This study was carried out to assess the hypotensive effect of low dose dexmedetomidine (DEX) infusion during middle ear surgery. 42 ASA grades I and II patients of either sex aged 18-45 years undergoing elective middle ear surgery were randomly divided into two groups of 21 each. Group I received placebo bolus and infusion of saline at a rate similar to DEX in Group II. Group II received 10-15 min prior to induction of anesthesia 1 μg/kg IV bolus DEX diluted in 10 ml of normal saline over 10 min. Immediately thereafter an infusion of 0.4 μg/kg/hr of DEX commenced. Standard anesthetic technique was used. Halothane was titrated to achieve a mean arterial pressure 30% below the control value (value taken just after premedication). We observed that a statistically signifi cant reduction in the percentage of halothane required to reduce MAP 30% below control value occurred in patients receiving DEX infusion (1.3 ± 0.4%) in comparison to those receiving placebo (3.1 ± 0.3%). Patients receiving DEX infusion had a better surgical fi eld. The mean awakening time was signifi cantly reduced in patients of Group II (9.1 ± 2.7 min) when compared to patients of Group I (12.8 ± 2.2 min).We conclude that DEX can be safely used to provide hypotensive anesthesia during middle ear surgery.
Ondansetron is a serotonin receptor antagonist which has been used frequently to reduce the incidence of post-operative nausea and vomiting in laparoscopic surgery. It has become very popular drug for the prevention of post-operative nausea and vomiting due to its superiority in-terms of efficacy as well as lack of side effects and drug interactions. Although cardiovascular adverse effects of this drug are rare, we found a case of symptomatic sinus bradycardia in a 43-year-old female patient, going for laparoscopic cholecystectomy, who developed the same after she was given intravenous ondansetron in operation theater during premedication. Hence, we report this case, as the rare possibility of encountering bradycardia effect after intravenous administration of ondansetron should be born in mind.
Positive suggestion during surgery reduces post hysterectomy emesisIn some areas of anaesthetised brain Information may be registered, processed or both, 1 leading to positive intraoperative suggestion to control post operative nausea and vomiting. However, these studies failed to establish a conclusive cause and effect relationship 2,s due to a lack of specificity of suggestions and standardisadon for anaesthetic techniques/surgical procedures. We studied 50 ASA I or II patients, undergoing elective abdominal hysterectomy, for the effect of specific positive therapeutic suggestions on episodes of emesis. Patients were divided into two groups of 25 patients (Table). All patients received 4-5 mg.kg -1 thiopentone for induction of anaesthesia and 0.1 mg.kg -~ vecuronium to facilitate intubation and relaxation. Anaesthesia was maintained with 02/N20 (Fi02 0.35) and halothane 1-2%. Positive suggestions (consisting of a male voice in the patients dialect) were played via head phones throughout anaesthesia to Group II patients only while a blank tape was played to Group I. Emetic episodes (vomiting and/or retching) were recorded in the recovery area and over the first 24 hours in the ward by a person blind to the groups. Patients with two or more emetic episodes were administered metoclopramide 0.25 mg.kg -1 iv. Postoperative pain was relieved with diclofenac sodium 1 mg-kg -l im on demand. Data were analysed using "Z" rest.None of the patients recalled the use of audiotape. Intraoperative suggestions reduced the incidence and severity of post-hysterectomy emetic episodes. Output from a Drager Vapor 19.1 on a moving trolleyWe commonly transport anaesthetised children from an induction room to the operating room on a trolley equipped with an oxygen cylinder and a rigidly mounted Drager Vapor 19.1 halothane vaporizer. In order to determine whether or not this alters halothane delivery, we compared the output of two such vaporizers when stationary and in motion. Under similar circumstances a Fluotec vaporizer (model unspecified) has been reported to cause no clinically relevant variation in delivered halothane concentration. ~ We collected gas into large plastic bags as our trolley was moved along a standardised route through our operating suite. An Ohmeda 5250 Respiratory Gas Monitor was used to measure the halothane concentrations. Twenty-eight pairs of vapour (stationary and in motion) from clinically relevant combinations of fresh gas flow and vaporizer dial settings were analysed from the first vaporizer. There was no clinically significant difference between the output during motion and the performance when stationary. However the output consistently measured 0.5% greater than the dial setting for 1, 2 and 3 % halothane at all flows. To confirm our findings, six further pairs ofvapour were collected from a second vaporizer. The figure shows the mean and upper limit of measured halothane concentration.Although we confirmed that our usual clinical practice does not change halothane delivery, an unexpect-
Aim:The aims of present study were to compare the propofol and rocuronium with thiopentone and rocuronium in terms of clinically satisfactory intubating conditions and to co-relate intubating conditions with degree of paralysis in adductor pollicis muscle using train of four ratio (TOFR). The intubating conditions were evaluated after rocuronium bromide 0.6 mg kg-1 at 60 s.Materials and Methods:60 patients of ASA grades I-II of either sex, age 18-50 years, undergoing various elective surgical procedures were randomly divided into two groups, propofol rocuronium (PR group) and thiopentone rocuronium (TR group) of 30 patients in each. In the PR group, patients received propofol 2.5 mg kg-1 and rocuronium 0.6 mg kg-1; in TR group, patients received thiopentone 5 mg kg-1 and rocuronium 0.6 mg kg-1. In all patients the intubating conditions were evaluated by the observer at 60 s. TOFR was measured at the time of intubation by an assistant.Results:In the PR group the number of the patients placed in intubating conditions grades I, II, III and IV were 40%, 36.67%, 13.33% and 10% and their mean TOFR were 31.8±17.9%, 61.8±;14.6%, 61.7±27.9%, and 78.3±5.7% respectively. While in theTR group the number of patients placed in intubating condition grade I, II, and III were 60%, 26.67%, and 13.33% and their mean TOFR , 41.2±28.3%, 68.0±10.9% and 78.7±6.8%, respectively. There was no patient in grade lV in theTR group.Conclusion:The clinical intubating conditions and degree of paralysis of adductor pollicis muscle after rocuronium 0.6 mg kg-1 at 60 s in adults induced with propofol or thiopentone sodium are comparable.
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.