scholarly journals Comparison of Pethidine and Dexmedetomidine for the Control of Intraoperative Shivering Under Spinal Anesthesia

2020 ◽  
Vol 5 (1) ◽  
pp. 96-99
Author(s):  
Viral Prakashkumar Patel ◽  
Shital Hardik Halvadia
Keyword(s):  
Spinal Anesthesia ◽  
Statistical Difference ◽  
Bolus Dose ◽  
Randomized Study ◽  
Study Groups ◽  
Sedation Score ◽  
Intravenous Bolus ◽  
Grade 3 ◽  
Time Required ◽  
Group D

Background: Spinal anesthesia significantly impairs the thermoregulation system by inhibiting tonic vasoconstriction, which plays a significant role in temperature regulation. Various non-pharmacological and pharmacological methods are available for the control of shivering during anesthesia. The present study was done with an aim to compare the two drugs Pethidine and Dexmedetomidine for the control of intraoperative shivering under spinal anesthesia.Subjects and Methods:A prospective randomized study was carried out in the Department of Anaesthesiology, on 100 patients who developed intra-operative shivering following spinal anesthesia for numerous surgical procedures. When patients developed shivering of higher than mentioned grades, they were randomly assigned to one of the 2 study groups: Group D- Dexmedetomidine group receiving single intravenous bolus dose of 0.5mcg/kg over 5 min.  Group P: Pethidine group patients receiving 0.5mg/kg Pethidine IV over 5 min. Patients were intently monitored for the failure of the drug, Recurrence of shivering and side effects like nausea, vomiting, bradycardia (< 50/min), hypotension (>20% of baseline), giddiness and sedation score were recorded.Results:We found the Pethidine group had 62.5% and Dexmedetomidine had 67.5% of grade 3 shivering. The grades of shivering were comparable between the two groups with no statistical difference. We found the dexmedetomidine group had a significant reduction in time required to control shivering and vanishing of shivering after drug.Conclusion:Both dexmedetomidine (0.5mcg/kg) and Pethidine (0.5mg/kg) are effective in treating patients with post-spinal anesthesia shivering but the time taken for control of shivering was shorter with Dexmedetomidine as compared to Pethidine.

COMPARISION OF ORAL PREGABALIN VERSUS BOLUS DOSE OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING THE HEMODYNAMIC RESPONSES DURING LARYNGOSCOPY, INTUBATION AND PNEUMOPERITONIZATION IN LAPROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED STUDY

2021 ◽  
pp. 74-77
Author(s):  
Jyoti Rani ◽  
Meenaxi Sharma ◽  
Deepak Kumar ◽  
Anumeha Jain
Keyword(s):  
Blood Pressure ◽  
Normal Saline ◽  
Bolus Dose ◽  
Pressor Response ◽  
Randomized Study ◽  
Intravenous Bolus ◽  
Hemodynamic Parameters ◽  
Randomised Study ◽  
Placebo Tablet ◽  
Group D

Background: Laryngoscopy, intubation and pneumoperitoneum during general anaesthesia are severe noxiousstimuli that can produce many adverse effects. Aim of the study was to compare the efcacy of oral pregabalin versus intravenous bolus dose of dexmedetomidine as premedication for attenuating the haemodynamic pressor response during intubation, pneumoperitonization and extubation as well as perioperative stability and requirement of postoperative analgesics. Methods: A Randomised study was conducted in 100 patients undergoing Laparoscopic Cholecystectomy. Participants were divided into two groups in which group P (n=50) received oral pregabalin 150mg with sips of water 1 hour prior to surgery and intravenous normal saline (0.9%) 10ml, 10 mins prior to induction over 10 minutes and those in group D (n=50) received oral placebo tablet with sips of water 1 hour prior to surgery and intravenous dexmedetomidine at 1mcg/kg diluted with normal saline (total volume 10ml), 10 minutes prior to induction over 10 minutes. Hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), oxygen saturation (SPO2) and ETCO2 were noted before premedication and induction (baseline), at the end of induction and at laryngoscopy and intubation (I0) and then at 1,3,5,10 minutes after intubation as well as atstart of pneumoperitoneum and then after every 10 minutesinterval till the deation of CO2 and also at the time of extubation and 10 minutes thereafte

scholarly journals Compare the Effects of Dexmedetomidine Infusion versus Normal Saline as Placebo on Haemodynamic Response in Elective Laparoscopic Surgery Under General Anaesthesia

