scholarly journals Effect of drugs used in general anesthesia on oocyte and embryo quality in Iraqi infertile females undergoing intracytoplasmic sperm injection

2020 ◽  
Vol 10 (1) ◽  
pp. 85-100
Author(s):  
Hameedah Abdul Hussein Mohsin ◽  
Mufeda Ali Jwad ◽  
Raed Ghazi Reshan
Keyword(s):  
Adverse Effects ◽  
General Anesthesia ◽  
Intracytoplasmic Sperm Injection ◽  
Embryo Quality ◽  
Oocyte Quality ◽  
Anesthetic Techniques ◽  
Infertile Women ◽  
Anesthetic Agents ◽  
Group I ◽  
Significant Difference

Various types of anesthetic techniques were described for oocyte recovery. Different anesthetic agents have been used with different effects on oocyte quality and embryonic development and studies on the potential toxicity of general anesthesia ended up with conflicting results. Many experiments as well as human studies documented the existence of anesthetic agents in the follicular fluid (FF) with possible adverse effects on the oocyte quality and subsequent embryo development. Ketamine and remifentanil were used for the studied groups to compare oocytes and embryos characteristic of infertile women during oocytes retrieval under general anesthesia: one group receiving ketamine, midazolam, and propofol and the other group receiving remifentanil, midazolam and propofol. 60 infertile females were undergoing intracytoplasmic sperm injection categorized in two groups, group I received midazolam, remifentanil and propofol; whereas, group II received midazolam, ketamine and propofol. There was highly significant difference in mean abnormal oocyte between ketamine and remifentanil groups. Grade III embryos were significantly limited to ketamine group. FF ketamine and remifentanil were not significantly correlated to any of oocyte characteristics or embryo characteristics. Anesthetic agents, ketamine and remifentanil, were detected in the FF of infertile women and within recommended doses. Ketamine resulted in adverse effects on oocyte and embryo quality in comparison with remifentanil represented by greater percentage of abnormal oocytes and that bad quality embryos were limited to ketamine group.

scholarly journals A comparative study of hemodynamic changes and adverse effects of intrathecal bupivacaine with fentanyl and intrathecal bupivacaine with clonidine in infra-umbilical abdominal and lower limb surgery

2019 ◽  
Vol 6 (11) ◽  
pp. 4048
Author(s):  
Krishna Prasad G. V. ◽  
Vipin Jaishree Sharma
Keyword(s):  
Adverse Effects ◽  
Lower Limb ◽  
Analgesic Effects ◽  
Anesthetic Agents ◽  
Group I ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
Hemodynamic Profile ◽  
Group Ii ◽  
Intrathecal Clonidine

Background: Adjuvants prolong the action of intrathecal local anesthetic agents. They have shown to have significant analgesic effects in the postoperative period much after the regression of the sensory and motor blockade. Our objective of the current study was to compared the hemodynamic profile and adverse effects (nausea, pruritus, sedation and respiratory depression) in two groups of adult patients undergoing infra-umbilical and lower limb surgery under spinal anaesthesia using either intrathecal clonidine or intrathecal fentanyl as an adjuvant to intrathecal bupivacaine (0.5% heavy).Methods: This randomized, prospective and observational study was undertaken in the Department of Anaesthesiology and Critical Care, 5 Airforce Hospital, Kanpur from the period of January 2014 to February 2016 on 120 patients fulfilling the inclusion criteria. Study patients were randomly allocated to the two groups Group I: Cases who received intrathecal 0.5% heavy bupivacaine (2.5 ml) + fentanyl (50 mcg/ml) (0.5 ml) (n=60 patients) and Group II: cases who received intrathecal 0.5% heavy bupivacaine (2.5 ml) + clonidine (60 mcg/ml) (0.5 ml) (n=60 patients).Results: Mean age of patients in Group I and Group II was 42.60±5.93 and 42.03±7.16 years, respectively. Mean BMI of patients in Group I and Group II was 22.0±1.92 and 21.54±2.14 kg/m2, respectively. Comparison of baseline hemodynamic parameters (heart rate (bpm), mean arterial pressure (mmhg), respiratory rate (/min) and oxygen saturation (%) did not show a significant difference between two groups.Conclusions: With respect to the side effects like nausea and pruritus, these are significantly more in fentanyl group as compared to clonidine group.

