepari ◽  
Sandrendu Rajan ◽  
Prachi Mohapatra ◽  
...  
Keyword(s):  
Normal Saline ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Statistical Significance ◽  
Saline Group ◽  
Sinus Surgery ◽  
Randomised Control Trial ◽  
Normal Saline Group ◽  
Sinonasal Polyposis

<p class="abstract"><strong>Background: </strong>Chronic rhinosinusitis with nasal polyposis (CRSwNP) relapse is commonly seen during follow up period after endoscopic sinus surgery. Some studies claim the credibility of topical furosemide in preventing the polyposis recurrence after surgery. This randomised control trial was done to check the effectiveness of topical furosemide on sinonasal polyposis relapse after the endoscopic sinus surgery.</p><p class="abstract"><strong>Methods:</strong> In the current study, 44 patients, attending ENT department, VSSIMSAR, for follow up after endoscopic sinus surgery, were evaluated clinically and endoscopically to demonstrate the prevalence and severity of polyposis relapse using Visual analogue scale (VAS) and meltzer endoscopic grading, before initiating the intervention. Patients were then randomised in two groups- one receiving topical furosemide nebulization and other intranasal normal saline spray, respectively. All patients were evaluated again at 1st, 2nd, 4th and 6th month follow-ups by VAS and MEG, setting statistical significance at p&lt;0.05.</p><p class="abstract"><strong>Results:</strong> The MEG was grade 0 in 77% (17) patients of furosemide group and 32% (7) of normal saline group (p=0.0147). Statistically significant improvement was also observed in VAS for nasal symptoms in former group (p=0.028) than latter. The rate of relapse was less (23.81%) in furosemide group as compared to normal saline group (65%) but result not statistically significant at p&lt;0.05.</p><p class="abstract"><strong>Conclusions:</strong> Topical furosemide can be used as a valid therapeutic approach for reducing the severity of sinonasal polyposis relapse after endoscopic sinus surgery with no known side effects of furosemide when administered topically.</p><p> </p>

The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

2020 ◽  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Normal Saline ◽  
Saline Group ◽  
Normal Saline Group ◽  
Hypertensive Patients ◽  
Group A ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

scholarly journals Outcome of the use of 0.9% saline versus 0.45% saline for fluid rehydration in moderate and severe diabetic ketoacidosis in children

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Nora El Said Badawi ◽  
Mona Hafez ◽  
Heba Sharaf Eldin ◽  
Hend Mehawed Abdelatif ◽  
Shimaa Atef ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Normal Saline ◽  
Sodium Concentration ◽  
Saline Group ◽  
Serum Electrolytes ◽  
Serum Chloride ◽  
Significant Difference ◽  
Rehydration Solution ◽  
The Moment

Abstract Background The debate for the optimum sodium concentration in the rehydration solution in diabetic ketoacidosis (DKA) persists till the moment. The aim was to compare the outcome of 0.9% saline versus 0.45% saline in children with moderate and severe (DKA) regarding the effect on serum electrolytes, duration of DKA resolution and the incidence of hyperchloremia. Results A retrospective analysis of 121 children with moderate or severe DKA was done. After the initial 4 h in which both groups received normal saline, patients were divided into two groups continuing on 0.9% (N=72) or switched to 0.45% saline (N=49). Serum chloride and Cl/Na ratios were significantly higher in 0.9% saline group at 4 and 8 h. The 0.9% saline group had significantly higher proportion of hyperchloremia at 4 and 8 h (P value: 0.002, 0.02). The median duration of correction of DKA (14 h among 0.9% saline versus 10 h among 0.45% saline) without significant difference (P value= 0.43). The change in plasma glucose, effective osmolarity, corrected Na levels were comparable between groups. Conclusion There is an unavoidable iatrogenically induced rise in serum chloride with higher incidence of hyperchloremia with the use of normal saline in rehydration of children presenting in DKA and shock. The use of 0.45% saline as post-bolus rehydration fluid is not associated with a decline in the corrected serum sodium concentration and does not affect the rate of correction of acidosis or rate of drop in blood glucose or duration of DKA resolution when compared to normal saline.

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