2020 ◽  
Vol 5 (2) ◽  
pp. 1-8
Author(s):  
V. Ravi Sankar ◽  
T. Jamuna ◽  
B. Raju
Keyword(s):  
Laparoscopic Surgery ◽  
Normal Saline ◽  
Bolus Dose ◽  
Sedation Score ◽  
Surgical Patients ◽  
Rescue Analgesia ◽  
Significant Group ◽  
Haemodynamic Stress ◽  
Group D ◽  
Dexmedetomidine Infusion

Background: Throughout the present medical age, laparoscopic surgery is the most effective diagnostic and therapeutic methods. But it is associated with potentially harmful neuroendocrine response. Subjects and Methods: In our study we used dexmedetomidine infusion in group D and normal saline at a rate of 0.4mcg / kg / hr as placebo in group N beginning from 10 minutes before induction before pneumoperitoneum release. Patients in both groups were alike in age, gender, BMI, grade of ASA and anaesthesia. Results: After 10 min infusion of dexmedetomidine and normal saline in group D and group N respectively, fall in HR, DBP and Mean arterial pressure was significantly increased in group D compared to group N. Difference found in both the groups was statistically significant. Group N showed significant increase in HR, SBP, DBP and MAP during laryngoscopy, intubation and at 2 min , 5 min and 10 min after creation of pneumoperitoneum. Difference found was statistically significant in both groups. Thus attenuation in HR, SBP, DBP and MAP was seen in group D as compared to group N during laryngoscopy, tracheal intubation and pneumoperitoneum which were statistically significant. Group N showed statically significant increase in HR, DBP  and MAP during extubation compared to group D. Difference found in both the groups was statistically significant. Thus attenuation in HR, DBP and MAP was seen in group D as compared to group N during extubation which was statistically significant. Postoperative sedation score was more in group D compared to group N which was statistically significant. Post-extubation, rescue analgesia was required early in group N compared to group D. Adverse effect in form of bradycardia was seen in 2 patients in group D which did not require atropine administration. Conclusion: Dexmedetomidine infusion at a rate of 0.4 mcg / kg / hr apparently started 10 minutes before the induction of anesthesia before release of pneumoperitoneum without any bolus dose. Useful adjuvant anesthesia to diminish the response of haemodynamic stress to intubation, Pneumoperitoneum, and extubation in laparoscopic surgical patients.

Prospective Randomized Trial Comparing Mitomycin, Cisplatin, and Protracted Venous-Infusion Fluorouracil (PVI 5-FU) With Epirubicin, Cisplatin, and PVI 5-FU in Advanced Esophagogastric Cancer

2002 ◽  
Vol 20 (8) ◽  
pp. 1996-2004 ◽  
Author(s):  
P. Ross ◽  
M. Nicolson ◽  
D. Cunningham ◽  
J. Valle ◽  
M. Seymour ◽  
...  
Keyword(s):  
Randomized Study ◽  
Squamous Carcinoma ◽  
Undifferentiated Carcinoma ◽  
Palmar Erythema ◽  
Esophagogastric Cancer ◽  
Equivalent Efficacy ◽  
Venous Infusion ◽  
Grade 3 ◽  
To Receive

