Background: General anesthesia is an essential component of anesthesia and endotracheal intubation is a basic step to secure the airway in patients undergoing any surgical procedure. Airway manipulation causes mucosal inflammation resulting in coughing, straining, bucking and subsequent distress to the patient. Aim: To find out whether preemptive use of nebulized lignocaine has some role in endotracheal tube tolerance during General anesthetic induction and emergence. Study design: Randomized control trial Methodology: The randomized controlled study was done on 68 patients scheduled for general surgical procedures.Patients were allocated intoGroup A and Group Bby closed envelope method with 34 patients in each group. In Group A lignocaine 2% (1.5-2mg/kg) with normalsaline 0.9% to prepare total of 5 ml solution, was used to nebulize the patients with face mask connected with O2 at 7L/min and in Group B5ml normal saline 0.9% was used to nebulize the patients for 15minutes. The endotracheal tube tolerance was noted at both intubation and extubation. Results: Endotracheal tube tolerancein Group A was markedly significant than in Group B both during intubation and extubation. In Group A, 32/34(94.12%) patients reflected tolerance to endotracheal tube both during intubation and extubation while in Group B only 06/34(17.65%) reflected tolerance to endotracheal tube both during intubation and extubation. Conclusion: Preemptive nebulized lignocaine suppresses the airway reflexes and significantly improves the endotracheal tube tolerance. Keywords: Endotracheal intubation, extubation, nebulization, lignocaine.
Acute ascending flaccid paralysis with areflexia were considered as Guillain-Barre Syndrome by medicine and neurology department as tradition. We present two patients 46 years old female and 57 years old male with acute ascending flaccid paralysis admitted in intensive care unit. They developed respiratory paralysis requiring mechanical ventilation. The male patient developed cardiopulmonary arrest during shifting to intensive care unit. Both the patients responded to vitamin d therapy dramatically. Respiratory paralysis on mechanical ventilation responding to vitamin d therapy dramatically were unique events. Vitamin d deficiency is a worldwide problem but its presentation as acute ascending paralysis with areflexia requiring mechanical ventilation is not cited in medical literature. Keywords; Acute ascending flaccid paralysis with areflexia, Respiratory paralysis, Vitamin D deficiency, Vitamin D therapy,
Background: Modified Limberg Flap (MLF) is regarded as the mainstay of treatment for Sacrococcygeal Pilonidal disease due to less postoperative complications as compared to other available surgical procedures. This Operative procedure can be performed under Spinal anesthesia as well as Local Anesthesia. Aim: To compare outcome of patients undergoing Modified Limberg Flap for Sacrococcygeal pilonidal sinus under Local anesthesia with adrenaline versus Spinal anesthesia in terms of post-operative pain, Seroma formation & Hospital stay. Methods: This was a randomized controlled clinical trial conducted at Department of Surgery, Sughra Shafi Medical Complex, Narowal. Study was conducted for a period of 06 months and 80 patients were included through non-probability consecutive sampling technique. Patients were randomly divided into 2 equal groups by computer generated method. Patients in group LA underwent MLF under Local anesthesia with adrenaline while patients in group SA underwent MLF under Spinal anesthesia. Informed written consent was obtained from all the participating patients. Results: Mean age of all patients was 24.78±5.12 years. Minimum and maximum age of patients was 16 and 37 years respectively. Gender distribution shows that 96.25% were male while 3.75% were female. Seroma formation in Group-LA was 0% while in Group-SA, it was 7.5%. Hospital stay of patients in Group-LA and in Group-SA was 9.60±9.39 and 29.10±9.37 hours respectively. Mean operation time in Group-LA was 42±5.64 minutes whereas in Group-SA mean operation time was 46±7.53 minutes. Mean pain score in Group-LA was 2±1.04 at 12th hour of surgery and in Group-SA it was 3.83±1.06 at 12th hour of surgery. Conclusion: It is concluded that Modified Limberg Flap can be performed under local anesthesia as a day case procedure to save time, reduce work burden and cost of surgery. Keywords: Modified Limberg Flap, Sacrococcygeal Pilonidal Sinus Disease, Local Anesthesia, Adrenaline, Spinal Anesthesia.
Background: Tonsillectomy is a common surgical procedure required to prevent recurrent infection, inflammation and related distress to the patients. Intervention in this highly vascularized area results in inflammatory responses and subsequent pain. Due to inadequate management 30-70% patients suffer from post-operative pain. Post tonsillectomy pain has its impact on analgesic consumption, hospital stay and return to normal activity. Methodology: This randomized control trial study design is a prospective randomized controlled including convenience sample of 32 patients of both genders, aged 4-30 years undergoing tonsillectomy.Tonsillectomy was performed by standard dissection method after giving general anesthesia to the patients. After completing the tonsillectomy on right side, surgeon infiltrated 6ml of 0.25 % bupivacaine in the tonsillar fossa on the right side. The surgeon did not infiltrate into the left side being observed as control. Postoperative pain score was recorded by asking patients on a VAS graded 1-10 scale (0= no pain and 10= maximum pain) after half an hour in recovery, 2 hours, 4 hours and 6 hours after the operation. Results: The mean age of the study patients was 14.08±7.32 years which included 20 (62.5%) females and 12(37.5%) males. The mean of duration of operation was 42.03±14.75 minutes. There was statistically significant difference between pain scores on VAS in infiltrated bupivacaine (right side) and control (left side) after ½, 2,4 and 6 hours respectively. Conclusion: Infiltration of 0.25% bupivacaine significantly reduces post tonsillectomy pain. Keywords: Tonsillectomy, Bupivacaine infiltration, Pain
Background: OCR commonly occurs during strabismus surgery, producing bradycardia, arrhythmias and even cardiac arrest after manipulation of orbital structures. Ketamine is NMDA receptor antagonist and acts as an analgesic. Aim: To determine the effect of ketamine premedication on prevention of OCR during strabismus surgery. Study design: Randomized control trial Methodology: 60 patients were randomly divided into two groups i.e., Ketamine 0.75mg/kg (Group K) and control (Group C). Group K patients were premedicated with 0.75mg/kg ketamine while Group C patients did not receive any premedication. Heart rate and ECG were observed 30 sec before and continuously after traction on extraocular muscles was applied upto end of surgery for bradycardia and arrhythmias. Percentage change in HR and presence of arrhythmias was documented. All the data was collected using case report form and analyzed using SPSS version 15. Results: In Group C, 15(50%) cases had arrhythmias while in Group K, only 4(13.33%) cases had arrhythmias. Mean HR in Group C was 118.77±6.92/min and in Group K was 101.57±15.65/min. In Group C, oculocardiac reflex was present in 23(76.7%) cases and in Group K, OCR was present in 6 (20%) cases and prevented in 24 (80%) cases. Conclusion: Premedication with 0.75mg/kg IV ketamine significantly reduces the occurrence of oculocardiac reflex during strabismus surgery. Keywords: Ketamine, Oculocardiac Reflex, Premedication, Prevention, Strabismus
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.