EFFECT OF NEBULIZED KETAMINE AND MAGNESIUM SULPHATE ON INCIDENCE OF POSTOPERATIVE SORETHROAT – A COMPARATIVE STUDY

BACKGROUND: Post-operative sorethroat(POST) following endotracheal intubation is a well-known complication, several methods have been tried to reduce this incidence. We are comparing the effects of nebulized ketamine & Magnesium Sulphate to reduce this. AIMS AND OBJECTIVES: To compare the efcacy of nebulized ketamine and magnesium sulfate in reducing the incidence of POST. MATERIALS AND METHODS: After obtaining Ethical clearance and patient consent, 40 Patients undergoing surgery under general anesthesia were randomized in to two groups. Five minutes prior to the induction of anesthesia, patients were nebulized with Group K = 1 ml of ketamine [50 mg] +4 ml normal saline, Group M = 0.5 ml of Magnesium Sulphate [250 mg] +4.5 normal saline, and Group S – 5 ml normal saline. RESULTS: There is moderate signicant difference between both the groups at 0 hr. No signicant difference between two groups at 2,6,12 and 24 hrs. CONCLUSION: Ketamineand Magnesium sulfate reduce the incidence of POST, are almost similar in their effects.

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The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

10.22514/sv.2020.16.0081 ◽

2020 ◽

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Normal Saline ◽

Saline Group ◽

Normal Saline Group ◽

Hypertensive Patients ◽

Group A ◽

Elderly Hypertensive ◽

Elderly Hypertensive Patients ◽

Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

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Post-operative wound infiltration with dexmedetomidine and magnesium sulphate as adjuvant to levobupivacaine for lumbar laminectomy: a prospective, double blinded, randomized controlled study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211345 ◽

2021 ◽

Vol 9 (4) ◽

pp. 1028

Author(s):

Neelesh Bhatnagar ◽

Vikram S. Rathore ◽

Malavsinh Jadeja ◽

Alka Chhabra ◽

Seema Partani ◽

...

Keyword(s):

Postoperative Analgesia ◽

Normal Saline ◽

Magnesium Sulphate ◽

Saline Group ◽

Controlled Study ◽

Normal Saline Group ◽

Analgesic Drug ◽

Wound Infiltration ◽

Paravertebral Muscles ◽

Double Blinded

Background: Wound infiltration with local anaesthetic is safe and effective technique for providing postoperative analgesia following lumbar laminectomy. The objective of this study was to compare the efficacy of local wound infiltration on postoperative analgesia with levobupivacaine, levobupivacaine plus magnesium sulphate and levobupivacaine plus dexmedetomidine in patient undergoing lumbar laminectomy.Methods: Ninety adult patients were randomly allocated into three groups. After the completion of lumbar laminectomy, the drug was locally infiltrated into the paravertebral muscles on either side. Group L received 10 ml of 0.5% levobupivacaine plus 10 ml normal saline, group LM received 10 ml of 0.5% levobupivacaine plus 500 mg magnesium sulphate (1 ml) plus 9 ml normal saline, group LD received 10 ml of 0.5% levobupivacaine plus 50 µg dexmedetomidine (0.5 ml) plus 9.5 ml normal saline. Postoperative visual analogue scale (VAS) pain score at 0, 1, 2, 4, 6, 8, 12 and 24 hours, time to first rescue analgesic drug and its total dose, quality of recovery score (QoR) and side effects were noted.Results: Postoperative VAS was significantly higher in group L as compared to group LM and LD (p<0.05). The time to first rescue analgesic drug was significantly longer in group LD (11.07±7.20 hr) than group LM (6.20±2.64 hr) and group L (3.93±2.70 hr) (p<0.001). The QoR score was significantly better in group LD as compared to group LM and L postoperatively (<0.01).Conclusions: Addition of magnesium sulphate or dexmedetomidine to levobupivacaine for local wound infiltration demonstrated enhanced postoperative analgesia.