PURPOSE: We report the results of a prospectively randomized study that compared the combination of epirubicin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) (ECF) with the combination of mitomycin, cisplatin, and PVI 5-FU (MCF) in previously untreated patients with advanced esophagogastric cancer. PATIENTS AND METHODS: Five hundred eighty patients with adenocarcinoma, squamous carcinoma, or undifferentiated carcinoma were randomized to receive either ECF (epirubicin 50 mg/m2 every 3 weeks, cisplatin 60 mg/m2 every 3 weeks and PVI 5-FU 200 mg/m2/d) or MCF (mitomycin 7 mg/m2 every 6 weeks, cisplatin 60 mg/m2 every 3 weeks, and PVI 5-FU 300 mg/m2/d) and analyzed for survival, response, toxicity, and quality of life (QOL). RESULTS: The overall response rate was 42.4% (95% confidence interval [CI], 37% to 48%) with ECF and 44.1% (95% CI, 38% to 50%) with MCF (P = .692). Toxicity was tolerable, and there were only two toxic deaths. ECF resulted in more grade 3/4 neutropenia and grade 2 alopecia, but MCF caused more thrombocytopenia and plantar-palmar erythema. Median survival was 9.4 months with ECF and 8.7 months with MCF (P = .315); at 1 year, 40.2% (95% CI, 34% to 46%) of ECF and 32.7% (95% CI, 27% to 38%) of MCF patients were alive. Median failure-free survival was 7 months with both regimens. Global QOL scores were better with ECF at 3 and 6 months. CONCLUSION: This study confirms response, survival, and QOL benefits of ECF observed in a previous randomized study. The equivalent efficacy of MCF was demonstrated, but QOL was superior with ECF. ECF remains one of the reference treatments for advanced esophagogastric cancer.

scholarly journals The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Health Care Providers ◽  
Study Groups ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Care Providers ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

Mo1118 Beneficial Effect of the Standardised Assessment of Gastrointestinal Symptoms (SAGIS) Instrument on the Time Required to Clinically Assess GI Patients in an Outpatient Environment: A Randomized Study

2016 ◽  
Vol 150 (4) ◽  
pp. S640-S641
Author(s):  
Saravana Ruban Gurusamy ◽  
Moritz T. von Wulffen ◽  
Johann Hammer ◽  
Natasha A. Koloski ◽  
Nicholas J. Talley ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Randomized Study ◽  
Gastrointestinal Symptoms ◽  
Time Required

scholarly journals Laparoscopic Sleeve Gastrectomy versus Laparoscopic Banded Sleeve Gastrectomy: First Prospective Pilot Randomized Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Valeria Tognoni ◽  
Domenico Benavoli ◽  
Emanuela Bianciardi ◽  
Federico Perrone ◽  
Simona Ippoliti ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Randomized Study ◽  
Control Group ◽  
Bodyweight Loss ◽  
Relevant Difference ◽  
Banded Sleeve Gastrectomy ◽  
Time Required

Introduction. The placement of ring or band around the gastric tube might prevent the dilation after Laparoscopic Sleeve Gastrectomy (LSG). We describe the first randomized study comparing LSG and Laparoscopic Banded Sleeve Gastrectomy (LBSG).Material and Method. Fifty obese patients were enrolled in the study between January 2014 and January 2015. We analysed differences in operative time, complication rate, mortality, and BMI between the two groups over a period of 12 months.Results. Twenty-five patients received LSG (group A) and 25 LBSG (group B). The mean preoperative BMI was47.3±6.58 kg/m2and44.95±5.85 kg/m2, respectively, in the two groups. There was no statistical relevant difference in operative time. No intraoperative complications occurred. Mean BMI registered after 3, 6, and 12 months in groups A and B, respectively, were37.86±5.72 kg/m2and37.58±6.21 kg/m2(p=0.869),33.64±6.08 kg/m2and32.03±5.24 kg/m2(p=0.325), and29.72±4.40 kg/m2and27.42±4.47 kg/m2(p=0.186); no statistical relevant difference was registered between the two groups.Conclusion. LBSG is a safe and feasible procedure. The time required for the device positioning did not influence significantly the surgical time. The results of bodyweight loss did not document any statistically significant differences among the two groups, even though LBSG group showed a mean BMI slightly lower than that of the control group.

