Comparative study of hemodynamic effects, quality of extubation and emergence - agitation response of the patients with dexmedetomidine versus lignocaine during and following the endotracheal extubation

2021 ◽  
Vol 19 (3) ◽  
pp. 91-95
Author(s):  
Manasi Panat ◽  
Keyword(s):  
Comparative Study ◽  
Stress Responses ◽  
Tracheal Extubation ◽  
Emergence Agitation ◽  
Quality Of Recovery ◽  
Group 12 ◽  
The Difference ◽  
Group D ◽  
Endotracheal Extubation

Background: Endotracheal extubation is the translaryngeal removal of a tube from the trachea via the nose or mouth. It is associated with hemodynamic changes because of reflex sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation. Various drugs and techniques have been tried to attenuate the airway and stress responses during tracheal extubation. In present study, we have compared the effects of dexmedetomidine and intravenous lignocaine on the hemodynamic and recovery profiles during endotracheal extubation. Material and Methods: Present study was prospective randomised comparative study, conducted in patients from age group of 18-45 years, ASA grade I/II, scheduled for elective abdominal surgeries. The patients were categorised into two different groups using the sealed envelope method as Group D and group L. Results: In present study, patients were divided in following 2 groups with 50 patients in each group as group D (Dexmedetomidine) and group L (Lignocaine). Age, gender, mean BMI were comparable in both groups and difference was not significant statistically. The difference between mean heart rate, systolic BP, diastolic BP and mean arterial BP during extubation, after extubation at 1, 3, 5, 10, 15, 20, 25, 30 minutes in dexmedetomidine group and lignocaine group was statistically significant. In Dexmedetomidine group, 12% of the patients had no cough during extubation, 72% of the patients had smooth extubation with minimal cough while in Lignocaine group, 22% of the patients had smooth extubation with minimal cough, 74 % of the patients had moderate cough during extubation. Statistical analysis of the Emergence agitation score shows better results in group D. Conclusion: Administration of Dexmedetomidine before tracheal extubation was more effective in maintaining the hemodynamic stability, facilitated smooth tracheal extubation and had a better quality of recovery as compared to Lignocaine.

scholarly journals Anaesthetic induction and recovery characteristics of a diazepam-ketamine combination compared with propofol in dogs

2015 ◽  
Vol 86 (1) ◽  
Author(s):  
Jacques P. Ferreira ◽  
T. Brighton Dzikit ◽  
Gareth E. Zeiler ◽  
Roxanne Buck ◽  
Bruce Nevill ◽  
...  
Keyword(s):  
Anaesthetic Induction ◽  
Quality Of Recovery ◽  
Acceptable Quality ◽  
Healthy Adult Male ◽  
Recovery Times ◽  
Recorded Data ◽  
Descriptive Scale ◽  
Induction Of Anaesthesia ◽  
Group D

Induction of anaesthesia occasionally has been associated with undesirable behaviour in dogs. High quality of induction of anaesthesia with propofol has been well described while in contrast variable induction and recovery quality has been associated with diazepam-ketamine. In this study, anaesthetic induction and recovery characteristics of diazepam-ketamine combination with propofol alone were compared in dogs undergoing elective orchidectomy. Thirty-six healthy adult male dogs were used. After habitus scoring (simple descriptive scale [SDS]), the dogs were sedated with morphine and acepromazine. Forty minutes later a premedication score (SDS) was allocated and general anaesthesia was induced using a combination of diazepam-ketamine (Group D/K) or propofol (Group P) and maintained with isoflurane. Scores for the quality of induction, intubation and degree of myoclonus were allocated (SDS). Orchidectomy was performed after which recovery from anaesthesia was scored (SDS) and times to extubation and standing were recorded. Data were analysed using descriptive statistics and Kappa Reliability and Kendall Tau B tests. Both groups were associated with acceptable quality of induction and recovery from anaesthesia. Group P, however, was associated with a poorer quality of induction (p = 0.014), prolonged induction period (p = 0.0018) and more pronounced myoclonus (p = 0.003), but had better quality of recovery (p = 0.000002) and shorter recovery times (p = 0.035) compared with Group D/K. Diazepam-ketamine and propofol are associated with acceptable induction and recovery from anaesthesia. Propofol had inferior anaesthetic induction characteristics, but superior and quicker recovery from anaesthesia compared with diazepam-ketamine.