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Effect of 2% Lignocaine Solution in Pain During Removal of Nasal Pack

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v15i2.22629 ◽

2019 ◽

Vol 15 (2) ◽

pp. 80-83

Author(s):

Ashish Dhakal ◽

Bikash Lal Shrestha ◽

Monika Pokharel

Keyword(s):

Normal Saline ◽

Saline Group ◽

Nasal Packing ◽

Distilled Water ◽

Left Nostril ◽

Normal Saline Group ◽

Nasal Pack ◽

Control Side ◽

Group 5

Background: Nasal packing is commonly done after septal surgeries. Nonabsorbable nasal pack is used to minimize bleeding from surgery site, support the mucoperichondrial flaps, and minimize the risk of formation of septal hematomas and adhesions. However, these materials cause pain and discomfort in-situ as well as during removal. This study was done to evaluate the effect of 2% lignocaine rehydration of nasal pack on pain during pack removal. Methods: This prospective study was conducted on 60 patients who had undergone septoplasty. The patients were divided into 2 groups: Lignocaine and Normal saline group, with 30 patients each. In the Lignocaine group, 2.5 ml of 2% of lignocaine was diluted with 2.5 ml of distilled water and was injected into the nasal pack; and in Normal saline group, 5 ml of normal saline was injected into the nasal pack. Nothing was injected to the left nostril, which acted as a control, in both groups. All patients were asked severity of pain during removal of nasal packing by VAS. Results: In lignocaine group, mean pain score was 3.73 ± 1.63 on lignocaine side and 6.23 ± 1.69 on control side (U=109.5, p<0.001). In Normal saline group, it was 6.5 ± 1.7 on normal saline side and 6.23 ± 1.96 on control side (U=425.5, p=0.711). On comparing VAS between lignocaine and normal saline group, pain was significantly lower in the lignocaine group (U=112.5, p<0.001) Conclusion: Rehydrating nasal pack with 2% topical lignocaine is a useful method to reduce pain during nasal pack removal.

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Effects of prophylactic ketamine and pethidine to control postanesthetic shivering: A comparative study

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i12.508 ◽

2018 ◽

Vol 5 (12) ◽

pp. 2898-2903 ◽

Cited By ~ 1

Author(s):

Masoum Khoshfetrat ◽

Ali Rosom Jalali ◽

Gholamreza Komeili ◽

Aliakbar Keykha

Keyword(s):

Normal Saline ◽

Pearson Correlation ◽

Saline Group ◽

Normal Saline Group ◽

Chi Square ◽

Double Blind ◽

Postanesthetic Shivering ◽

Significant Difference ◽

The Mean ◽

One Way Anova

Background: Shivering is an undesirable complication following general anesthesia and spinal anesthesia, whose early control can reduce postoperative metabolic and respiratory complications. Therefore, this study aims to compare the effects of prophylactic injection of ketamine and pethidine on postoperative shivering. Methods: This double-blind clinical trial was performed on 105 patients with short-term orthopedic and ENT surgery. The patients were randomly divided into three groups; 20 minutes before the end of the surgery, 0.4 mg/kg of pethidine was injected to the first group, 0.5 mg/kg of ketamine was injected to the second group, and normal saline was injected to the third group. After the surgery, the tympanic membrane temperature was measured at 0, 10, 20, and 30 minutes. The shivering was also measured by a four-point grading from zero (no shivering) to four (severe shivering). Data were analyzed by one-way ANOVA, Kruskal Wallis, Chi-square and Pearson correlation. Results: The mean age of patients was 35.8+/-11.45 years in the ketamine group, 34.8+/-11.64 years in the normal saline group, and 33.11+/-10.5 years in the pethidine group. The one-way ANOVA showed no significant difference in the mean age between the three groups (P=0.645). The incidence and intensity of shivering were significantly higher in the normal saline group than in the ketamine and pethidine groups (p=0.001). However, there was no significant difference in the incidence and the intensity of shivering between the ketamine and the pethidine groups (p=0.936). Conclusion: The results showed that the 0.5 mg/kg of ketamine could control the post-anesthetic shivering.

