BACKGROUND Numerous attempts have been made in the past to attenuate the haemodynamic responses occurring during laparoscopic cholecystectomy. The present study compared the effect of three opioids namely Butorphanol, Fentanyl and Nalbuphine in obtundation of haemodynamic responses in laparoscopic cholecystectomy in terms of Heart rate, BP (SBP, DBP and MAP) and secondary aim was to calculate duration of analgesia and sedation score. MATERIALS AND METHODS This was a randomised study comparing three opioid drugs-nalbuphine, fentanyl and butorphanol. It was carried out on 75 patients of either sex aged 18-60 years scheduled for elective laparoscopic cholecystectomy under GA. Subjects were enrolled into three groups-Group B (n= 25) patients received inj. Butorphanol 25 mcg/kg IV, Group F (n= 25) received inj. Fentanyl 2 mcg/kg IV and Group N (n= 25) patients received inj. Nalbuphine 0.2 mg/kg 5 minutes before the induction. RESULT At the time of extubation, mean MAP in Group B, F and N was 99.88, 95.32 and 97.24 respectively. This difference is highly significant when compared statistically (p value is 0.005). CONCLUSION With this study, we conclude that the administration of intravenous fentanyl and nalbuphine five minutes prior to induction of anaesthesia helps in better obtundation of haemodynamic responses to laparoscopic cholecystectomy than butorphanol.
HighlightsThe duct fully obliterates (narrows and disappears) during the 5–6th week of fertilization age (9th week of gestational age), but a failure of the duct to close is termed a vitelline fistula.We present a case of 1 year male with paraumblical abcess due to patent vitellointestinal duct who underwent incision and drainage twice.Of all the anomalies of the VID, complete patency of the duct is the rarest.
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes ABSTRACTIntroduction: Acute pancreatitis is the acute inflammation of the pancreatic gland, attributed to a wide range of etiological factors. It is a well-known fact that approximately 80% of the causes are associated with cholelithiasis and alcohol abuse. However, the exact incidence of drug induced pancreatitis is difficult to determine due to the rare presentation, it requires larger, case-controlled studies to determine its incidence and prevalence. Up to 2% cases may be caused by drug. Case Report: This is a case report focusing on a 26-year-old female patient who developed acute pancreatitis following administration of levofloxacin and methylprednisolone for treatment of pneumonitis in intensive care unit. Both the drugs appear to be responsible for pancreatitis because of temporal relationship between the administration of drug, onset of symptoms and improvement of clinical symptoms when drugs were stopped. Conclusion:Levofloxacin and methylprednisolone appears to be responsible for pancreatitis because of the temporal relationship between the administration of drug, onset and improvement of clinical symptoms when drugs were stopped.
Introduction: For routine and emergency upper limb surgeries, brachial plexus block is better alternative to general anaesthesia. As compared to classic Interscalene brachial plexus Block (ISB), Low Interscalene Block (LISB) deposit Local Anesthetic (LA) more caudad causing sensory-motor blockade of upper limb. It acts as bridge between supraclavicular and classic ISB. Local anaesthetic mixture are used to shorten the onset of sensorymotor blockade. Alongside, various adjuvants are mixed with LA to further improve quality of block. Aim: To compare the efficacy of dexmedetomidine and clonidine as adjuvants to LA mixture in LISB for upper limb surgeries to assess onset and duration of Sensory-motor block and to observe any complication associated with block. Materials and Methods: This double-blind, randomised prospective clinical study was conducted on 90 patients, aged 18 to 60 years, posted for upper limb surgeries with American Society of Anesthesiologists (ASA) grade I, II at a tertiary care centre of Government Medical College, Patiala, Punjab, India from February 2021 to November 2021. The patients were randomly divided into three groups. Group I: levo-bupivacaine 0.5% (20 mL)+ lignocaine 2% (10 mL)+ Normal Saline (NS) (1 mL), group II: levo-bupivacaine 0.5% (20 mL)+ lignocaine 2% (10 mL) + dexmedetomidine 50 mcg (1 mL), group III: levo-bupivacaine 0.5% (20 mL)+ lignocaine 2% (10 mL)+ clonidine 50 mcg (1 mL). The parameters observed were: onset and duration of sensory and motor block, any intraoperative complication. Data was compiled with the help of MS-Excel and analysis done with IBM Statistical Package for Social Sciences (SPSS) version 22. Results: The mean onset time of sensory and motor block was faster in group II (4.20±0.62, 5.25±0.89 min) as compared to group III (5.24±0.99, 6.23±0.96 min) and group I (6.48±0.87, 7.03±1.02 min). The mean duration of sensory and motor block was prolonged in group II (743.38±12.55, 673.21±22.29 min) as compared to group III (480.65±14.72, 433.03±7.28 min) and group I (311.28±5.75, 272.03±6.09 min). No adverse effect was observed during this study. Conclusion: Dexmedetomidine was more effective than clonidine as an adjuvant to LA mixture (0.5% levobupivaciane + 2% lignocaine) in low interscalene brachial plexus block and no episode of pneumothorax and phrenic nerve palsy was seen.
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