Is a combination of Isoflurane with nitroglycerine better than halothane with nitroglycerine for controlled hypotension in spine surgery: A comparative clinical evaluation?

Abstract Background: In spine surgery rapid emergence and extubation with haemodynamic stability is crucial for early neurological examination. Here, we have studied the effect of α2 agonist – dexmedetomidine intravenous (IV) and lignocaine spray instilled into the endotracheal tube at the end of the procedure to attenuate the extubation responses. Methods: A total of 45 patients undergoing spine surgery were randomly allocated in three groups. After the return of spontaneous respiration, Group-D: Dexmedetomidine 0.3 mcg/kg IV, Group-L: 10% lignocaine spray 1.5 mg/kg through endotracheal route and Group-P: Normal saline IV given over 60 s. Haemodynamic responses (systolic blood pressure, diastolic blood pressure, mean arterial pressure [MAP], heart rate [HR] and SpO2) were recorded before and after administration of drugs and also duration of emergence, extubation, quality of extubation and post-operative sedation level were evaluated. Results: The increase in MAP and HR during extubation was significantly less in Group-D than Group-L and Group-P, 2 min after administration of the respective drugs (P < 0.05). There were no significant differences in the grade of a cough after extubation and post-operative sedation level. Conclusion: Dexmedetomidine (0.3 mcg/kg) attenuates haemodynamic response better than lignocaine spray (1.5 mg/kg) during emergence and extubation. It also provides smooth extubation and easy recovery without any post-operative sedative effect.

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Dexmedetomidine versus nimodipine for controlled hypotension during spine surgery

Egyptian Journal of Anaesthesia ◽

10.1016/j.egja.2013.06.002 ◽

2013 ◽

Vol 29 (4) ◽

pp. 325-331 ◽

Cited By ~ 2

Author(s):

Hatem Saber Mohamed ◽

Salah Mostafa Asida ◽

Ossama Hamdi Salman

Keyword(s):

Spine Surgery ◽

Controlled Hypotension

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Effects of Hydralazine Pretreatment on Esmolol-induced Controlled Hypotension during Spine Surgery

Korean Journal of Anesthesiology ◽

10.4097/kjae.2006.50.6.s31 ◽

2006 ◽

Vol 50 (6) ◽

pp. S31

Author(s):

Kum Suk Park ◽

Young Jin Roh ◽

Jong Su Kim ◽

Sang Hwan Do

Keyword(s):

Spine Surgery ◽

Controlled Hypotension

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Educational impact of the mini-Clinical Evaluation Exercise in resident standardization training: a comparative study between resident and professional degree postgraduate trainees

Journal of International Medical Research ◽

10.1177/0300060520920052 ◽

2020 ◽

Vol 48 (5) ◽

pp. 030006052092005

Author(s):

Yali Wu ◽

Mingfu Gong ◽

Dong Zhang ◽

Chun Zhang

Keyword(s):

Physical Examination ◽

Retrospective Analysis ◽

Treatment Regimen ◽

Clinical Diagnosis ◽

Clinical Evaluation ◽

History Taking ◽

Educational Impact ◽

Professional Degree ◽

Evaluation Exercise ◽

Better Than

Objective We aimed to explore differences in the educational impact of the mini-Clinical Evaluation Exercise (mini-CEX) on resident (RE) and professional degree postgraduate (PDPG) trainees, as well as influencing factors, to provide suggestions for hospital managers, trainers, and trainees. Methods We performed a retrospective analysis of all scores among first-year resident standardization training trainees registered during 2017 to 2019 at Xinqiao Hospital of Army Medical University, to identify differences in mini-CEX outcomes between REs and PDPGs. Results We collected data of 154 registered trainees for retrospective analysis, including 57 PDPG trainees and 97 RE trainees. The mean (standard deviation) overall performance score of PDPGs was 84.18 (4.25), which was higher than that of REs (81.48 (3.35)). In terms of domain analysis, PDPG trainees performed significantly better than REs in history taking, physical examination, clinical diagnosis/treatment regimen, and the knowledge examination; communication skills/humanistic care were comparable between the groups. Conclusions PDPGs performed better than REs in overall competency, history taking, physical examination, clinical diagnosis/treatment regimen, and the knowledge examination. A better knowledge base, supervisor-dominated one-to-one teaching mode, higher self-esteem and learning goals, and more sophisticated responses to feedback were potential contributors to a superior educational impact of the mini-CEX.

