scholarly journals Effects of intravenous Dexmedetomidine on Intraoperative Hemodynamic Parameters in the Patients Undergoing Laparoscopic Cholecystectomy

2020 ◽  
Vol 9 (2) ◽  
pp. 6-7
Author(s):  
Arjun Singh ◽  
Ravi Singh Dogra ◽  
Poonam ◽  
Reva Thakur
Keyword(s):  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Tracheal Extubation ◽  
Anesthesia Induction ◽  
Hemodynamic Parameters ◽  
Time Points

Background: Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics in laparoscopic cholecystectomy. Subjects and Methods: Five patients undergoing laparoscopic cholecystectomy received dexmedetomidine. Dexmedeto- midine was loaded (1 µg/kg) before anesthesia induction and infused (0.6 µg/kg/h) during surgery. Anesthesia was induced with propofol. Mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and at various time points from the loading of drugs to just after tracheal extubation. Results: Both HR and MAPdecreased till insufflation and then increased at extubation. Conclusion: During propofol-based anesthesia for laparoscopic cholecystectomy, dexmedetomidine provides stable intraoperative hemodynamics.

scholarly journals Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemodynamic Response ◽  
Anesthesia Induction ◽  
Group I ◽  
Significant Difference ◽  
Scalp Block ◽  
One Way Anova

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.

A Non-inferiority Trial: Safety and Efficacy of Topical 1:1000 versus 1:10 000 Epinephrine in Sino-nasal Surgeries

2020 ◽  
pp. 000348942096282
Author(s):  
Cassie L. Dow ◽  
Anders W. Sideris ◽  
Ravjit Singh ◽  
Mitchell H. Giles ◽  
Catherine Banks ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Nasal Passage ◽  
Hemodynamic Parameters ◽  
Hemodynamic Stability ◽  
Absolute Change ◽  
Significant Difference ◽  
Blood Pressures ◽  
Surgical Conditions

Objective: This study aimed to test the non-inferiority of topical 1:1000 epinephrine compared to topical 1:10 000 with regard to intraoperative hemodynamic stability, and to determine whether it produced superior visibility conditions. Methods: A single-blinded, prospective, cross-over non-inferiority trial was performed. Topical 1:1000 or topical 1:10 000 was placed in 1 nasal passage. Hemodynamic parameters (heart rate, systolic and diastolic blood pressures, and mean arterial pressure) were measured prior to insertion then every minute for 10 minutes. This was repeated in the contralateral nasal passage of the same patient with the alternate concentration. The surgeon graded the visualization of each passage using the Boezaart Scale. The medians of the greatest absolute change in parameters were compared using a Wilcoxon Rank-Signed test and confidence intervals were calculated using a Hodges-Lehman test. The non-inferiority margin was pre-determined at 10 bpm for heart rate and 10 mmHg for blood pressures. A Wilcoxon Rank-Signed test was used to assess superiority in visualization. Results: Thirty-two patients were enrolled and after exclusions, nineteen were assessed (mean age = 35.63 ± 12.49). Differences in means of greatest absolute change between the 2 concentrations were calculated (heart rate = 2.49 ± 1.20; systolic = −1.51 ± 2.16; diastolic = 2.47 ± 1.47; mean arterial pressure = 0.07 ± 1.83). In analyses of medians, 1:1000 was non-inferior to the 1:10 000. There was a significant difference (–0.58 ± 0.84; P = .012) in visualization in favor of topical 1:1000. Conclusion: Topical 1:1000 epinephrine provides no worse intraoperative hemodynamic stability compared to topical 1:10 000 but affords superior visualization and should be used to optimize surgical conditions.

Propofol and Sufentanil Titration with the Bispectral Index to Provide Anesthesia for Coronary Artery Surgery

2003 ◽  
Vol 99 (2) ◽  
pp. 334-346 ◽  
Author(s):  
François Forestier ◽  
Marie Hirschi ◽  
Pierre Rouget ◽  
Jean-Cristophe Rigal ◽  
Michel Videcoq ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Artery ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Arterial Pressure ◽  
Bispectral Index ◽  
Artery Bypass ◽  
Tracheal Extubation ◽  
Group 4 ◽  
Group 1

