Background & Objective: Laryngoscopy and intubation (L&I) are strong stimulus for cardiovascular system. Hypertensive patients have a greater incidence of coexisting coronary artery disease and cerebrovascular insufficiency. Several methods have been in practice to prevent or alter the hemodynamic response to L&I. Although the main use of gabapentin has been as an antiepileptic, but its effect on the hemodynamic reflexes is still under evaluation. We compared the effectiveness of a single dose of gabapentin 800 mg on the mean arterial pressure (MAP) in response to L&I in hypertensive patients undergoing day care surgery. Methodology: This randomized, control trial was conducted in operating rooms, Dr Ruth K M Pfau Civil Hospital Karachi, from May 2017 to November 2017. A total of 150 patients undergoing elective surgery requiring general anesthesia with tracheal intubation were included in this study. Patients were randomly allocated equally into two group; Group G (gabapentin group) and Group P (placebo group). Patients in Group G received gabapentin 800 mg and Group P received placebo, 2 h prior to induction of anesthesia. MAP was measured at baseline (before induction), before intubation (after induction), at time 0 (immediately after intubation), and at 1 min, 3 min, 5 min, and 10 min after intubation. Effectiveness was defined as all the MAP reading to be within 30% of the baseline reading. Results: There were 72(48%) males and 78(52%) females. Effectiveness was significantly higher in patients of Group G, as compared to placebo group (Group P) [94.7% vs. 65.3%; p = 0.0005]. Conclusion: Gabapentin effectively suppresses the increase in MAP in response to laryngoscopy and tracheal intubation as compared to the placebo. Abbreviations: L&I: Laryngoscopy and intubation; MAP: Mean arterial pressure; ECG: Electrocardiography; ASA: American Society of Anesthesiologists; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure Key words: Laryngoscopy; Intubation; Hypertension; Gabapentin; Stress response Citation: Riasat MI, Chohan HT, Kumar A, Sultan SF, Javaid H, Siddiqui SZ. Premedication with gabapentin for laryngoscopy: a double-blind randomized control trial in hypertensive patients. Anaesth. pain intensive care 2021;25(2):163-169. DOI: 10.35975/apic.v25i2.1464
Objective: To compare between the efficacy of Ketorolac and Paracetamol in the management of post-operative pain following elective cardiac surgery. Study Design: Randomized (single-blind) Control Trial (RCT NCT05361824.) Place and Duration of Study: This study was conducted in the Surgical Intensive Care Unit (SICU) at the National Institute of Cardiovascular Diseases Hospital, Karachi Pakistan, From 1st Jan to 30th Jun 2021. Methodology: Randomization of 60 patients undergoing elective cardiac surgery into either Paracetamol (30 control patients) or Ketorolac (30 treatment patients) was done.In addition, to a low dose, short duration background infusion of Nalbuphine, the control group was administered. Injection Paracetamol 1gm every six-hours. Whereas the treatment group was administered injection Ketorolac 30mg every eight-hours. Assessment of pain was done at 6, 12, 18 and 24 hours post-extubation, using a Visual analog scale (VAS). For the purpose of this study, a score of 4 or less was taken as a cut-off for adequate pain control. Results: VAS score was significantly lower in Ketorolac group as compared to the Paracetamol group at all four-time points with an average rating of 3.2±1.9 vs. 5.3±1.7; p<0.001, 3.5±1.5 vs. 5±1.7; p<0.001, 3.3±1 vs. 5.0±1.4; p<0.001, and 3.0±1.4 vs. 4.3±1.6; p<0.001 at 6, 12, 18, and 24 hours respectively. The total dose of Nalbuphine administered (infusion + bolus doses) over 48 hours post-operatively was 15.3±5.2 vs 25.7±6.8 ml; p<0.001 in the Ketorolac and Paracetamol groups, respectively. Conclusion: The use of Ketorolac in conjunction with Nalbuphine gives better control over post-operative pain in elective cardiac surgeries than Paracetamol and Nalbuphine.
Objective: To find out the effect of Dexmedetomidine infusion on renal function in patients undergoing Coronary Artery Bypass Graft (CABG) surgery. Study Design: Randomized control trial (RCT- NCT05375188). Place and Duration of Study: The research was conducted in the Department of Anesthesia, National Institute of Cardiovascular Diseases Karachi Pakistan, from Jun to Sep 2021. Methodology: 60 patients were allocated randomly into two groups. In Group-D, Dexmetedomidine was given as an infusion of 0.4 μg/kg/h from induction of anesthesia for 24 hours. In Group-C, patients were receiving an equal volume of normal saline. The primary outcome of the study was Serum Creatinine (mg/dl) which was measured 24 hours before the surgery as baseline and then 24 hours and 48 hours after surgery. Results: In Group-C Serum Creatinine was found to be 0.96 +/- 0.21mg/dl at baseline, 1.02 +/- 0.35 mg/dl after 24 hours and 1.38 +/- 0.47 mg/dl after 48 hours of surgery. In Group-D Serum Creatinine was found to be 0.76 +/- 0.12 mg/dl at baseline,0.85 +/- 0.17 mg/dl after 24 hours and 0.82+/- 0.24 mg/dl after 48 hours of surgery. p-value was found to be <0.001 after 48hours of surgery. Conclusion: Dexmetedomidine infusion significantly reduced incidence of acute kidney injury in patients undergoing coronary artery bypass graft surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.