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The Effect of Glycopyrrolate on Induction Dose of Propofol during General Anesthesia

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1146 ◽

2015 ◽

Vol 49 (2) ◽

pp. 62-65

Author(s):

Suman Arora ◽

Harihar Vishwanath Hegde ◽

Jyotsna Wig

Keyword(s):

Heart Rate ◽

Cardiac Output ◽

General Anesthesia ◽

Significant Positive Correlation ◽

Saline Group ◽

Small Extent ◽

Loss Of Consciousness ◽

Test Drug ◽

Normal Saline Group ◽

Induction Dose

ABSTRACT Background Preinduction cardiac output (CO) is a small but significant predictor of induction dose of propofol. We hypothesized that glycopyrrolate, by inducing tachycardia (although to a small extent) would increase CO, and hence the induction dose of propofol. Aim of the study was to find out the dose of propofol required to induce anesthesia in patients receiving glycopyrrolate as compared to those not receiving it. Meterials and methods Eighty female patients (25-60 years, ASA-1, 2) undergoing elective procedures under general anesthesia were randomized into group G (glycopyrrolate) and group C (control). Patients received 1 ml (0.2 mg) glycopyrrolate (group G) or 1 ml normal saline (group C) intravenously 5 minutes before induction. Anesthesia was induced with propofol at a rate of 0.8 mg/kg/min titrated to achieve a target BIS = 40. Dose of propofol required for induction of anesthesia (loss of consciousness) and to reach the target BIS, heart rate (HR) and mean arterial pressure (MAP) at various intervals were compared. Correlation between the dose of propofol required to reach target BIS = 40 and heart rate after giving the test drug was performed by regression analysis. Results The dose of propofol required for achieving target BIS was significantly higher (p < 0.001) in group G (2.08 ± 0.42 mg/kg) (mean ± SD) as compared to group C (1.66 ± 0.23 mg/ kg). There was a significant positive correlation between the preinduction HR (3 minutes after giving the test drug) and the propofol dose required to reach target BIS = 40 (r = 0.356, p < 0.01). Conclusion Administration of 0.2 mg of glycopyrrolate intravenously before induction of general anesthesia significantly increased the dose of propofol required for induction of anesthesia. How to cite this article Arora S, Hegde HV, wig J, Puri GD. The Effect of Glycopyrrolate on Induction Dose of Propofol during General Anesthesia. J Postgrad Med Edu Res 2015;49(2): 62-65.

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The Effect of Subtenons Lidocaine on Emergence Agitation after General Anesthesia in Pediatric Strabismus Surgery

European Scientific Journal ESJ ◽

10.19044/esj.2016.v12n6p48 ◽

2016 ◽

Vol 12 (6) ◽

pp. 48

Author(s):

Agolli. L ◽

Shuteriqi. B

Keyword(s):

General Anesthesia ◽

Normal Saline ◽

Recovery Room ◽

Eye Contact ◽

Saline Group ◽

Strabismus Surgery ◽

Emergence Agitation ◽

Surrounding Environment ◽

Lidocaine Injection ◽

In The Beginning

Objectives: To study the effect of subtenon lidocaine injection at the end of intervention on the post-operative emergence agitation in pediatric strabismus surgery under general anesthesia with sevofluran. Material: We studied 191 children patients undergoing muscle surgery for strabismus from 2-6 years old. Children were (prospectively) randomized to one of the four groups. These groups include: A –Group Sevofluran fentanyl; B –Group sevoflurane fentanyl, Subtenon lidocaine injection; C – Group Propofol, fentanyl, sevofluran; and D – Group Propofol, fentanyl, Sevoflurane, Subtenon lidocaine injection. In the beginning of the induction of anesthesia, children received dexametasone and metoclopropamide. At the end of the surgery, children received either lidocaine (2%) or normal saline (1ml) into the subtenons space. This was conducted on the recovery room using five scoring scale. These scale include: 1- the child makes eye contact, 2- Purposeful response after repeated stimuli, 3 – the child is aware of the surrounding environment, 4- severe restlessness, and 5 – The child is inconsolable. The degree of emergence agitation was observed. Furthermore, the score 4 and 5 was considered as an emergence agitation. Results: There are no differences regarding age and weight. The incidence of emergence agitation was significantly lower in the groups which were receiving subtenon lidocaine compared with saline group injections (p< 0.05). Conclusions: A lidocaine injection into subtenon space reduces the emergence agitation after general anesthesia in pediatric strabismus surgery.

