scholarly journals Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study

2021 ◽  
Author(s):  
Prakriti Gupta ◽  
Suraj Kumar ◽  
Samiksha Parashar ◽  
Manoj Kumar Giri ◽  
Sujeet Rai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Anaesthesia ◽  
Randomised Clinical Trial ◽  
P Value ◽  
Test Results ◽  
Hyperbaric Bupivacaine ◽  
Induced Hypotension ◽  
Crystalloid Solution ◽  
Exact Test ◽  
American Society

Introduction: Both crystalloids and colloid preloading is recommended for spinal anaesthesia. Preloading of intravenous fluids increases circulating volume and cardiac output; thus preventing spinal anaesthesia-induced hypotension. Crystalloids have a short intravascular half-life, poor plasma expanders and large volumes are thus required. Aim: To compare the efficacy of 5 mL/kg of 6% Hetastarch (colloid) to that of 15 mL/kg of Plasmalyte (crystalloid) solution to prevent hypotension during spinal anaesthesia in patients undergoing lower abdominal surgeries. Materials and Methods: This was a randomised clinical trial from June 2016 to April 2017 on a total 80 patients, belonging to American Society of Anaesthesiologist (ASA) Grade I and II scheduled for lower abdominal surgeries under spinal anaesthesia. They were divided into two groups- Group H and Group P. Patients in group H were preloaded with 5 mL/kg solution of 6% Hetastarch, whereas those in group P were preloaded with 15 mL/kg of Plasmalyte solution. After institution of spinal anaesthesia with 3.0 mL of hyperbaric Bupivacaine using 25G Quincke’s needle, Blood Pressure (BP) and other vital parameters were monitored intraoperatively every 3 minutes for first 30 minutes and then every 5 minutes till the end of surgery. Descriptive statistics, frequency (n) and percentages (%) were calculated and the variables between the groups were compared by Students t-test, Fischers exact test and Mann Whitney U-test. Results: Both the groups showed a fall in Mean Blood Pressure (MBP) immediately after the block. Group P showed more decline in MBP and Diastolic Blood Pressure (DBP) after the block and thedifference was statistically significant at 9, 12, 15, 18 and 21minute (p-value <0.05). A 30% patients in group P as comparison to 10% in Group H required ephedrine for the treatment of hypotension and found significant (p-value=0.025). Systolic Blood Pressure (SBP), pulse rate changes and nausea and vomiting among both groups was non-significant (p-value >0.05). Conclusion: Pre-loading with 5ml/kg of 6% Hetastarch is more effective than 15ml/kg of Plasmalyte in preventing hypotension in patients undergoing lower abdominal surgeries under spinal anaesthesia.

scholarly journals COMPARISON OF HAEMODYNAMIC STABILITY WITH 0.5% AND 0.75% HYPERBARIC BUPIVACAINE DURING SPINAL ANAESTHESIA IN WOMEN UNDERGOING CAESAREAN SECTION

2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
The Mean ◽  
The Difference

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.

scholarly journals CT Scan Evaluation of Prevalence of Paradoxical Middle Turbinate In Adult Population of Bihar

2020 ◽  
Vol 6 (1) ◽  
pp. 01-04
Author(s):  
Raag Reeti ◽  
Md Jawed Akhtar ◽  
Avanish Kumar ◽  
Binod Kumar ◽  
Rajiv Ranjan Sinha
Keyword(s):  
Convex Surface ◽  
Adult Population ◽  
Middle Turbinate ◽  
Lateral Wall ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
P Value ◽  
Test Results ◽  
Common Cause ◽  
Exact Test

Introduction: Middle turbinate overlying the middle meatus is the most important anatomic area in the lateral wall of the nose. It is a thinsheet of bone which curves in different planes very similar to a dried leaf. Paradoxical Middle Turbinate (PMT) is the abnormal curvatureof middle turbinate, where the convex surface faces laterally instead of its usual medial curvature and may block the drainage pathway ofmiddle meatus. The present study aimed at observing the prevalence of the paradoxical middle turbinate in the adult population of Bihar. Subjects and Methods: This was a retrospective study being conducted on 150 patients who presented to the Department of Radiodiagnosis. Their CT scans were analysed for the presence of paradoxical middle turbinate. The results were analysed as percentage and ‘p’ value was calculated using Fischer’s Exact Test. Results: Prevalence of Paradoxical Middle Turbinate was observed in 28 cases i.e. 18.6% cases; 16 in males and 12 in females. ‘p’ value was 0.677 on applying Fisher’s Exact test. Conclusion: Anatomical variations of the paranasal sinus region like paradoxical middle turbinate are quite common cause of diseases involving paranasal sinuses and they must be searched for by the surgeons planning any endoscopic sinus surgery. This study attempted to provide the prevalence of the paradoxical middle turbinate which will definitely help the FESS surgery and its outcomes.