scholarly journals Administration of I.V. lidocaine before induction of general anesthesia prolong suxamethonium action in caesarian section surgeries. clinical assessment--------

2019 ◽  
Vol 13 (2) ◽  
pp. 97-100
Author(s):  
Layla Khalil
Keyword(s):  
General Anesthesia ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Caesarian Section ◽  
Cross Sectional ◽  
Lidocaine Group ◽  
General Anesthesia Group ◽  
Anesthetic Agents ◽  
Group I ◽  
Significant Difference

Background: Known as suxamethonium or succinylcholine, is a medication used to cause short-term paralysis as part of general anesthesia. The duration of operation is one of the important factors accounting to the success of the operation. Simple safe available drug can change the plan of anesthesia. Objective:  The purpose of this study was to assess adding Lidocaine three minutes intravenously before induction of general anesthesia on the duration of optimum prolongation the action of  Suxamethonium  . With other group with regular method. Type of the study: a cross-sectional study   Methods: A 100 candidate to compare the effect of Lidocaine for unpremeditated patients ,American society of anesthesia( ASA)  physical status II .patients were scheduled for caesarian section surgery were randomly assigned to two groups: Group I patients received 1.5 mg/kg   Lidocaine 3 minutes before induction of general anesthesia, Group 2 patients received just the anesthetic agents.  For assessment of prolongation of action  the researcher Deepened on the clinical signs of recovery from Suxamethonium which are: spontaneous breathing, ability to swallow when we open the patient's lower jaw ( observing movement of the tongue ).between the two group Both groups received general anesthesia.  Results:   The  of prolongation of Suxamethonium in elective cases in Group I was a about 7 - 15 minutes, while in Group II the time of Suxamethonium was about 3 - 5 minutes Conclusions :  The study concluded  that there was a significant difference  between the two groups from the side of suxamethonium time in group one( lidocaine group)as there was prolongation of time more than group two .

scholarly journals Evaluation of Presepsin as a Predictive Marker in Women Undergoing ICSI

2020 ◽  
Vol 1 (6) ◽  
Author(s):  
Bushra Rasheed Al-Azawea ◽  
Hayder A. L. Mossa ◽  
Liqaa R. Altamimi ◽  
Lubna Amer Al-Anbary
Keyword(s):  
Follicular Fluid ◽  
Intracytoplasmic Sperm Injection ◽  
Ovarian Stimulation ◽  
Predictive Marker ◽  
Clinical Findings ◽  
Clinical Pregnancy ◽  
Infertile Women ◽  
Poor Predictor ◽  
Significant Difference ◽  
Antagonist Protocol

Purpose: The purpose of this study was to determine the ability of using Presepsin as a biomarker to evaluate the clinical pregnancy rate in a cohort of couples undergoing ICSI in a sample of Iraqi population. Patients and Methods: Sixty infertile women selected for undergoing intracytoplasmic sperm injection, the patient’s ovarian stimulation were by antagonist protocol accordingly to their clinical findings. Results: The results of the study shows there was no significant difference in the serum Presepsin between pregnant and non-pregnant ladies, 421.57 (1534.65) versus 878.64 (1322.23), respectively (P = 0.875), Furthermore, there was no significant difference in follicular fluid Presepsin between pregnant and non-pregnant ladies, 1286.73 (1232.00) versus 0.00 484.15 (1467.00), respectively (P = 0.296). Conclusions :We conclude that serum or follicular fluid Presepsin as a biomarker is a poor predictor of fertility outcome with no significant difference between pregnant and non-pregnant ladies

scholarly journals Correlation Among Obesity, Oocyte Characteristics, Embryo Characteristics and Maternal Plasma Folate Level in a Sample of Iraqi Women Undergoing Intracytoplasmic Sperm Injection (ICSI)

2020 ◽  
Vol 10 (1) ◽  
pp. 1-19
Author(s):  
Nahlah Abdulmajeed Hasan ◽  
Wasan Adnan Abdulhameed ◽  
Ali Ibrahim Rahim
Keyword(s):  
Pregnant Women ◽  
Follicular Fluid ◽  
Intracytoplasmic Sperm Injection ◽  
Statistical Significance ◽  
Research Work ◽  
Maternal Body Mass Index ◽  
Folate Level ◽  
Infertile Women ◽  
Plasma Folate ◽  
Significant Difference