scholarly journals Attenuation of extubation responses: Comparison of prior treatment with verapamil and dexmedetomidine

2016 ◽  
Vol 03 (01) ◽  
pp. 033-039 ◽  
Author(s):  
Tuhin Mistry ◽  
Shobha Purohit ◽  
Gunjan Arora ◽  
Nitesh Gill ◽  
Jaya Sharma
Keyword(s):  
Blood Pressure ◽  
Stress Response ◽  
Tracheal Extubation ◽  
Group V ◽  
Airway Response ◽  
Significant Attenuation ◽  
American Society ◽  
Airway Responses ◽  
Group D

Abstract Background: Tracheal extubation is almost always associated with stress response, airway response, and arrhythmias. There are many ways to attenuate this stress response. We have compared verapamil and dexmedetomidine on attenuation of these responses. Materials and Methods: Thirty patients (American Society of Anaesthesiologists Grade I, II) scheduled for spinal surgeries under general anaesthesia were randomly divided into two groups. At the end of surgery, after return of spontaneous efforts (bispectral index >80), in “Group V” verapamil 0.1 mg/kg and in “Group D” dexmedetomidine 0.3 mcg/kg were administered as bolus intravenously over one minute. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded just before (T0) and 2 min after intravenous administration of study medications (TM), just after oral suction (TS), immediately after extubation (TE) and 1, 3, 5 and 10 min postextubation (E1, E3, E5, E10). Duration of emergence and extubation, quality of extubation, Richmond Agitation Sedation Scale (RASS) score and time to reach modified Aldrete score ≥9 were compared. Results: HR, SBP, DBP, MAP were higher in Group V than Group D, but statistically insignificant (P > 0.05). Extubation quality scores was 1 for 20%, 2 for 60% and 3 for 20% patients in Group V, whereas 1 in 80%, 2 in 20% in Group D. There was occurrence of bradycardia within 2 min of administration of drug in one patient in Group D. RASS score was in the range of -1 to +1 in >90% patient in Group V, whereas -3 to -1 in 80% cases in Group D. Conclusion: Single dose of dexmedetomidine (0.3 mcg/kg) given before extubation produced significant attenuation of circulatory and airway responses during extubation as compared to verapamil (0.1 mg/kg).

Factors driving the difference in quality of recovery scores between scheduled and unscheduled Caesarean delivery patients

2022 ◽  
Author(s):  
Cyrus Bhiladvala ◽  
Robert ffrench-O’Carroll ◽  
Yeganeh Dadkhah ◽  
Susan Bright ◽  
Anthony Chau ◽  
...  
Keyword(s):  
Caesarean Delivery ◽  
Quality Of Recovery ◽  
The Difference

scholarly journals A comparative study of different adjuncts to enhance the effects of intrathecal bupivacaine

2017 ◽  
Vol 5 (5) ◽  
pp. 2046
Author(s):  
Debajyoti Sur ◽  
Archana Agarwal ◽  
Ajay Kumar Chaudhary ◽  
Jaishri Bogra ◽  
Prithvi Kumar Singh ◽  
...  
Keyword(s):  
Comparative Study ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Magnesium Sulphate ◽  
Saline Group ◽  
Total Power ◽  
American Society ◽  
Group D ◽  
Single Blind

Background: Spinal anaesthesia is the commonly used technique for lower abdominal surgeries. Adjuvants to bupivacaine have been used to provide good quality of perioperative and postoperative analgesia. The aim of the study was to evaluate the effects of subarachnoid administration of bupivacaine with clonidine, magnesium, dexmedetomidine and saline group.Methods: The prospective, comparative single blind study included 120 patients in American society of anaesthesiologist (ASA) grade I and II, scheduled for lower abdominal surgeries were allocated in four groups. Each group included 15 mg bupivacaine with various adjuvants (30 µg clonidine, 50 mg magnesium sulphate and 3µg dexmedetomidine) were compared with saline group (group S).Results: Time of onset was earlier in groups D and C but delayed in group M. The total power regains (B0) in group D (250.8±18.87), group M (235.23±24.66) and group C (242.70±25.98) were significantly delayed (p<0.05) as compare with group S (180.07±18.53). Demand of analgesia was significantly earlier in group S as compared with groups C, M and D. Similarly, the time of two segment regression was significantly earlier in group S as compared with groups C, M and D (p<0.001). Patients were hemodynamically stable in groups D, C and M as compared to Group S.Conclusions: Dexmedetomidine and clonidine were equally effective and better as compared to magnesium as an adjunct to intrathecal bupivacaine.