scholarly journals Air Rebusan Seledri Menurunkan Tekanan Darah

2015 ◽  
Vol 6 (2) ◽  
Author(s):  
Wiwik Afridah ◽  
Budi Setiawan
Keyword(s):  
Blood Pressure ◽  
Elderly People ◽  
Elderly Population ◽  
Fruits And Vegetables ◽  
Healthy Lifestyle ◽  
Control Group ◽  
Fisher Exact Test ◽  
Random Allocation ◽  
Test Results ◽  
Exact Test

The increasing elderly population will lead to problems such as health problems, one of which is hypertension. The purpose of this study was to determine the effect of celery stew on blood pressure in elderly people with hypertension Hulaan Village District Menganti Gresik regency. This study uses a design Case control design with the aging population in the first level of hypertension by 12 people, with a large sample of elderly with hypertension entire first level is 12 people, and how to use the total sampling sampling and divided into 6 groups of 6 cases and the control group with random allocation techniques. Celery stew independent variables and the dependent variable blood pressure. The data was collected by means of measuring the blood pressure recorded recapitulation and analyzed using the Fisher exact test with α = 0.05. The research results obtained from 6 groups of cases that were given celery stew all experienced a decrease in blood pressure, whereas in the control group of 6 people who were not given celery stew is only 1 person that declined. Fisher Exact test results obtained ρ (0.015) <α (0.05), means that the research hypothesis is accepted ie no celery stew effect on blood pressure in elderly people with hypertension Hulaan Village District Menganti Gresik Regency. The conclusions of this study are no celery stew effect on blood pressure of elderly with hypertension. Hypertensive patients are expected to maintain your diet, multiply to consume fruits and vegetables that contain potassium, as well as a healthy lifestyle change. 

scholarly journals Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries

2016 ◽  
Vol 1 (2) ◽  
pp. 35-40 ◽  
Author(s):  
Naina P Dalvi ◽  
Narendra Patil
Keyword(s):  
Blood Pressure ◽  
Postoperative Analgesia ◽  
Total Duration ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Prolonged Duration ◽  
American Society

ABSTRACT Introduction This single-center, prospective, randomized, double-blind study compares the effect of intrathecal fentanylbupivacaine and tramadol-bupivacaine on the onset and duration of sensory and motor blockade, as well as postoperative analgesia in lower abdominal surgeries. Materials and methods Patients of either sex, aged 18 to 60 years, American Society of Anesthesiologists (ASA) grade I/II undergoing lower abdominal surgeries like appendicectomy, inguinal hernia repair surgery, and hydrocele surgery were administered either 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 μg) of fentanyl citrate (group F) or 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 mg) of tramadol (group T) intrathecally. Monitoring of the vital parameters, onset and duration of sensory and motor block, duration of postoperative analgesia, visual analog scale (VAS) score, sedation score, and any adverse drug reactions was done at predetermined intervals. Results Sixty patients were randomized to the group F (n = 30) and group T (n = 30). The duration of sensory blockade was significantly prolonged in group F (314.66 ± 49.25 minutes) as compared to group T (261.66 ± 27.92 minutes). Similarly, duration of motor blockade was longer in group F (263.66 ± 40.97 minutes) compared to group T (214.66 ± 26.61 minutes). The total duration of analgesia was significantly prolonged (p < 0.001) in group F (412 ± 97.888 minutes) compared to group T (301 ± 38.75 minutes). Hemodynamic parameters, such as pulse, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups. Visual analog scores were significantly lower in the group F patients as compared to the group T patients. The group F patients had got significantly higher sedation scores as compared to Group T patients. Discussion Fentanyl 25 μg, when added to 2.5 mL of 0.5% hyperbaric bupivacaine, confers prolonged duration of sensory and motor blockade than 25 mg tramadol added to 2.5 mL of 0.5% hyperbaric bupivacaine. The bupivacaine-fentanyl combination prolonged duration of sensory and motor blockade, improved analgesia, as manifested by lower pain scores, and prolonged duration of postoperative analgesia. How to cite this article Dalvi NP, Patil N. Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries. Res Inno in Anesth 2016;1(2):35-40.