Background To provide anesthesia for cardiac surgery, hypnotics and opioids are frequently titrated on variables such as mean arterial pressure and heart rate. In this study conducted in patients scheduled to undergo coronary artery bypass grafting, propofol and sufentanil, both administered by computer-controlled infusion, were titrated on the Bispectral Index (BIS) values using a predefined algorithm. Methods After written informed consent, 110 patients, 95 men and 15 women aged 61 (9) yr [mean (SD)], were randomly allocated to receive predicted sufentanil effect site concentrations (Ce) of 0.5, 0.75, 1, 1.25, and 1.5 ng/ml, decreased by a third after sternotomy (groups 1-5). Target induction propofol concentration was 1.5 microg/ml and subsequently adjusted on BIS values. The following parameters were recorded: BIS values, predicted propofol Ce, the number of changes of propofol target, mean arterial pressure, heart rate, the number of bolus injection and doses of vasoconstrictor and vasodilator drugs, time to tracheal extubation, postoperative awareness and satisfaction scores, and cumulative morphine doses for the first postoperative day. Results One patient randomized to group 1 required 0.75 ng/ml sufentanil Ce instead of 0.5 ng/ml for increased BIS values on tracheal intubation. BIS values were similar in the five groups. The predicted propofol Ce values were different (P &lt; 0.05; analysis of variance) among the five groups: 1.59 (0.47) to 1.23 (0.25) microg/ml in group 1 and group 4, respectively. Significantly fewer changes of propofol target were required in group 4 as compared to group 1. There were no differences among the five groups for mean arterial pressure, heart rate, time to tracheal extubation, awareness, satisfaction scores, and morphine requirements. Conclusion These results suggest the BIS, as part of an algorithm that uses both the absolute BIS value and its increase following tracheal intubation, can be used to effectively titrate both propofol and sufentanil. A predicted sufentanil Ce of 1.25 ng/ml before and 0.8 ng/ml after sternotomy was associated with the lowest predicted propofol Ce and fewer changes of propofol target. Lower sufentanil concentrations required higher propofol concentrations and more frequent changes of the target propofol concentration and were associated with similar hemodynamic tolerance.

scholarly journals COMPARATIVE CHARACTERISTICS OF THE DYNAMICS OF CARDIOVASCULAR AND RESPIRATORY EFFECTS OF PNEUMOPERITONEUM BASED ON CARBON DIOXIDE AND ARGON IN LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 90-95
Author(s):  
O. L. Tkachuk ◽  
R. L. Parakhoniak ◽  
S. V. Melnyk ◽  
O. O. Tkachuk-Hryhorchuk
Keyword(s):  
Carbon Dioxide ◽  
Heart Rate ◽  
Cardiac Output ◽  
Laparoscopic Cholecystectomy ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Negative Impact ◽  
Abdominal Pressure ◽  
The Mean ◽  
Respiratory Systems

Pneumoperitoneum is one of the most critical components of laparoscopic surgery, which has a negative effect on gas exchange and stress to circulatory buffering system. One of the top priorities of laparoscopic technologies is to minimize the impact on the respiratory and cardiovascular systems, metabolic dynamics and compensatory abilities of homeostasis. The main goal of this research work is to compare the effects of carboxyperitoneum and argonoperitoneum on the intraoperative dynamics of CO2 concentration as well as cardiovascular and respiratory characteristics in patients undergoing laparoscopic cholecystectomy for various forms of cholelithiasis. Materials and methods. Four experimental groups involved patients based on their nosological form of cholelithiasis and the gas used to induce pneumoperitoneum. All patients underwent laparoscopic cholecystectomy by means of standard procedure. Either medical carbon dioxide or medical argon was used to induce pneumoperitoneum. Intraoperative monitoring of blood carbon dioxide levels PaCO2 was performed by taking venous blood every 15 minutes. Capnometry was performed by means of mainstream analysis using “BIOMED” BM1000C modular patient monitor by recording the discrete values of PetCO2 every 15 minutes, as well as by analyzing photocopies of capnography curves every 15 minutes. Intraoperative echocardiography was performed to identify the mean arterial pressure (MAP), heart rate (HR) and cardiac output (CO) in order to assess the effects of different types of pneumoperitoneum on the cardiovascular system. Results. The obtained data confirm the expected difference in the indices of cardiorespiratory functions between patients with acute cholecystitis and cholelithiasis without signs of inflammation. The investigation revealed that under the influence of pneumoperitoneum, heart rate and mean arterial pressure increase, while the cardiac output decreases. The respiratory pressure marker depends more on the intra-abdominal pressure and presumably the patient’s body type than on the presence of inflammatory syndrome. Argon insufflation has a slight negative impact on the cardiovascular system. Particularly, the mean arterial pressure and heart rate increase, while the cardiac output marker is less decreased as compared to the use of carbon dioxide. Abdominal pressure has a significant effect on the cardiovascular and respiratory systems regardless of the used type of gas. The combination of high intra-abdominal pressure with the elevated head end of the operating table, which is a common practise during cholecystectomy, has especially great influence on cardiovascular and respiratory functions. Operation which is carried out at decreased pressure allows reducing the deviations of practically all indices. Conclusions. Thus, the cardiovascular and respiratory systems adapt under the influence of pneumoperitoneum, providing compensation for the negative effects of mechanical and resorptive-metabolic character. Compensatory-adaptive abilities of the cardiovascular and respiratory systems increase with the decrease of intra-abdominal pressure. The use of argon as a working gas for insufflation into the abdominal cavity during laparoscopy reduces the negative impact of pneumoperitoneum on the cardiovascular and respiratory systems, providing a greater reserve of homeostatic and buffer systems of the body.

