Patients undergoing CABG surgery have abnormal cardiovascular physiology and are commonly associated with multivessels disease, have compromised ventricular function and are often associated with other co morbid conditions. Aim of the study was to compare the peroperative hemodynamic effect in CABG surgery before aortic cannulation of two anesthetic techniques, e.g. TIVA (propofol-fentanyl) vs conventional (N20-halothane). 40 patients scheduled for CABG surgery were allocated in double blind, randomized study. Patients were divided into two groups. In group A patients were maintained anaesthesia with TIVA (Propofol-fentanyl) technique and in group B patients conventional (N20-halothane) technique. Hemodynamic parameters were taken at different stages in peroperative period upto the time of aortic cannulation. Hemodynamic supports were manipulated in a systematic approach. Hemodynamic status was evaluated and compared on the basis of support requirements between the groups. No significant changes of all the hemodynamic parameters were observed at induction, intubation, skin incision, sternotomy and then in maintenance phase (mean of 15 minutes interval) upto aortic cannulation in both groups. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.3-8
Nearly twenty five percent of the cases of cushings syndrome are due to adrenal hyperplasia without an ACTH secreting tumour. Twenty percent of patients with endogenous cushing have adrenocortical tumour about half of which are benign adenoma. Surgical intervention done due to failed medi cal therapy and in case of adrenal adenoma. A child aged 4½ years, weighting 29kg with features suggestive of cushings syndrome was admitted under paediatric surgery unit in Bangabandhu Sheikh Mujib Medical University. On investigation serum cortisol levels were raised. blood pressure was controlled by ACE inhibitor, calcium channel blocker and beta-blocker. He was scheduled for resection of adrenal cortical tumour. Electrolyte imbalance was corrected, steroid replacement was done. Patient was haemodynamically stable preoperatively.Surgery was completed unevenetfuly. Postoperatively patient was kept in ICU, ventilation maintained by control mode (CMV). After 24 hours the patient was extubated. When the patient found haemodynamically stable he was sent to the recovery room. DOI: http://dx.doi.org/10.3329/jbsa.v22i2.18148 Journal of BSA, 2009; 22(2): 84-87
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