Randomised clinical trial comparing the perioperative analgesic efficacy of oral tramadol and intramuscular tramadol in cats

2021 ◽  
pp. 1098612X2110404
Author(s):  
Sébastien H Bauquier
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Analgesic Efficacy ◽  
Randomised Clinical Trial ◽  
Rescue Analgesia ◽  
Exact Test ◽  
Pain Scores ◽  
Significant Difference ◽  
American Society ◽  
Induction Of Anaesthesia

Objectives The aim of this study was to evaluate the analgesic efficacy of oral tramadol in cats undergoing ovariohysterectomy. Methods Twenty-four female domestic cats, American Society of Anesthesiologists class I, aged 4–24 months, were included in this positive controlled, randomised, blinded clinical trial. Cats admitted for ovariohysterectomy were allocated to group oral tramadol (GOT, n = 12) or group intramuscular tramadol (GIMT, n = 12). In GOT, tramadol (6 mg/kg) was given orally 60 mins, and saline was given intramuscularly 30 mins, before induction of anaesthesia. In GIMT, granulated sugar in capsules was given orally 60 mins and tramadol (4 mg/kg) intramuscularly 30 mins before induction of anaesthesia. In both groups, dexmedetomidine (0.007 mg/kg) was given intramuscularly 30 mins before induction of anaesthesia with intravenous propofol. Anaesthesia was maintained with isoflurane in oxygen, and atipamezole (0.037 mg/kg) was given intramuscularly 10 mins after extubation. The UNESP-Botucatu multidimensional composite scale was used to conduct pain assessments before premedication and at 20, 60, 120, 240 and 360 mins post-extubation or until rescue analgesia was given. To compare groups, the 60 min postoperative pain scores and the highest postoperative pain scores were analysed via a two-tailed Mann–Whitney test, and the incidences of rescue analgesia were analysed via a Fisher’s exact test; P <0.05. Results There was no significant difference between groups for the 60 min ( P = 0.68) pain scores. The highest postoperative pain score was higher for GIMT compared with GOT ( P = 0.04). Only two cats required rescue analgesia, both from GIMT. The incidence of rescue analgesia was not significantly different between groups ( P = 0.46). Conclusions and relevance In the present study, preoperative administration of oral tramadol at 6 mg/kg to cats provided adequate analgesia for 6 h following ovariohysterectomy surgery.

The Effectiveness of Young Coconut Water and Watermelon Juice in Reducing Blood Pressure

2021 ◽  
Vol 15 (5) ◽  
pp. 1313-1322
Author(s):  
S. Fadlilah ◽  
A. Sucipto
Keyword(s):  
Blood Pressure ◽  
Nursing Students ◽  
Coconut Water ◽  
Control Group ◽  
P Value ◽  
Test Results ◽  
Watermelon Juice ◽  
Post Test ◽  
The Mean ◽  
Pressure Analysis

Background: Blood pressure is influenced by psychosocial (stress), genetic, age, gender, nutritional status, and lifestyle (diet, lack of fiber consumption, smoking, lack of physical activity). 30 ml of young coconut water contains 61 mg of potassium, 5.45 mg of sodium, and 1.3 mg of sugar, affecting blood pressure changes. Coconut water contains K minerals and is useful for lowering blood pressure. Whereaswatermelon contains anti-hypertensive content, namely sodium, beta carotene, and potassium. Watermelon is rich in water, amino acids, L-arginine, which can maintain healthy blood pressure. Aim: This study aims to determine the effect of young coconut water and watermelon juice on blood pressure in the 2013 nursing students of Respati University Yogyakarta. Methods: This type of research is a quasi-experimental design with a nonequivalent control group pre and post-test. The sample was taken by simple random sampling, namely the control group (18 respondents), the young coconut water group (18 respondents), and papaya juice (18 respondents). Data pre-posttest of each group was tested using Paired T-test. The comparison control-treatment group was tested using an independent-test. Results: The mean differences of systole and diastole pre-posttest blood pressure in the control group were -1.8 mmHg and -1.0 mmHg. The mean difference in systole blood pressure and the pre-posttest diastole of young coconut water groups were -3.1mmHg and -2.4 mmHg. The mean systole and diastole blood pressure in the pre-posttest watermelon juice group were -2.9 mmHg and -1.5 mmHg. The pre-posttest results of systole and diastole blood pressure analysis in the p-value control group were 0.100 and 0.450. The pre-post test results of systole and diastole blood pressure analysis of young coconut water groups gained p-value of 0.030 and 0.194. The pre-post test results of the juice watermelon group's systole and diastole blood pressure analysis gained p-value of 0.032 and 0.181. The posttest results of systole and diastole blood pressure analysis in the control group and young coconut water gained p-value of 0.014 and 0.157. The post-test results of the systole and diastole blood pressure analysis control group and juice watermelon gained p-value of 0.013 and 0.420. Conclusion: Consumption of young coconut water and watermelon juice affects systole blood pressure, but it does not affect diastole blood pressure in nursing students in 2013 in Respati University Yogyakarta. Keyword: Blood pressure, Coconut Water, Watermelon Juice

scholarly journals A Randomised Clinical Trial to Compare the Efficacy of Tramadol and Nalbuphine for Treatment of Shivering after Spinal Anaesthesia in Patients Posted for Lower Limb Orthopaedic Surgery

