scholarly journals Perbedaan Respon Hemodinamik terhadap Penambahan Clonidin 1 dan 2 mcg/kgbb pada Scalp Block untuk Operasi Kraniotomi

2021 ◽  
Vol 10 (3) ◽  
pp. 162-171
Author(s):  
Syarif Afif ◽  
◽  
Tri Ardana Arianto ◽  
Sugeng Budi Santosa

Bacground and Objective: The addition of a levobupivacaine scalp block is effective in reducing hemodynamic responses such as blood pressure, mean arterial pressure (MAP) and pulse rate, especially when pinning, skin incisions, and durameter incisions in craniotomy. Adjuvants are often added to local anesthetics to enhance and prolong the analgesic effect of peripheral nerve blocks. Clonidine has a synergistic action with local anesthetic agents. Clonidine increases sensory and motor blocks in both peripheral and neuraxial blocks. The common dose is 2 mcg/kgbw. The aim of this study was to determine the effectiveness of adding clonidine 2 mcg/kg and 1 mcg/kg on scalp block as craniotomy analgesic. Subjects and Methods: Study on 30 patients met the inclusion criteria. Subjects were divided into three groups, group I: scalp block with levobupivacain 0.25%, group II: scalp block plus clonidine 1 mcg/kg, group III: scalp block plus clonidine 2mcg/kg. All patients were treated with general anesthesia according to the standard then assessed their blood pressure, MAP, pulse rate before intubation, pinning, skin incision and duramater incision. Results: There was a significant difference in the addition of clonidine with the control group, especially in the pulse and diastolic rates. Clonidine 2 mcg/kg at several times showed a significant difference compared to 1 mcg/kgbb dose. Conclusion: The clonidine addition to scalp block of levobupivacaine was effective in maintening hemodynamic responses, especially pulse rate and diastolic blood pressure.

2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.


Author(s):  
Ni Komang Ayu Juni Antari ◽  
Alex Pangkahila ◽  
Muh. Ali Imron ◽  
I Putu Adiartha Griadhi ◽  
Luh Made Indah Sri Handari Adiputra ◽  
...  

ABTSRACT Introduction: Physical exercise as anticipate of hypertension along with nutrition and medicines. One of physical exercise that can be applicated here is relaxation techniques which is showed positive impact in decreased blood pressure. Objective: Determine the difference between PMR intervention with SSBM intervention to reduce blood pressure for grade I hypertension patients whose consumed anti-hypertension medicine in badung regency. Methods: Experimental method Pre and post-test control group design and used 24 subjects, divided in to 2 groups, in which the experimental group I (n=12) received progressive muscle relaxation (PMR) while the treatment group 2 (n=12) received slow stroke back massage (SSBM). Intervention is given 3 times a week for 4 weeks. This study was using simple random sampling. Blood pressure was measured by sphygmomanometer and stethoscope. Result: Independent Sample T-test showed there was significant difference between Group 1 and Group 2 which (p<0.05) for systolic and diastolic blood pressure. Conclusion: Progressive muscle relaxation intervention decrease blood pressure more than slow stroke back massage intervention in patients grade I hypertension whose consumed anti-hypertension medicine in Badung Regency.Keywords: progressive muscle relaxation, slow stroke back massage, grade I hypertension, blood pressure


Author(s):  
SÜLEYMAN CAMGÖZ ◽  
Serap DİKER ◽  
Betül GÜVEN AYTAÇ ◽  
İsmail Aytaç

Background: The widespread use of ultrasonography in peripheral nerve blocks requires an assistant. Pappin et al. described the “Jedi grip” technique in which the practitioner works alone by controlling the ultrasound prob with one hand and the needle and injector with the other. In this study, we aimed to compare the block characteristics of the “Jedi grip” technique with the classical technique that performed with an assistant. Methods: 78 patients were included in our study. They were randomly divided into two groups (Group I: Jedi grip and Group II: Classical grip technique). Local anesthetic was applied to both groups from 10 ml of 0.5% bupivacaine +10 ml of 2% prilocaine mixture. The block characteristics were evaluated and recorded every 5 minutes for the first 30 minutes after each block. When the sensory block score was 7 and the total score was 14 or above, the block was considered successful, and the patient was ready for surgery. Results: There was no significant difference between the groups in terms of block characteristics such as block pain, number of attempts, arterial puncture, sensory and motor block onset and regression times, time to be ready for surgery, tourniquet pain, use of additional anesthesia method, use of postoperative analgesia. The duration of block application was 158±47 sec in the Jedi group and 121±83 sec in the control group. Conclusion: The Jedi grip technique has been found to be applicable with the same confidence compared to the classical method in terms of block success and complications.


