Balanced Anesthesia VS General Anesthesia for Upper Abdominal Surgery-A Comparative Study of Outcome

This is a prospective randomized clinical study was done in the dept. of Rajshahi Medical College Hospital & in different Clinics in Rajshahi city from August 2013 to December 2014 to evaluate the outcome of patient undergoing upper abdominal surgery such as cholecystectomy, cholidocholithotomy, Nephrolithotomy, Gastrojejunestomy, Splenectomy, Hysterectomy, LUCS, Appendisectomy etc. by balanced anesthesia. This is also a comparative study of patient undergoing upper abdominal surgery either by balanced anesthesia or by general anesthesia. For this study 80 patients of upper abdominal surgery were randomly selected in two groups (Each group contain 40 patients) Group 'A' Patient received balanced anesthesia & group 'B' Patient received general anesthesia. Then these patient were monitored during per-operative & post operative period to evaluate its outcome. After completion of operation we have seen that those patent received balanced anesthesia had better outcome than general anesthesia undergoing upper abdominal surgery.TAJ 2012; 25: 47-54

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The Effect of Oral Clonidine at Different Doses on Post-Operative Analgesic and Hemodynamic Status in Upper Abdominal Surgery

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i2.51147 ◽

2021 ◽

Vol 28 (2) ◽

pp. 131-135

Author(s):

Mohammmad Shaddam Hoshain Mondol ◽

Rajat Shuvra Das ◽

Md Arman Ali ◽

Ishrat Jhahan Shathi ◽

Mohammad Abdul Karim Miah ◽

...

Keyword(s):

Abdominal Surgery ◽

Visual Analogue Score ◽

Medical College ◽

Oral Clonidine ◽

Upper Abdominal Surgery ◽

Severe Postoperative Pain ◽

Group A ◽

Group B ◽

Oral Premedication ◽

Upper Abdominal

Background: Upper abdominal surgery (like- hepatobiliary surgery, gastrectomy, esophagectomy, hepatictomy, and whipples operations that involve large surgical incisions) lead to severe postoperative pain that lead to higher doses of opoids use in post-operative period as a result incidence of unwanted side effect and respiratory complication increase hospital stay and morbidity. To reduce the use of opioids clonidine can be used as a multimodal analgesic approach. It is reported that clonidine 150mcg intravenous (I/V) produce a similar analgesic effect to morphine 5mg in patient after orthopedic surgery. Because of its dose, route, and surgical variation it is very much important to specify the dose for upper abdominal surgery. Material and methods: After considering the inclusion and exclusion criteria the patients were randomized to receive Group: A (2mcg/kg oral clonidine) and Group: B (4mcg/kg oral clonidine), one hour (60minutes) before surgery as an oral premedication. All groups were compared for preoperative analgesic, sedation and anxiety level along with changes of heart rate and mean arterial pressure prior to premedication and post-operative periods as follows VAS (visual analogue score) pain scores. Result: The post-operative pain measured on VAS showed Group A expressed highest VAS at 6thpost-operative hour Group –B showed highest VAS at 14th post-operative hour. So it is very clear to us that pethedine requirement of Group B (4mcg/kg oral clonidine) is less than Group A (2mcg/kg oral clonidine). The oral premedication with clonidine at 2 microgram per kg or 4 microgram per kg for postoperative analgesia and hemodynamic stability of elective upper abdominal surgery patients. Conclusion: As a part of multimodal analgesic approach, 4mcg/kg oral clonidine premedication is effective to perioperative pain control and keep stable the haemodynamic in upper abdominal surgery J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 131-135

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Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49882 ◽

2020 ◽

Vol 21 (2) ◽

pp. 105-110

Author(s):

Md Shawkat Alam ◽

Sudip Das Gupta ◽

Hadi Zia Uddin Ahmed ◽

Md Saruar Alam ◽

Sharif Muhammod Wasimuddin

Keyword(s):

Comparative Study ◽

Acute Urinary Retention ◽

Bladder Capacity ◽

Inclusion Criteria ◽

College Hospital ◽

Medical College ◽

High Incidence ◽

Group A ◽

Group B ◽

Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

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Diaphragm function and respiratory response after upper abdominal surgery in dogs

Journal of Applied Physiology ◽

10.1152/jappl.1984.57.2.576 ◽

1984 ◽

Vol 57 (2) ◽

pp. 576-582 ◽

Cited By ~ 46

Author(s):

J. D. Road ◽

K. R. Burgess ◽

W. A. Whitelaw ◽

G. T. Ford

Keyword(s):

Abdominal Surgery ◽

General Anesthesia ◽

Minute Ventilation ◽

Esophageal Pressure ◽

Transdiaphragmatic Pressure ◽

Diaphragm Function ◽

Upper Abdominal Surgery ◽

Postoperative Changes ◽

Upper Abdominal ◽

Diaphragm Activity

Decreased diaphragm activity has been demonstrated after cholecystectomy in humans (Am. Rev. Respir. Dis. 127: 431–436, 1983). To investigate the mechanism(s) of postoperative diaphragm dysfunction we have established a dog model. Three groups of mongrel dogs were studied under general anesthesia: six dogs received no surgery (control); nine dogs underwent upper abdominal surgery (cholecystectomy); and six dogs underwent lower abdominal surgery (pseudoappendectomy). Diaphragm function was assessed by changes in transdiaphragmatic pressure swings, the ratio of changes in gastric to esophageal pressure swings, and the ratio of changes in abdominal to rib cage diameters during quiet tidal breathing. In the upper abdominal surgery group there were significant postoperative decreases in all parameters of diaphragm function and an increase in minute ventilation and respiratory frequency. However, there were no significant postoperative changes in the parameters of diaphragm function in the control or lower abdominal surgery groups. These studies establish that general anesthesia is not responsible for the reduced diaphragm activity seen postoperatively and that diaphragm function is not affected by lower abdominal surgery in dogs.

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