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Effect of Low-Dose (Single-Dose) Magnesium Sulfate on Postoperative Analgesia in Hysterectomy Patients Receiving Balanced General Anesthesia

Anesthesiology Research and Practice ◽

10.1155/2015/306145 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Arman Taheri ◽

Katayoun Haryalchi ◽

Mandana Mansour Ghanaie ◽

Neda Habibi Arejan

Keyword(s):

Single Dose ◽

Postoperative Pain ◽

General Anesthesia ◽

Magnesium Sulfate ◽

Pain Score ◽

Normal Saline ◽

Low Dose ◽

Rating Scale ◽

Controlled Trial ◽

Control Group

Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of single low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH) pain relief under balanced general anesthesia.Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N=20) and normal saline (N=20) groups randomly. The magnesium group received magnesium sulfate 50 mg·kg−1in 100 mL of normal saline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100 mL of 0.9% sodium chloride solution at the same time. The same balanced general anesthesia was induced for two groups. Pethidine consumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale (NRS) at 0, 6, 12, and 24 hours after the surgeries.Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24 hours after the operations significantly (P<0.05).Pethidinerequirement was significantly lower in magnesium group throughout 24 hours after the surgeries (P=0.0001).Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could be considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH.

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Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Kathmandu University Medical Journal ◽

10.3126/kumj.v10i3.8013 ◽

2013 ◽

Vol 10 (3) ◽

pp. 25-29

Author(s):

Jeevan Singh ◽

RS Shah ◽

N Vaidya ◽

PK Mahato ◽

S Shrestha ◽

...

Keyword(s):

Side Effects ◽

Normal Saline ◽

Saline Group ◽

Single Shot ◽

Normal Saline Group ◽

Post Operative Pain ◽

Caudal Anaesthesia ◽

Caudal Analgesia ◽

Lower Pain ◽

Group B

Background Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. Objectives To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single shot technique in children. Methods Eighty children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg (Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl 1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32 min) than other three groups P < 0.05. The pain score assessed using FLACC scale was compared between the four groups, and children in Group BC had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects in compare to fentanyl or ketamine. Conclusion We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75 ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25% bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone, without any side effects. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 25-29 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8013

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Effect of Non-Anticoagulant N-Desulfated Heparin on Basic Fibroblast Growth Factor Expression, Angiogenesis, and Metastasis of Gastric Carcinoma In Vitro and In Vivo

Gastroenterology Research and Practice ◽

10.1155/2012/752940 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Jin-Lian Chen ◽

Jing Fan ◽

Ming-Xiang Chen ◽

Ying Dong ◽

Jian-Zhong Gu

Keyword(s):

Gastric Cancer ◽

Growth Factor ◽

Gastric Carcinoma ◽

Normal Saline ◽

Saline Group ◽

Fibroblast Growth ◽

Normal Saline Group ◽

Heparin Group

Objective. The present study was performed to investigate the effect of N-desulfated heparin on basic fibroblast growth factor (bFGF) expression, tumor angiogenesis and metastasis of gastric carcinoma.Methods. Human gastric cancer SGC-7901 tissues were orthotopically implanted into the stomach of NOD SCID mice. Twenty mice were randomly divided into two groups which received either intravenous injection of 0.9% NaCl solution (normal saline group) or 10 mg/kg N-desulfated heparin (N-desulfated heparin group) twice weekly for three weeks. In vitro, human gastric carcinoma SGC-7901 cells were treated with N-desulfated heparin in different concentration (0.1 mg/mL, 1 mg/mL, N-desulfated heparin group), and treated with medium (control group).Results. In vivo, the tumor metastasis rates were 9/10 in normal saline group and 2/10 in N-desulfated heparin group (P<0.05). The intratumoral microvessel density was higher in normal saline group than in N-desulfated heparin group (P<0.05). bFGF expression in gastric tissue was inhibited by N-desulfated heparin (P<0.05). There was no bleeding in N-desulfated heparin group. In vitro, N-desulfated heparin inhibited significantly bFGF protein and mRNA expression of gastric carcinoma cells (P<0.05).Conclusions. N-desulfated heparin can inhibit the metastasis of gastric cancer through inhibiting tumor bFGF expression and tumor angiogenesis with no obvious anticoagulant activity.

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Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

Journal of Lumbini Medical College ◽

10.22502/jlmc.v3i2.71 ◽

2016 ◽

Vol 3 (2) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Mahesh Sharma ◽

Kalpana Kharbuja ◽

Nil Raj Sharma

Keyword(s):

Laparoscopic Cholecystectomy ◽

Pain Relief ◽

Normal Saline ◽

Randomized Study ◽

Saline Group ◽

Normal Saline Group ◽

Analgesic Requirement ◽

Number Of Patients ◽

Group A ◽

Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy. Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy. Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19. Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable. Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

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