2019 ◽  
Vol 10 (3) ◽  
pp. 1580-1586
Author(s):  
Harini Krishnan ◽  
Archana R ◽  
Kannan Rajendran

Hypertension is known to be a major risk factor for coronary artery disease, stroke, heart failure, vision loss which remains asymptomatic until late in its course and even severely elevated pressures can be clinically silent for years.  Measurement of diameter of the pupil is indicative of autonomic function, and recording of the pupil to limbus diameter (PLD) ratio correlates with alterations in blood pressure.  As hypertension is more prevalent in males and the incidence is increasing year by year, measurement of PLD ratio can be used as a simple screening tool in the general population to measure the autonomic alterations associated with changes in blood pressure.  This study aims at finding the correlation of pupil to limbus diameter (PLD) ratio with blood pressure and pulse rate in Hypertensive Males.  45 male patients attending O/P of Saveetha Medical College and Hospital in the age group of 30 to 65 years, fulfilling the inclusion criteria were enrolled in the study.  It's a case-control study with non-probability convenient sampling.  Blood pressure, using a sphygmomanometer and pulse rate were measured by the physician according to AHA criteria, and PLD ratio was assessed by the two-box method.  There was a significant decrease observed in PLD ratio when normal and hypertensive groups.  Mean pulse rate of hypertensive males was significantly higher compared to the control group.  The systolic blood pressure and diastolic blood pressure were significantly high in hypertensive male patients.  A significant difference in PLD ratio exists between the control and hypertensive males though no positive correlation was observed.  


Author(s):  
Lucky Shrihari ◽  
V. Suresh ◽  
V. Yuvaraj ◽  
R. Sathyanarayanan ◽  
M. Shyamala ◽  
...  

Background: The purpose of the study was to compare the efficacy of 0.5% centbucridine and 2% lignocaine with adrenaline (1:200,000).Methods: A clinical prospective, controlled, randomized, double blind group study was conducted on 22 patients referred for extraction of mandibular premolars, who were randomly assigned to 2 groups by the split mouth method. Before extraction of mandibular premolar, either 0.5% centbucridine or 2% lignocaine with 1:200,000 adrenaline were used for anesthesia. All the patients were given inferior alveolar, lingual, and long buccal nerve blocks. Pain on injection, onset of anesthesia, duration of anesthesia and changes in blood pressure and pulse rate were monitored and recorded.Results: In our study, statistically significant difference was found between the efficacy of agents as for time for onset of anesthesia, duration of action, and changes in blood pressure and pulse rate, but no statistically significant difference was found for pain on injection between two groups.Conclusions: The efficacy of centbucridine was found to be more as compared to lignocaine with adrenaline, in rapid onset of anesthesia, longer duration of action, and cardiovascular stability. There was no significant difference in the pain on injection for both centbucridine and lignocaine with adrenaline. Centbucridine can be used in medically compromised condition where adrenaline is contraindicated.


Author(s):  
Reham AlJasser ◽  
Sundus Bukhary ◽  
Mohammed AlSarhan ◽  
Dalal Alotaibi ◽  
Saleh AlOraini ◽  
...  

The aim of this in-vivo study was to evaluate/compare the clinical periodontal parameters in patients with true combined endo-perio lesions (EPL), treated with gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with addition of bone grafting in such lesions. 120 Saudi patients (mean age = 41yrs) diagnosed with true combined EPL participated in this study. Group I (control group, n = 30) was treated with conventional endodontic treatment using GP for obturation. Group II (n = 30) was treated with conventional endodontic treatment using MTA for obturation. Group III (n = 30) was treated with conventional endodontic treatment using GP for obturation + grafting procedure to fill the bony defect. Group IV (n = 30) was treated with conventional endodontic treatment using MTA for obturation + grafting procedure to fill the bony defect. Clinical parameters (Pocket depth (PD); Clinical attachment loss (CAL); keratinized tissue width (KTW); gingival phenotype (G.Ph.) and Cone Beam Computed Tomography Periapical Index (CBCTPAI)) were recorded and compared at baseline, 3, 6, 12 months’ interval. For the groups III and IV, CBCTPAI showed significant difference (p < 0.0001) with the other groups at 6 months and 1-year interval. The group with MTA + bone graft showed 76% and 90% patients with 0 score at 6 months and 1-year follow-up, respectively. Comparison of mean values of PD among study groups at 3 months, 6 months and 1 year showed significant difference at 3 months, whereas the mean PD values of subjects in GP + bone graft showed significantly higher PD values than other 3 groups (p = 0.025). Use of GP and MTA for root canal obturation along with periodontal therapy and bone augmentation helps in resolving complex endo-perio lesions. Bone grafting in addition to obturation with MTA was found to be the best treatment strategy in management of EPL cases and is recommended for clinicians who are treating EPL patients.