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Personal experience in studying symptomatic BPH

Urologia Journal ◽

10.1177/039156039606300309 ◽

1996 ◽

Vol 63 (3) ◽

pp. 324-327

Author(s):

R. Zucconelli

Keyword(s):

Benign Prostatic Hyperplasia ◽

Medical Treatment ◽

Clinical Evaluation ◽

Personal Experience ◽

Prostatic Hyperplasia ◽

Placebo Control ◽

Urodynamic Study ◽

Urodynamic Parameters ◽

Better Than

In an open randomised three-branch study without placebo control, an attempt was made to form a hypothesis regarding the most effective medical treatment of benign prostatic hyperplasia (BPH). 195 patients were enrolled in the study according to precise criteria of eligibility and were evaluated after 6 months both subjectively (IPSS) and objectively (urodynamic study). 53 were treated with finasteride, 45 with alfuzosin and 49 with an association of the two drugs. A statistically significant improvement was noted in the main urodynamic parameters (B better than C and C better than A), clinical evaluation revealed a positive overall influence of the treatments on the IPSS without specific correlations with obstruction urodynamic parameters, which although showing improvement mostly remained at a pathological level.

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Clinical evaluation of a system for precision enhancement in spine surgery

Clinical Biomechanics ◽

10.1016/0268-0033(95)00004-5 ◽

1995 ◽

Vol 10 (6) ◽

pp. 293-303 ◽

Cited By ~ 95

Author(s):

L-P Nolte ◽

L Zamorano ◽

H Visarius ◽

U Berlemann ◽

F Langlotz ◽

...

Keyword(s):

Spine Surgery ◽

Clinical Evaluation

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Outcome assessment for pyeloplasty in pediatric age group on the basis of ultrasonography

IP International Journal of Medical Paediatrics and Oncology ◽

10.18231/j.ijmpo.2021.012 ◽

2021 ◽

Vol 7 (2) ◽

pp. 57-62

Author(s):

Vasu Gautam ◽

RK Maurya ◽

RK Tripathi ◽

Ajay Kumar ◽

Pinaki Ranjan Debnath ◽

...

Keyword(s):

Renal Function ◽

Functional Outcome ◽

Outcome Assessment ◽

Clinical Evaluation ◽

Renal Pelvis ◽

Age Group ◽

Pediatric Age ◽

Pediatric Age Group ◽

Better Than

At present, duration and methods of radiographic follow-up after pediatric pyeloplasty are not well defined. We prospectively studied pediatric age group patients to assess outcome for cases of pyeloplasty on the basis of ultrasonography and DTPA scan. : We assessed all cases of PUJ obstruction in age group 0-18 years, who got admitted in LLR hospital, Kanpur and underwent pyeloplasty. Patients were excluded if cause of pyeloplasty was acquired. Preoperatively patients underwent clinical evaluation with history and examination followed by radiological investigations including Renal USG & DTPA scan. All patients were followed up postoperatively at 3, 6, 9 & 12 months. In USG, renal parenchyma thickness, antero-posterior diameter of renal pelvis was assessed. In DTPA scan, differential renal function was assessed. Data of USG and DTPA scan were statistically compared. 32 patients who underwent pyeloplasty at a median age of 4.2 years were studied. Follow-up was done for 1 year. On the basis of our study, DTPA scan is better than renal USG to assess functional outcome after pyeloplasty in pediatric age group up to 6 months during follow-up. But results are comparable for follow-up during 9 & 12 months postoperatively. The results of our study show that in the first 6 months, renal USG is not as much informative as DTPA scan to assess functional outcome after pyeloplasty but after 6 months, renal USG is equally effective as DTPA scan.Our study concludes that for poor resource countries, renal USG can be used to assess functional outcome after pyeloplasty in pediatric age group for post-operative follow-up, instead of costly & scarcely available investigation like Renal DTPA scan.

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Is Hearing Preservation Useful in Vestibular Schwannoma Surgery?

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940211100502 ◽

2002 ◽

Vol 111 (5) ◽

pp. 392-396 ◽

Cited By ~ 11

Author(s):

Hilla Levo ◽

Göran Blomstedt ◽

Ilmari Pyykkö

Keyword(s):

Clinical Evaluation ◽

Vestibular Schwannoma ◽

Functional Results ◽

Hearing Preservation ◽

Speech Distortion ◽

Operative Findings ◽

Almost All ◽

Better Than

The goal of our study was to examine the usefulness of preserved hearing after unilateral vestibular schwannoma removal. The patients were assessed by clinical evaluation, preoperative and postoperative audiometric evaluation, operative findings, and postoperative functional results. Hearing was preserved in 47 of 119 patients. The postoperative hearing was better than 30 dB in 10 patients. During the follow-up, the hearing decreased 5 dB on average, and almost all of the decrement occurred during the first 6 months. Subjectively, the preserved hearing assisted in understanding of speech in 62% of the patients. Tinnitus did not interfere with understanding of speech. The age of the patients was the most significant factor associated with preserved hearing. Sixty-six percent of the patients with hearing preservation rated their preserved hearing as valuable. Neither tinnitus nor speech distortion reduced the appreciation for hearing preservation. We conclude that efforts to preserve hearing are worthwhile.

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