The effect of maternal body mass index (BMI) on fertility outcomes in women undergoing in vitro fertilization/intracytoplasmic sperm injection cycles has been extensively evaluated and the results of these studies have shown a lot of controversial issues. Folate is a naturally occurring type of vitamin B9 crucial for reproductive health. 65 infertile couples were subjected to intracytoplasmic sperm injection cycles. Both primary and secondary types of infertility were involved, with different causes. The mean plasma folate of all infertile women was 12.71±6.52, with pregnant 11.60±5.57 and non-pregnant 11.74±8.80; with no significant difference in mean plasma folate between them. Moreover, the means of follicular fluid folate of all infertile women, pregnant women, and non-pregnant women were 8.00±5.39, 7.84±4.68, and 8.39±6.19 respectively. There was no significant statistical difference in mean follicular fluid folate between pregnant and non-pregnant women (p=0.719). Also, both plasma folate and follicular fluid folate were not significantly correlated to oocyte and embryo characteristics. Although plasma folate was higher in obese than normal and overweight women, the difference did not reach statistical significance. It appears that the correlation among maternal BMI, folate level and fertility outcomes in women undergoing intracytoplasmic sperm injection cycles are still controversial and much research work is needed to figure out such complex interaction among these variables.

scholarly journals Comparative evaluation of isoflurane and sevoflurane in avian patients

2021 ◽  
pp. 1067-1073
Author(s):  
R. R. Anjana ◽  
P. V. Parikh ◽  
J. K. Mahla ◽  
D. N. Kelawala ◽  
K. P. Patel ◽  
...  
Keyword(s):  
Induction Time ◽  
Recovery Time ◽  
Muscle Relaxation ◽  
Complete Recovery ◽  
Versus Group ◽  
Quality Of Recovery ◽  
Anesthetic Agents ◽  
Group I ◽  
Significant Difference

Background and Aim: Literature comparing the use of isoflurane and sevoflurane inhalation anesthetic agents in birds is scarce. This study aimed to evaluate the comparison of isoflurane and sevoflurane during induction, maintenance, and recovery of anesthesia in avian patients. Materials and Methods: In this study, 24 injured avian patients (n=24) were selected randomly and divided into four groups during kite flying festival. In the present study, isoflurane and sevoflurane were used as induction and maintenance anesthetic agents, with and without butorphanol tartrate premedication agent in all the birds. Different physiological parameters were evaluated, namely, cloacal temperature (°F), heart rate (beats/min), respiratory rate (breaths/min), and SpO2 (%) were recorded at 0, 10, 20 min, and at recovery time. The quality of anesthesia was assessed on the basis of induction time, quality of induction, production of analgesia, muscle relaxation, body reflexes, recovery time, quality of recovery, sitting, standing, and complete recovery time (CRT). Results: The mean±standard error value of induction time was 230.00±32.55, 280.00±25.29, 180.00±21.90, and 260.00±36.87 s, respectively, in Groups I, II, III, and IV. The feather plucking, pharyngeal, and toe pinching reflexes were noticed, when the birds were passing through the light plane of anesthesia during induction. Comparison of cloacal temperature at the time of recovery between Group-I versus Group-III revealed a significant difference (p<0.05). Comparison of mean respiratory rates at the time of recovery between Group-II versus Group-IV revealed a significant difference (p<0.05). Excellent quality of recovery was observed in all the groups of anesthetic protocols. Sitting, standing, and CRT were observed shortest in avian patients maintained with sevoflurane as compared to isoflurane. Conclusion: The quality of induction of anesthesia was rapid in avian patients when induced with sevoflurane as compared to isoflurane. Rapid onset of induction and recovery of anesthesia were found with sevoflurane followed by isoflurane. Induction and maintenance of anesthesia in avian patients with sevoflurane resulted in the lowest time required for sitting, standing, and CRT.

scholarly journals Efficacy of Low Dose Topiramate and Propranolol in Migraine Prophylaxis