Open Hemorrhoidectomy With Ligasure™ Under Local or Spinal Anesthesia: A Comparative Study

2021 ◽  
pp. 000313482110385
Author(s):  
Claudio F. Feo ◽  
Chiara Ninniri ◽  
Cinzia Tanda ◽  
Giulia Deiana ◽  
Alberto Porcu
Keyword(s):  
Spinal Anesthesia ◽  
Operating Room ◽  
Local Anesthesia ◽  
Outpatient Clinic ◽  
Perioperative Complications ◽  
Study Groups ◽  
Reoperation Rate ◽  
Hyperbaric Bupivacaine ◽  
Open Hemorrhoidectomy ◽  
American Society

Background There is increasing evidence that many anorectal surgical procedures may be performed under local anesthesia. The aim of the present study was to evaluate the safety and efficacy of local anesthesia in the outpatient clinic vs spinal anesthesia in the operating room for open hemorrhoidectomy. Methods Sixty-two patients with grade III or IV hemorrhoids underwent open hemorrhoidectomy with LigaSure™ between 2018 and 2020. Of them, 32 procedures were performed in the operating room under spinal anesthesia with hyperbaric bupivacaine and other 30 procedures were undertaken in the outpatient clinic under local anesthesia with ropivacaine. Results There were no significant differences regarding age, gender, American Society of Anesthesiologists class, and Goligher’s grade in between groups. No significant differences were observed in postoperative pain score (P = .85), perioperative complications (P = .51), and reoperation rate (P = .96). No recurrences and no differences in patients’ satisfaction degree (P = .76) were documented at long-term follow-up in both study groups. Discussion Our results suggest that open hemorrhoidectomy with LigaSure™ performed in selected patients under local anesthesia in the outpatient clinic is a well-tolerated, safe, and effective procedure.

scholarly journals Assessment and comparison of the levels of N-nitrosonornicotine and 4-(n-methyl-n –nitrosamino) -1-(3-pyridyl)-1-butanone in the saliva of tobacco chewers and non- chewers -a hospital based study

2018 ◽  
Vol 6 (2) ◽  
pp. 66
Author(s):  
Dr Harpreet Kaur Gandhoke ◽  
Dr Vasanti Lagali Jirge ◽  
Dr Anjana Bagewadi
Keyword(s):  
Statistical Analysis ◽  
Smokeless Tobacco ◽  
Statistical Difference ◽  
Study Groups ◽  
P Value ◽  
Sample Collection ◽  
Group Iii ◽  
Group I ◽  
The Mean ◽  
Tobacco Specific Nitrosamines

Background: Studies estimating the Tobacco- specific nitrosamines, (TSNA’s) which are the strongest carcinogens in the saliva oftobacco users and tobacco quitters, are limited.Objectives: To assess and compare the levels of N- nitrosamines (NNN, NNK) in the saliva of tobacco chewers and non -chewers including those who have quit the habit of tobacco use.Methods: The study included 120 patients who were divided into three groups of 40 each: Group I- Smokeless tobacco chewersGroup II- Tobacco chewers who have completely stopped the habit at least 2 weeks prior to sample collection andGroup III- non-chewers. The salivary levels of two tobacco specific nitrosamines; NNN & NNK levels were estimated in the three study groups. Statistical analysis was done by Kruskal– Wallis, one-way analysis of variance (ANOVA) test, Mann-Whitney U test. (p-value < 0.05 was considered to be statistically significant)Results: In Group I, the mean level of NNN was 651.84 ± 359.78 and mean level of NNK was 168.32 ± 131.83. In Group II, the mean level of NNN was 119.52 ± 95.05 and mean level of NNK was 42.78 ± 43.19. In Group III, the mean level of NNN was 3.44 ±6.55 and mean level of NNK was 1.98 ± 3.68. There was a statistical difference in the 3 groups with respect to mean levels of NNN and NNK.Conclusion: The study indicated that salivary tobacco-specific nitrosamines are elevated in tobacco chewers. Saliva can be used to detect TSNA’s and screen for TSNA’s during each patient’s de-addiction process.  

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.

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