Introduction:Anaesthesia may influence intraoperative bleeding in several ways both physiologically and pharmacologically. Elective hypotension is used to reduce operative blood loss especially in those operations like spine surgery 1 , middle ear surgery, cerebro-vascular surgery where even a small quantity of blood can obscure the operative field and make difficulties for the surgeon for a good proper surgery and prolong duration of operation 1 . Laryngoscopic stimulation of oropharyngeal structure may be an important factor in the haemodynamic stress response associated with tracheal intubation. 2 Original ArticleUse of labetalol and glyceryl trinitrate for induced hypotension in spine surgery-A comparative study
Background: Preemptive administration of single dose pregabalin reduces postoperative narcotic analgesicconsumption after abdominal hysterectomy under sub-arachnoid block. Objectives: The present study was designed to evaluate the effect of pregabalin as a preemptive agent toreduce postoperative pain. Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in theDepartment of Anesthesia, Analgesia and Intensive Care Medicine at Banghabandhu Sheikh Mujib MedicalUniversity, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40 to 60years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population.A total of one hundred and twenty women were randomly allocated into two equal groups by cardsampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study.Group A was known as study group who were received 300mg oral pregabalin one hour before performanceof SAB and group B was known as control group who were received matching placebo one hour beforeSAB.Pain in the postoperative period was assessed on visual analogue scale and managed with PCAusing morphine. Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. Ateach visit, outcomes were measured in the following order: heart rate, mean arterial pressure, respiratoryrate, SpO2, and VAS pain score, sedation score, and any side effects which would develop. Finally, totalamount of morphine administered in 24 hour was recorded. The time since spinal anaesthesia to firstdose of analgesic was also recorded. Result: The mean 24hrs morphine consumption was 13.3 (±1.5) mg in Group-A, whereas in Group-B was29.1(±2.1) mg. The Group-A showed a significant reduction in morphine consumption then the Group-B(P<0.001). The time interval of first dose of analgesic was 5.2(±0.4) hrs in the Group-A, whereas in theGroup-B was 2.3(±0.2) hrs.The difference was significant (P<0.05).It was seen that side effects like respiratorydepression more in Group-B, dizziness and somnolence was more in Group-A than Group-B.Sedationscore was higher in Group-A than Group-B. Incedence of nausea/vomotting was same in both groups. Conclusion: It is demonstrated that preemptive use of Pregabalin led to significant reduction in narcoticanalgesic requirement and thereby a significant reduction in morphine related side effects. Beside this,pregabalin caused increased levels of sedation which may be beneficial for certain patients in earlypostoperative periods. JBSA 2017; 30(2): 66-74
Background: Effect of pregabalin on heart rate and arterial pressure is important in its use as preemptive analgesia. Objective: The purpose of the present study was to evaluate the effect of pregabalin use as preemptive analgesia after abdominal hysterectomy on heart rate and arterial pressure.Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine, Banghabandhu Sheikh Mujib Medical University, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40-60 years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population for this study. A total of one hundred and twenty women meeting the above mentioned criteria were randomly allocated into two equal groups by card sampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study. Group A was known as study group who were received 300mg oral pregnabin one hour before performance of SAB and group B was known as control group who were received matching placebo one hour before SAB. The patients were examined preoperatively and preoperative baseline parameters including heart rate, mean arterial pressure were recorded immediately before sub-arachnoid block (SAB). Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. In each visit, heart rate and mean arterial pressure were measured and were recorded. Result: The present study was conducted on 120 women undergoing abdominal hysterectomy. Of them, 60 received preemptive single oral doses (300mg) Pregabalin (Group A) and the rest 60 received matching placebos (Group B) 1hr before surgery. The mean heart rate with SD before SAB was 79.4±4.7 and 90.5±5.7 in group A and B respectively (p=0.011). After 24 hours of operation the mean heart rate with SD was 73±5 and 85±4 in group A and B respectively (p= 0.043). The mean arterial pressure with SD before SAB was 94.3±5.3 and 95.8±20.4 in group A and B respectively (p=0.569). After 24 hours of operation the mean arterial pressure with SD was 89.4±4.45 and 96.1±2.56 in group A and B respectively (p <0.001). Conclusion: In conclusion the mean heart rate and arterial pressure are statistically significantly changes in the women after abdominal hysterectomy to whom pregabalin is used as preemptive analgesia. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 98-102
To compare the haemodynamic changes between LMA insertion & endotracheal intubation, 60 patients were assigned randomly to one of the two groups of thirty each. They were grouped randomly by card sampling. Every patient included in the study was allowed a card preoperatively. According to the card number patients were grouped. Group A. Airway was maintained by LMA. Group B: Airway was maintained by ETT. Haemodynamic parameter i.e. pulse rate, systolic blood pressure, diastolic blood pressure and presence of any dysrhythmia were monitored after 1,3,5 & 10 minutes after LMA insertion or ETT intubations. There was statistically significant changes (P<0.05) in pulse rate, systolic blood pressure, diastolic blood pressure and (appearance of dysrhythmia in some patients) in group ti patients whereas there was less changes in pulse rate, systolic blood pressure, diastolic blood pressure whose airway was maintained by LMA insertion (Group-A). We conclude that LMA insertion causes less Haemodynamic changes than that of endotracheal intubation. So LMA insertion is safer than ETT intubations in some selected patients. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.28-32
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