2018 ◽  
Vol 9 (2) ◽  
pp. 49-54
Author(s):  
Muhammad Abdul Momen Khan ◽  
Jannatul Ferdous ◽  
AKM Golam Kabir ◽  
Md Mamnur Rashid ◽  
Md Enayet Ul Islam ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Migraine Prophylaxis ◽  
Drop Out ◽  
Group I ◽  
Significant Difference ◽  
Propranolol Group ◽  
Baseline Information ◽  
Group Ii

Background: Migraine, the second most common cause of headache that can significantly impair the lives of people. Various drugs are available for migraine prophylaxis but all of which have varying degrees of adverse effects that may significantly limit their use.Objectives: To observe whether low dose topiramate is more effective compared to propranolol in migraine prophylaxis.Methods: Total 120 patients the age range of 18 to 50 years were recruited as study population of migraine in the Out Patient Department (OPD) & Headache Clinic,BSMMU.60 patients were administered by Tab.Topiramate 50 mg/ day named as group-I and rest of 60 patients were administered by Tab. Propranolol 80 mg /day named as group-II. Out of them in total 96 patients had completed the study. 47 patients had completed study in group-I and 49 patients in group-II. During trial, three follow up visits were taken for both groups, 1st follow up after 4 weeks of baseline information, 2nd follow up after 4 weeks of treatment, 3rd follow up after 8 weeks of treatment. Efficacy of treatment was measured by frequency, duration and severity of headache as measured by the visual analogue scale (VAS).Results: The mean (SD) age of group-I (topiramate) and group-II (propranolol) group were found 29.72±9.58 years and 30.96±10.11 years respectively. Female sex was found predominant in both groups. At final follow up, there was statistically significant difference in mean (SD) value of frequency of migraine between topiramate and propranolol group (4.72±2.80 vs. 3.48±2.20; p=0.024]. Propranolol appeared statistically significant than topiramate [TPM 5.53±2.98 vs. PRO 4.36±1.55; p=0.047].Regarding severity of headache, better results also were observed in the propranolol group than topiramate (p< 0.05). Both drugs appeared significant in efficacy measurement (p<0.001). Patient drop out was more in the topiramate group than the propranolol group (21.68 % vs. 18.34%). Furthermore, in the topiramate group, patients complained of more adverse effects than propranolol group (23.4% vs. 14.3%), which was statistically significant.Conclusion: The present study suggests that low dose topiramate and propranolol are effective for migraine prophylaxis in reduction of frequency, severity and duration of migraine individually and propranolol appears more effective compared to that of topiramate.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 49-54

scholarly journals The effect of cult-active medium on pregnancy outcomes after intracytoplasmic sperm injection in azoospermic men: A case-control study

2022 ◽  
pp. 1059-1066
Author(s):  
Elham Asa ◽  
Rahil Janatifar ◽  
Seyedeh Saeideh Sahraei ◽  
Atefeh Verdi ◽  
Naser Kalhor
Keyword(s):  
Active Medium ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Embryo Quality ◽  
Obstructive Azoospermia ◽  
Oocyte Activation ◽  
Control Groups ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Background: Failed oocyte activation following intracytoplasmic sperm injection (ICSI) as a result of calcium deficiency is a major challenge. Objective: We compared the effect of cult-active medium (CAM) on ICSI outcomes in obstructive azoospermia cases. Materials and Methods: The present study was conducted with 152 ICSI cases, classified into CAM and control groups. The injected oocytes in the control group were cultured in the cleavage medium, while in the artificial oocyte activation group, oocytes were chemically activated through exposure to 200 µL of CAM for 15 min. Fertilization and cleavage rates, quality of embryos, and biochemical pregnancy and live birth rates were assessed in both groups. Results: There were significant differences between the groups in terms of fertilization and cleavage rates after using the CAM in the percutaneous epididymal sperm aspiration (PESA) subgroup (p = 0.05, p ≤ 0.001) and in the testicular sperm extraction subgroup (p = 0.02, p = 0.04), compared to their control groups. Also, the pregnancy rate was significantly higher in the PESA-CAM subgroup (p = 0.03). The PESA-CAM subgroup demonstrated a significant difference in embryo quality after ICSI (p = 0.04). Unsuccessful embryo transfer and abortion were lower in both subgroups compared to the control groups, but this difference was not significant. Surprisingly, live birth rate was higher in the PESA-CAM subgroup (p = 0.03). Conclusion: CAM treatment could improve fertilization and cleavage rates in obstructive azoospermia participants. It had a significant effect on embryo quality, and pregnancy and live birth rates in PESA cases. Key words: Calcium ionophore, Obstructive azoospermia, Fertilization, ICSI.