2021 ◽  
Author(s):  
Sara Mary Thomas ◽  
Ananya Pradhan ◽  
Dinesh Chauhan
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Spinal Anaesthesia ◽  
Muscular Activity ◽  
Total Sample ◽  
Randomised Clinical Trial ◽  
Muscle Group ◽  
P Value ◽  
Entire Body ◽  
Grade 3

Introduction: Nalbuphine and tramadol are opioids which have been used to control post-anaesthetic shivering. Aim: To compare the efficacy of nalbuphine and tramadol in the treatment of post-spinal anaesthesia shivering. Materials and Methods: This was a randomised clinical trial conducted on 60 patients of either gender (20-60 years age group) from January 2019 to June 2020, American Society of Anaesthesiologists (ASA) Grade I or II, having post-spinal anaesthesia shivering. The total sample was divided into two groups of 30 patients each. Group T received injection (Inj) tramadol 1 mg/kg intravenously (iv) and Group N received Inj. nalbuphine 0.1 mg/kg iv. Grade of shivering was assessed with a five point scale as Grade 0- no shivering; Grade 1; No visible muscle activity, but one or more of piloerection, peripheral vasoconstriction or peripheral cyanosis Grade 2; Muscular activity in only one muscle group; Grade 3: Moderate muscular activity in more than one muscle group, but not generalised shaking; Grade 4: Violent muscular activity that involves the entire body. The time taken for disappearance of shivering, assessment of improvement of shivering (complete- if grade of shivering becomes 0, partial- if grade of shivering deceased but not zero), recurrence rate and side-effects such as nausea, vomiting, deep sedation were noted. Independent t-test and Chi-square test were used to analyse the data. A p-value <0.05 were considered statistically significant. Results: The time taken for disappearance of shivering was shorter in group N than T (3.20±0.96 minutes and 6.43±0.97 minutes respectively, p=0.001). Significantly better sedation (p-value 0.04) was seen in nalbuphine group as grade 3 sedation were seen in 15 patients of nalbuphine group as compared to none in tramadol group. All the patients in group N had complete improvement of shivering and there was no recurrence, while in group T six patients had partial improvement in shivering and four (13%) had recurrence. Complications such as nausea (three patients) and vomiting (one patient) were seen in Group T while none were seen in Group N. Conclusion: The efficacy of nalbuphine is greater than tramadol in controlling post-spinal anaesthesia shivering, with minimal side-effects.

scholarly journals A COMPARISION OF INTRATHECAL HYPERBARIC BUPUVACAINE WITH BUPRENORPHINE AND HYPERBARIC BUPIVACAINE ALONE IN GYNAECOLOGICAL SURGERIES FOR POSTOPERATIVE ANALGESIA

2021 ◽  
Vol 9 (06) ◽  
pp. 773-777
Author(s):  
Archana Jadhav ◽  
◽  
Rashmi Bengali ◽  
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Spinal Anaesthesia ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Group B ◽  
Effective Analgesia

This study was performed at a tertiary care centre after the approval of the Institutional Ethical Committee and obtaining written informed consent from all patients. Sixty ASA I and II, aged 18- 65yrs, bodyweight 45-70kgs scheduled for gynaecological surgeries under spinal anaesthesia were chosen for the study and were divided into two groups named Group B and Group BN each comprising 30 patients. Group B received 3ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline and Group BN received 3ml of 0.5% hyperbaric bupivacaine with 0.5ml (150mcg) of buprenorphine. Vital parameters like pulse rate, blood pressure, respiratory rate, SpO2 were recorded at 0 (basal) 15, 30, 45, 90 and 180 minutes. Postoperatively heart rate, blood pressure, respiratory rate and SP02 were monitored at 3 ,6 ,12 and 24 hrs. The mean age, height, weight, duration of surgery were comparable. Time of onset of sensory blockade and motor blockade were noted. The time for rescue medication was 909.0±216.9 min in group BN with a range from 690 min to 1500 min and in group B it was 412.0±89.28 min with a range from 130 min to 195 min. Comparing both groups duration of effective analgesia was significantly higher in group BN with P<0.0001.thus, it can be concluded that addition of buprenorphine as an adjuvant in spinal anaesthesia excellently prolongs duration of analgesia in postoperative period with minimal side effects.

Sign in / Sign up

Export Citation Format

Share Document