scholarly journals Comparison of Haemodynamic Response to Intubation with KingVision and C-MAC Videolaryngoscope in Adults

2020 ◽  
Author(s):  
Prathima Padavarahalli Thammanna ◽  
Kavya Marasandra Seetharam ◽  
Tejesh Channasandra Anandaswamy ◽  
Prapti Rath ◽  
Geetha Chamanhalli Rajappa ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
General Anaesthesia ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Haemodynamic Response ◽  
Time Points ◽  
Universal Device ◽  
Spss Software

Background: Videolaryngoscopes are now being advocated as the universal device for airway management due to their ability to provide an improved glottic visualisation. Due to their ability to see around the corners, they obviate the need to align the airway axes and thus may lead to less airway stimulation. This may result in less haemodynamic response during laryngoscopy and intubation. The present study was designed to compare the haemodynamic response to intubation with King Vision and C-MAC videolaryngoscopes. Methods: After obtaining informed consent, adults with unanticipated difficult intubation, scheduled to undergo surgery under general anaesthesia were randomised to be intubated with either King Vision (Group K) or C-MAC (Group C) videolaryngoscope. Following a standardised general anaesthesia induction protocol all subjects were intubated with the allocated videolaryngoscope and haemodynamic parameters (heart rate, systolic pressure, diastolic pressure and mean arterial pressure) were recorded at specific time points. Statistical analysis was done using the SPSS Software (version 18.0). Results: The changes in the heart rate, systolic pressure, diastolic pressure and mean arterial pressure following laryngoscopy and intubation with the allocated videolaryngoscope were statistically similar between the two groups at all time points. Conclusion: Haemodynamic responses to laryngoscopy and intubation with King Vision and C-MAC videolaryngoscopes were similar.

Dexmedetomidine as a Single Bolus Dose in Laparoscopic Cholecystectomy under General Anesthesia – A Comparison of Different Doses

2020 ◽  
Vol 5 (2) ◽  
pp. 1045-1049
Author(s):  
Kumud Pyakurel ◽  
Lalit Kumar Rajbanshi ◽  
Chitra Thapa ◽  
Gunjan Regmi
Keyword(s):  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Mean Arterial Pressure ◽  
Adverse Events ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Induction Dose ◽  
Pharmacodynamic Profile ◽  
Duration Of Surgery ◽  
Sedation Scores

Introduction: Dexmedetomidine has an ideal pharmacodynamic profile for attenuation of stress response during general anesthesia for laparoscopic cholecystectomy. Since, the value of dexmedetomidine as a single premedication dose remains largely unexplored, this study compared dexmedetomidine in 0.5μg/kg and 1μg/kg dose for laparoscopic cholecystectomy under general anesthesia.  Objectives: The primary objective of this study was to compare dexmedetomidine in a single premedication dose of 0.5μg/kg and 1μg/kg in terms of hemodynamic (heart rate and mean arterial pressure) changes to critical incidences such as laryngoscopy, endotracheal intubation, pneumoperitoneum and extubation. The secondary objectives were to compare induction dose of propofol required, sedation scores in the immediate post anesthesia period and adverse events such as bradycardia and hypotension.  Methodology: This was a prospective double blind study. Ninety-two patients aged 18-55 years of either gender of American Society of Anesthesiologists physical status I-II were randomly allocated into two groups to receive either Dexmedetomidine 1μg/kg or 0.5μg/kg slowly IV over 10 minutes as a premedication before induction. Heart rate, Mean arterial pressure, induction dose of propofol, sedation scores, and adverse events were compared.  Results: The patient characteristics, Fentanyl consumption, duration of surgery and anesthesia in both groups were comparable. There was comparable attenuation of hemodynamics in both groups during laryngoscopy and intubation. Dexmedetomidine in 1μg/kg compared to 0.5μg/kg had significantly better attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum. After 40 minutes, there was no attenuation in either group. The post anesthesia sedation scores were comparable. The induction dose of propofol was significantly less and the incidence of bradycardia was significantly higher with dexmedetomidine 1μg/kg.  Conclusion This study demonstrates that a premedication dose of Dexmedetomidine in 1μg/kg compared to 0.5μg/kg has significantly betier attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum.