scholarly journals A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

2016 ◽  
Vol 2 (9) ◽  
pp. 227
Author(s):  
Smita R. Engineer ◽  
Digant B. Jansari ◽  
Saumya Saxena ◽  
Rahul D. Patel
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Hemodynamic Parameters ◽  
Randomized Clinical Study ◽  
Group I ◽  
Supraglottic Airway Devices ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Supraglottic airway devices have been widely used as an alternative to tracheal intubation during general anesthesia both in adults and children. This study was carried out to compare classical laryngeal mask airway (LMA) and i-gel, regarding ease of insertion, adequate placement of device, ability to maintain ETCO<sub>2</sub> and SPO<sub>2</sub>, perioperative hemodynamic parameters and intra operative and postoperative complication.</p><p class="abstract"><strong>Methods:</strong> This prospective, randomized clinical study was done on 100 patients of either sex, age between 5 to 60 years, ASA grade I-III who underwent different surgical procedures under general anesthesia in supine position. After giving premedication, induction of anesthesia was done with inj. Propofol 2-3 mg/kg and inj. Succnylcoline 1.5-2 mg/kg. In “sniffing air” position, airway was secured with either LMA or i-gel. An effective placement of device was checked by a square wave capnography, normal chest expansion, SPO<sub>2</sub> &gt;95%, and absence of audible leak. Patients were observed for time and ease of insertion, number of attempts, perioperative hemodynamic changes and complications.</p><p><strong>Results:</strong> No statistically significant difference was reported between both the groups, regarding heart rate, BP, SPO<sub>2</sub> and ETCO<sub>2</sub>. Duration of insertion was more in group LMA. Insertion was easy and was possible in first attempt in 88% of patients without much manipulation in group i-gel.</p><p><strong>Conclusions:</strong> I-gel is a better alternative supraglottic airway device than LMA in view of ease of insertion with minimal manipulations and minimal complications. Hemodynamic parameters, SPO<sub>2</sub> and ETCO<sub>2 </sub>were maintained in both the groups. </p>

scholarly journals Thyroid surgery when general anesthesia is not feasible

2016 ◽  
Vol 44 (1) ◽  
pp. 38-40
Author(s):  
Manilal Aich ◽  
Md Asadur Rahman ◽  
Sharfuddin Mahmud ◽  
Siddikur Rahman ◽  
Md Mizanur Rahman ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Postoperative Recovery ◽  
Anesthetic Techniques ◽  
General Anesthetic ◽  
Early Assessment ◽  
Duration Of Action ◽  
Anesthetic Agents ◽  
Sedation And Analgesia ◽  
Effective Sedation

Historically, thyroid and parathyroid surgery was done initially under local anesthesia. With the advent of safer general anesthetic techniques, the need for local anesthesia fell dramatically. Recently the use of local anesthesia combined with monitored anesthesia care (MAC) has been reintroduced as an alternative to general anesthesia for some particular thyroidectomy. Newer intravenous anesthetic agents allow for the establishment of effective sedation and analgesia with adjusted level and duration of action. This allows for monitoring of the effectiveness of the anesthesia during the surgical procedure that meet the patient's comfortable needs and the surgeon's technical needs. This approach allows for rapid recovery of alertness and early assessment of the patient's initial postoperative recovery. Additionally, it optimizes the potential for outpatient .Bangladesh Med J. 2015 Jan; 44 (1): 38-40

scholarly journals Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Galeotti ◽  
Annelyse Garret Bernardin ◽  
Vincenzo D’Antò ◽  
Gianmaria Fabrizio Ferrazzano ◽  
Tina Gentile ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Adverse Effects ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Young Patients ◽  
Dental Patients ◽  
Dental Procedures ◽  
Significant Difference ◽  
Disabled Patients

Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients.Methods. 472 noncooperating patients (aged 4 to 17) were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score.Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment.Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

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