Perbedaan PERBEDAAN NILAI LEKOSIT ANTARA KOMPONEN DARAH PACKED RED CELLS (PRC) DAN PACKED RED CELLS LEUCODEPLETED (PRC-LD) DI UTD PMI KOTA SURABAYA TAHUN 2019

2021 ◽  
Vol 9 (2) ◽  
pp. 106-111
Author(s):  
Renata Primasari
Keyword(s):  
Comparative Study ◽  
Red Cells ◽  
Blood Component ◽  
Blood Transfusions ◽  
Blood Components ◽  
European Standard ◽  
The Difference ◽  
The Relationship ◽  
Transfusion Reactions

  Abstract This leukodepleted PRC (PRC-LD) is considered capable of preventing reactions related to blood transfusions because it contains only a small number of leukocytes. The blood component of PRC-LD has also been shown to prevent or reduce transfusion reactions. Leukodepleted is a procedure to reduce the number of leukocytes in the blood or blood components to be transfused to a minimum of <1x106 leukocytes/unit (European standard) or reduce the number of leukocytes >99%. The purpose of this study was to see the difference in leukocyte values ​​in the PRC and PRC-LD components. The method used is analytic, namely research that aims to determine the relationship between variables within the scope of the laboratory. The method used is a comparative study. This study used 30 samples of PRC products and 30 samples of Leucodepleted PRC products at UTD PMI Surabaya City with 450 cc bags. The study was conducted in October - December 2019. The result was that the leukocyte value in the PRC blood component contained blood quality that did not meet the specifications as many as 30 bags (100%) had leukocyte levels >1x106 per bag. Meanwhile, the blood component of PRC-LD contains blood quality that meets the specifications as many as 30 bags (100%), having leukocyte levels <1x106 per bag. Conclusion The quality of PRC Leukodepleted blood component products, the quality of leukocyte levels that meet the specifications, there are 30 blood bags (100%). Keywords: Packed Red Cells Leukodepleted

scholarly journals Quality of Recovery after Laparoscopic Cholecystectomy Following Neuromuscular Blockade Reversal with Neostigmine or Sugammadex: A Prospective, Randomized, Controlled Trial

2021 ◽  
Vol 10 (5) ◽  
pp. 938
Author(s):  
Jiwon Han ◽  
Ah-Young Oh ◽  
Yong-Tae Jeon ◽  
Bon-Wook Koo ◽  
Bo Young Kim ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Urinary Retention ◽  
Neuromuscular Blockade ◽  
Controlled Trial ◽  
Tracheal Extubation ◽  
Anesthetic Care ◽  
Quality Of Recovery ◽  
Patient Reported ◽  
Secondary Outcomes

The risk of neuromuscular blockade is certainly minimized by sugammadex in combination with monitoring. However, the effect of sugammadex-aided recovery on patients’ satisfaction is unclear. This study compared the Quality of Recovery (QoR)-15 score, which is a patient-reported outcome, in patients undergoing laparoscopic cholecystectomy. Eighty patients were randomly assigned to the neostigmine or sugammadex groups. At the end of surgery, neostigmine or sugammadex was administered, and tracheal extubation was performed after confirmation of a train of four ratio ≥ 0.9. The QoR-15 questionnaire was administered at 1 day before surgery and on post-operative days (POD) 1 and 2. The primary outcome was the QoR-15 score on POD 1. The secondary outcomes were the QoR-15 score on POD 2, modified Aldrete score, length of post-anesthetic care unit stay, post-operative pain, administration of anti-emetics, urinary retention, and length of hospital stay. No significant differences were found in QoR-15 scores on POD 1 (94.4 vs. 95.5, p = 0.87) or 2 (116.3 vs. 122, p = 0.33). Secondary outcomes were also comparable, with the exception of urinary retention (15.8% neostigmine vs. 2.6% sugammadex, p = 0.04). This study demonstrated that the quality of recovery was comparable between the neostigmine and sugammadex groups when reversal and tracheal extubation were performed in accordance with the current guidelines.

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