A STUDY ON HAEMODYNAMIC RESPONSE ATTENUATION DURING HEAD HOLDER APPLICATION FOR CRANIOTOMY COMPARING IV DEXMEDITOMIDINE AND LOCAL LIGNOCAINE

2021 ◽  
pp. 28-30
Author(s):  
Jayadheer. D
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Intracranial Pressure ◽  
Arterial Pressure ◽  
Demographic Data ◽  
Hemodynamic Response ◽  
P Value ◽  
Hemodynamic Parameters ◽  
Neurosurgical Patients ◽  
Head Holder

Background; One of the goals of neuro anesthesia is to ensure stable perioperative cerebral hemodynamics, thus avoiding a sudden rise in intracranial pressure and prevent acute brain swelling.1 The intense surgical stimuli associated with craniotomy frequently causes sympathetic activation, which results in changes in heart rate (HR), blood pressure (BP), and cerebral blood ow (CBF). These changes may increase intracranial pressure (ICP) and a reduction in cerebral perfusion pressure (CPP). Finally, it leads to cerebral ischemia, especially in patients with impaired autoregulation and compromised cerebral compliance2,3. Thus, it is essential to preserve cerebral homeostasis and to prevent abrupt changes in hemodynamics. Smooth and rapid recovery from anesthesia allows immediate neurological assessment. Application of skull pin head holder is a necessity for stabilizing the head during craniotomy. Mayeld device or head holder is a clamp thatconsists of a C-shaped metal piece with three sharp interchangeable metal pins arranged triangularly to one another.4 These pins forced through the layers of scalp and periosteuminto the external lamina of the skull. Skull pins support the head without allowing any direct pressure on the face, allow access to the airway, and hold head rmly in one position that can nely be adjusted for optimal neurosurgical exposure. This study was conducted in fty ASA grade 1 or 2 patients who were adm Methods: itted at Government General Hospital, Guntur afliated to Guntur Medical College, Guntur, to undergo elective craniotomies under general anesthesia. After getting Ethical committee approval, a total of fty patients were allocated into two groups of 25 each. They were connected to the non-invasive monitors, and the basal heart rate and mean arterial pressure were recorded.Patients randomized to group dexmedetomidine received 1mcg/kg of dexmedetomidine diluted to 10ml with 0.9% saline over 10 min through a syringe pump, after recording pre-induction baseline hemodynamic parameters. Before the pin application, these patients received inltration of the pin sites with 0.9% saline (3ml for each site). Patients randomized to group lidocaine received infusion of 10ml of 0.9% saline over 10min, after recording baseline hemodynamic parameters. They then received inltration of the pre-marked pin sites with 2% lidocaine (without adrenaline), 3ml for each site. Heart rate and mean arterial pressure were recorded at various time intervals.Baseline, preinltration, post inltration, pre pin, 1 minute after post pin, 2minutes after post pin, 3 minutes, 5 miutes, 10 minutes and 15 minutes after post pin application. The result was analyzed using student t-test, and a P value of less than 0.05 was taken as signicant. ResultsWith patients matched for demographic data, the results showed there was no signicant difference in baseline values between the two groups. Heart rate and mean arterial pressure were comparable between the groups at various time intervals in the study. Thus both dexmedetomidine and lidocaine are equally effective in controlling the hemodynamic response to skull pin application. Despite being comparable to lidocaine inltration, dexmedetomidine causes signicantlymore episodes of hypotension and bradycardia, which could be detrimental in neurosurgical patients. Dexmedetomidine 1mcg/kg infusion and 2% li Conclusion gnocaine inltration both are equally effective in controlling the hemodynamic response to skull pin placement. Despite being comparable to lignocaine inltration, dexmedetomidine causes signicantly more episodes of bradycardia and hypotension, so they need rescue medication, which could be detrimental in a neurosurgical patient. We conclude that 2% of local lignocaine inltration is better in controlling hemodynamic responses to skull pin head holder application and does not cause any adverse effects in any of the patients.

