Aim: To determine the intraoperative Ramsay sedation score after dexmedetomidine infusion in patients undergoing perineal surgery. Study design: Descriptive study. Place and duration of study: Department of Anaesthesia, JPMC, Karachi from 13th February 2021 to 13th August 2021. Methodology: One hundred and seventy four patients who met the diagnostic criteria were enrolled. Results: The mean age was 46.51 years with the standard deviation of ±10.87. 66 (37.9%) were male and 108 (62.1%) were female. Whereas, mean duration of surgery, Ramsay sedation score at 5 minutes, 15 minutes, 30 minutes, height, weight and BMI in our study was 1.41±0.40 hours, 1.72±0.44, 3.51±0.60, 4.57±0.62, 165.62±8.23 cm, 68.34±8.23 kg and 24.85±3.34 kg/m2 respectively. Conclusion: Intraoperative dexmedetomidine proved beneficial in perineal surgeries and could be served as a potent sedative drug. Keywords: Ramsay sedation score, Anesthesia, Dexmedetomidine, Pain, Perineal surgery, Sedation
Background/Objective: Orthopedic patients have a particularly high risk for post-spinal shivering, a typical consequence of spinal anesthesia. Without treatment, shaking may worsen wound pain, increase oxygen use, and impair healing. There have been a number of studies looking at the efficacy of ketamine and other medications for reducing post-spinal shivering. Despite this, there is a dearth of data on more effective and widely available preventive medicines. As a result, the purpose of this research was to evaluate the efficacy of 0.25 mg/kg of Ketamine (K) against 0.5 mg/kg of Tramadol (T) in preventing shivering after spinal anesthesia. Methodology: 200 patients who were to have orthopedic surgery under spinal anesthesia were randomly chosen to participate in this prospective cohort study. Patients who were given a prophylactic dosage of intravenous ketamine prior to spinal anesthesia are referred to as the Ketamine group(n=100), whereas those who were given Tramadol are referred to as the Tramadol group (N=100). During the intraoperative phase, vital signs such as shivering intensity and frequency, blood pressure, heart rate, and axillary body temperature were monitored hourly at 10-minute intervals for a whole hour. Results: There were 87 patients (43%) who had post-spinal shivering; this number was 32 (32%) for those given ketamine and 55(55%) for those given tramadol (p=0.001). With a p-value of 0.000, the incidence of nausea and vomiting was statistically significantly higher in the tramadol group of 82(82%). The ketamine group had significantly more intraoperative sedation than the tramadol group (p 0.007). Conclusion: After spinal anesthesia, low-dose ketamine is more active in lowering the frequency and intensity of shivering. Therefore, we advise patients having orthopedic surgery under spinal anesthesia to take low-dose ketamine beforehand as a preventative measure against post-spinal shivering. Keywords: Ketamine, Tramadol, Shivering, Orthopedic surgery
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