2015 ◽  
Vol 03 (02) ◽  
pp. 080-084
Author(s):  
Vijay Singh ◽  
Poonam Bogra ◽  
Saurabh Gupta ◽  
Navneet Kukreja ◽  
Neha Gupta

AbstractFracture resistance of endodontically treated teeth restored with post. Aims: This study aims to compare the fracture resistance of endodontically treated teeth restored with resin fiber and stainless steel post. Commercially available prefabricated resin fiber post(Dentsply Maillefer Easy Post), prefabricated stainless steel post(Coltene/Whaledent Parapost) were used. Methods and Material: Forty five maxillary central incisors were obturated and divided into 3 groups: Control Group (Group I) without any post (n = 15), Resin Fiber Post Group (Group II) (n = 15) and Stainless Steel Post Group (Group III) (n = 15). In all Groups except control group, post space was prepared; a post was cemented, and a core build-up was provided. All the specimens were subjected to compressive force under a universal testing machine until fracture. Statistical analysis used: The results were analyzed using the variable analysis test (ANOVA). Results: One-way analysis of variance revealed significant difference among test groups. The control group demonstrated highest fracture resistance (925.2183 N), followed by the resin fiber post group (486.7265 N) and stainless steel post group (423.539N). Conclusions: Teeth restored with resin fiber post showed higher fracture resistance values than prefabricated stainless steel post.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Myeong-Sook Ju ◽  
Sahng Lee ◽  
Ikyul Bae ◽  
Myung-Haeng Hur ◽  
Kayeon Seong ◽  
...  

The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n=28), the placebo group (n=28), and the no-treatment control group (n=27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F=6.71,P=0.002) between groups after intervention. There was also a significant difference in SBP (F=13.34,P=0.001) and diastolic blood pressure (DBP) (F=8.46,P=0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F=6.75,P=0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eman Gomaa El Saeed ◽  
Manal H Moussa ◽  
Gehad A Hammouda ◽  
Sahar M. M Omar

Abstract Background Repairing urinary bladder (UB) defect by enterocystoplasty remains the gold standard surgical bladder reconstruction procedure to increase the capacity and compliance of dysfunctional bladders. However, many complications were recorded. Aim of the work This work aimed to compare the consequences of reconstruction of urinary bladder defect using untreated small intestinal submucosal (SIS) matrix versus seeded and unseeded decellularized SIS matrix. Material and Methods Fifty female albino rats were used in this study. The animals were divided into three groups: Group I (Control) included ten adult rats from which ileal tissue was obtained. Group II included ten adult rats in which their UB defect was repaired by untreated cellular SIS. Group III included twenty adult rats that were subdivided into two subgroups, 10 rats each; Subgroup IIIA where rats had their UB defect repaired by acellular SIS and subgroup IIIb where rats had their UB defect repaired by acellular SIS seeded with adipose mesenchymal stem cells (AMSCs).Ten young rats were used for preparation of AMSCs. Morphometric and statistical analysis were also performed. Results In rats where UB defect was repaired by untreated cellular SIS, the graft area showed loss of epithelial polarity, presence of intraepithelial cysts and occasional extension of urothelium to the outer surface forming fistula. There were areas of metaplasia with the appearance PAS positive cells. In the lamina propria, there was areas of lymphocytic infiltration together with significant increase in the collagen fiber deposition (p &lt; 0.05). There was a significant decrease thickness of muscle layer as compared to control (p &lt; 0.05). In rats where UB defect was repaired by acellular SIS, urothelium in the graft area showed occasional squamous metaplasia and often the urothelium extended to the deeper layers forming Brunn's nest. There was minimal muscle regeneration in the graft area. However, in rats where UB defect was repaired by acellular SIS seeded with AMSCs, the urothelium in the graft area was nearly similar to control group with uniform urothelium thickness, minimal collagen fibers deposition and thick muscle layer that showed no significant difference from the control (p &gt; 0.05). Conclusion Acellular SIS seeded with AMSCs showed better results compared to non-seeded and cellular SIS in reconstructing urinary bladder defects.


Author(s):  
Krishna Mohan Kumar

Objective This study aimed to evaluate the impact of the dietary supplement of Moringa oleifera leaves (MOL) on semen quality and characteristics in rabbits. Methods Eighteen (n=18) breeding bucks of New Zealand white, of similar age group, were used for the study. Three feeding regimes, (i) 100% commercial rabbit pellets (CRP)-Group I (ii) 90% CRP + 10% fresh MOL on a dry matter (DM) basis – Group II and (iii) 80% CRP + 20% fresh MOL on a DM basis – Group III, were adopted and the trial continued for 21 days. After adaptation to the diet, semen was collected from each buck and subjected to evaluation using a computer-assisted semen analyser. Results In Group III, the sperm count, normal sperm morphology, and sperm motility increased (52.0%) in comparison with the control (Group I; 50.1%). The inclusion of 20% Moringa oliefera in the diet (Group III) caused a significant increase (P<0.05) in semen concentration (Control =136.2 M/mL; Group III=297.2 M/mL). There was no significant difference (P>0.05) in sperm motility and semen volume among the groups. Conclusion The results suggest that supplementing commercial rabbit pellets with 20% fresh Moringa oliefera leaves on a DM basis can improve the quality and characteristics of semen in breeding bucks.


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