Background: Dexmedetomidine is a newer adjuvant anesthetic agent which is gaining its popularity day by day in our perspective. As an anaesthetic adjuvant dexmedetomidine has been shown to provide good perioperative haemodynamic stability during laparoscopic surgeries. But still it is to be judged its efficacy as adjuvant agent in our aspect. Objective: To observe the haemodynamic effects of intravenous dexmedetomidine during laparoscopic cholecystectomy. Methods: Eighty(80) patients (ASA grade l and ll) who underwent laparoscopic cholecystectomy surgery were randomly selected and were scrutinized according to eligibility criteria.The selected patients were divided into two groups on even and odd number basis. Even number Group A (n=40): received a bolus dose of I.V dexmedetomidine 1μg/kg over 10 minutes before induction of Anesthesia and then I.V infusion of 0.5 μg/kg/hr as a maintenance infusion and odd number Group B(n=40): received a bolus dose of same volume of normal saline before induction of Anesthesia and infusion was continued during surgery. General anesthesia was administered in all patients using fentanyl, thiopentone, succinylcholine, nitrous oxide in oxygen, halothane and muscle relaxation maintained with vecuronium bromide. A pre-tested, observation based, peer-reviewed data collection sheet was prepared before study. Results: Intra-operative mean Heart rate of Group B patients were more higher than those of Group A patients and showed statistically significant differences (P=0.003). Mean arterial pressure of Group B patients were far more higher than Group A patients in different events of peroperative period which is statistically significant (P=0.001). Mean diastolic blood pressure in Group B was significantly higher than that of Group A (P=0.0001). Conclusion: Dexmedetomidine is an effective drug that can be used as adjunctive infusion in general anesthesia in an intention to stable the hemodynamic profile in the peroperative period of different surgeries. Specially in laparoscopic cholecystectomy some patients with cardiac risk become vulnerable after CO2 gas in sufflation which can be properly managed using Dexmedetomidine. J Shaheed Suhrawardy Med Coll 2021; 13(1): 26-32
Background: Spinal anesthesia (SA) with bolus dose has rapid onset but may causes hypotension. When we inject local anesthetic in fractions with a time gap, it provides more hemodynamic stability an. We aimed to compare fractionated dose with bolus dose in SA for hemodynamic stability in patients undergoing elective lower segment caesarean section (LSCS). Objectives: To find out whether the fractionated dose of spinal local anesthetics could reduce the incidence of hemodynamic changes in comparison to bolus dose of spinal local anesthetics. Methods: After clearance from the Institutional Ethics Committee, the study was carried out in 80 patients undergoing elective LSCS. Patients were divided into two groups. Group B patients received single bolus SA with injection bupivacaine heavy (0.5%) and Group F patients fractionated dose with 2/3rd of the total dose of injection bupivacaine heavy (0.5%) given initially followed by 1/3rd dose after 90 s. The intraoperative hemodynamics were recorded and analyzed with chi- square test Student’s t-test. Result: Intraoperative mean blood pressure of group –F were higher than those of Group-B patient and showed statistically significant difference. Mean heart rate of group –F were higher than those of Group-B patient and showed statistically significant difference. Conclusion: Fractionated dose of SA provides greater hemodynamic stability compared to bolus dose. J Shaheed Suhrawardy Med Coll 2021; 13(2): 150-157
Introduction: Patients frequently suffer from shivering following surgery. The shivering experienced by the patients may be a natural, thermal regulatory response to central hypothermia or as a result of the release of cytokines during the surgical process. This is unpleasant and occurs following surgery in 30-65% of patients who have received general anesthetics. Shivering increases the muscular activity, O2 consumption, CO2 production and may result in hypoxaemia, hypercarbia and lactic acidosis. It is not only uncomfortable but also cold sensation which is even worse feeling than pain sensation. Objective: To assess the Comparison the efficacy of ketamine on the patients undergoing elective surgery for prevention of postoperative shivering. Material & Methods: In this prospective study was conduct at the dept. of Anaesthesia, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to June-2021. Fifty (50) patients included in our study. The inclusion criteria were women aged between 30-65 years and ASA-PS classes I and II. Patients preoperative period were fasted at least 6 hrs and on arrival at OT I/V line was inserted; pulse, BP respiratory rate and SpO2 were recorded. Results: In our study fifty two (52) patients demographic data concerning the patient age, weight as well as duration of anaesthesia and type of surgery were comparable in two groups which are fairly matched. In preoperative situation in Group A mean pulse rate was 79 ±2.4, in Group B 82 ±1.5, mean anterial pressure 92.71±1.05 (Group A), 94.01±1.14 (Group B), SpO2 99±0.56 Group A, 98 ±0.26 (Group B) which showed no significant difference between the groups. In the postoperative period, incidences of shivering were 80.07% & 50% in Group-A and Group-B which are highly significant between the groups P<.001 Cardiovascular parameters SAP, DAP, MAP and SpO2 between the groups were not significant P>.05. The study showed that patients of Group-B were less shivering with good recovery. Conclusion: In concluded that the post-operative shivering are the most common complaints. The aetiology of postoperative shivering is multifactorial including anesthetic, patients and surgical factors. Antishivering prophylaxis may be justified in patients who are at great risk of developing post-operative shivering after general anaesthesia. The incidence of major side effects is not significant in ketamine group and contributes to some extent to post-operative analgesia.
Introduction: Spinal anesthesia is the most commonly used technique for lower abdominal surgeries postoperative pain control is a major problem because spinal anesthesia using only local anesthetics is associated with relatively short duration of action, and thus early analgesic intervention is needed in the postoperative period. Short acting spinal anaesthesia may help to prevent complications associated with delayed immobilization. Objective: To examine whether adding intrathecal Fentanyl to bupivacaine intensify sensory and motor block without prolonging recovery time for urosurgeries. Materials and Methods: A prospective observational study was contact at dept. of Anaesthesia, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from March to August 2021. Seventy five (75) patients included in our study. American Society of Anaesthesiologists physical status I and II scheduled for elective urological procedures were studied in a double-blinded, randomized prospective manner. Random allocation was done as, Group A (n=25) receiving intrathecal bupivacaine 12.5 mg; Group B (n=25) bupivacaine 10 mg with 25 μg of fentanyl; and Group C (n=25), bupivacaine 5 mg with 25 μg of fentanyl. Assessment of sensory, motor block and duration of sensory analgesia was done. Results: In our study the demographic data were comparable in all the three groups. The time for two segment regression was statistically significant between all three groups (p<0.001). The mean time for two segment regressions for group A was 104.8 minutes whereas for group B mean time was 161.8 min and for group C mean time was 80.37 minutes. It was longest for group B and shortest for group C. The total duration of motor block was compared among the three groups after initiation of the SAB. There was statistically significant difference regarding total duration of motor block, time for two segment regression and duration of sensory analgesia between each pair of groups. The duration of motor
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