Background: Laryngoscopy and endotracheal intubation causes marked increase in heart rate and blood pressure. Even though various agent tried to blunt the hemodynamic response but none of them proved to be an ideal. The aim of the study was to compare dexmedetomidine and placebo in blunting the hemodynamic response to laryngoscopy and endotracheal intubation.Methods: A randomized placebo controlled study with total of 90 patients were included in the study of which 30 patients received dexmedetomidine (Group D) 10 minutes prior to endotracheal intubation and 30 patients received 3 ml Normal Saline (Group C) 10 minutes prior to endotracheal intubation. They were evaluated with change in heart rate and mean arterial pressure at 1, 3 and 5 minutes post laryngoscopy and endotracheal intubation. Any adverse effect of the drug was noted. Results: Age, gender, physical status and weight were comparable between the groups. Heart rate and mean arterial pressure attenuated significantly in dexmedetomidine group (p<0.001 in 1, 3 and 5 minute intervals respectively), whereas placebo failed to attenuate hemodynamic response after laryngoscopy and intubation in any measured interval. No complications were noted. Conclusions: Dexmedetomidine 1 mcg/kg given 10 min prior to endotracheal intubation significantly attenuates heart rate and mean arterial pressure at 1, 3 and 5 minutes compared to placebo.
Background: Induction of anesthesia is a critical event and hemodynamic stability is an important factor during this period. Propofol is a commonly used intravenous anesthetic and Sevoflurane is a newly introduced inhalational anesthetic in the context of a developing country. This study compared the hemodynamics on induction of anesthesia with Propofol and Sevoflurane.
Background: Deep sedation or general anesthesia is usually required for Magnetic Resonance Imaging when patients cannot remain motionless in the suite. Various anesthetic devices have been used to maintain the airway and ventilate the lungs during this period. Some of them produce artifacts that pose difficulties in the interpretation of images. The aim of this study was to identify the devices that produced artifacts during Magnetic Resonance Imaging.Methods: Twelve anesthetic devices were considered: oro-pharyngeal airway, nasopharygeal airway, face mask with reservoir bag, nasal cannula, endotracheal tube, disposable Ambu Laryngeal Mask Airway, Laryngeal Mask Airway Unique, Disposable Laryngeal Tube Sonda, i-gel, Ambu bag, Bain Circuit, Jackson Rees Circuit. Magnetic Resonance Imaging was performed with each device placed on the top of a phantom simulator respectively to resemble the position in vivo.Results: The artifacts with Disposable Laryngeal Tube Sonda, Laryngeal Mask Airway Unique and endotracheal tube were related to ferromagnetic material in the pilot valve and were similar. No artifacts were found with oro-pharyngeal airway, nasopharygeal airway, nasal cannula, endo-tracheal tube with pilot valve detached, face masks with reservoir bag (metal removed), Ambu bag (without Adjustable Pressure Limiting valve), i-gel , disposable Ambu Laryngeal Mask Airway, Bain Circuit and Jackson Rees Circuit.Conclusion: Anesthetic devices that produce Magnetic Resonance Imaging artifacts are disposable Laryngeal Tube Sonda, Laryngeal Mask Airway Unique and Endotracheal Tube.Journal of Society of Anesthesiologists of Nepal 2015; 2(1): 13-16
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