scholarly journals A Comparative Study of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 26-30
Author(s):  
Sangeeta Subba ◽  
Richa Mishra ◽  
Rupak Bhattarai ◽  
Arjun Chhetri
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Bolus Dose ◽  
Hemodynamic Responses ◽  
Minimal Invasiveness ◽  
Quick Recovery

Background: Laparoscopic surgery has various advantages like minimal invasiveness and quick recovery. However carbon dioxide used for pneumoperitoneum during laparoscopic surgery causes increase in heart rate, blood pressure and systemic vascular resistance. The present study compared the efficacy of Dexmedetomidine and Esmolol on hemodynamic responses during laparoscopic cholecystectomy. Material and Methods: A total of 100 patients scheduled for laparoscopic cholecystectomy were randomly allocated in two groups, 50 in each group. Esmolol group received bolus dose of 1 mg/kg intravenous Esmolol just before pneumoperitoneum followed by an infusion of 200 mcg/kg/minand Dexmeditomidine group  received bolus dose of 1 mcg/kg iv Dexmedetomidine over 10 minutes before pneumoperitoneum  followed by 0.6 mcg/kg/hr in infusion. Hemodynamic parameters like Heart rate, Mean arterial pressure, Systolic blood pressure, Diastolic blood pressure were recorded at different time intervals. Results: It was found that in Dexmeditomidine group  there was a statistically significant decrease in heart rate before pneumoperitoneum (84.24±9.17) and 10 minutes after pneumoperitoneum (79.40±7.41)compared to Esmolol Group  before pneumoperitoneum (91.40±5.98) and10 minutes after pneumoperitoneum (95.18±14.17).There was statistically significant decrease in Mean arterial pressure in Dexmeditomidine group  at  30 minutes (86.53±6.13), 50 minutes (77.95±4.85) , after release of pneumoperitoneum (92.42±3.91) and after extubation (99.50±11.81) compared  to Esmolol group  at 30 minutes (91.23±8.97), 50 minutes (94.34±12.64) after release of pneumoperitoneum (102.5±10.44) and after extubation (112.39±11.15). Conclusion: Dexmedetomidine was found to be more effective than Esmolol in attenuating the hemodynamic responses following pneumoperitoneum during laparoscopic cholecystectomy.

scholarly journals Comparative Evaluation of Topical Lignocaine Versus Intravenous Lignocaine for Laryngeal Mask Airway Insertion in Wardha, Maharashtra

2021 ◽  
Vol 10 (28) ◽  
pp. 2078-2082
Author(s):  
Swathi Reddy G. ◽  
Karuna Taksande
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Laryngeal Mask Airway ◽  
Arterial Pressure ◽  
Comparative Evaluation ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Hemodynamic Parameters ◽  
Group I

BACKGROUND The purpose of present study was to compare and evaluate both topical lignocaine and intravenous lignocaine for laryngeal mask airway (LMA) insertion prior to propofol. Main objective was to study the conditions for LMA insertion with respect to gagging, coughing, Laryngospasm and No. of attempts for LMA insertion and also study the hemodynamic parameters in both the groups (Heart rate, SBP,DBP, MAP, SpO2) METHODS This study included 60 patients of 30 in each group, ASA I & II day care surgeries were performed in our hospital between 2019 and 2021. Patients were randomized into two groups. Group I received intravenous lignocaine 1.5 mg / kg over 30 seconds and group II received topical lignocaine 40 mg. Conditions of LMA insertion, gagging, laryngospasm, coughing were noted at the time of insertion, ECG, NIBP, SPO2 and ETCO2 were recorded according to scheduled times. RESULTS In conditions of LMA insertion, difference between both the groups was found to be significant, P < 0.05 in groups with first minute rise in heart rate, fall in Systolic blood pressure, diastolic blood pressure, mean arterial pressure was significant. At two minutes and three minutes after the LMA insertion, HR, SBP, DBP, MAP all these parameters changed slightly but these changes were statistically not significant. CONCLUSIONS Prior to Propofol induction, compared to intravenous lignocaine, topical lignocaine 10 % aerosol provided excellent conditions for the insertion of LMA without the use of neuromuscular blockers. KEY WORDS IV Lignocaine, Topical Lignocaine, LMA

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