ABSTRACT
The frequent occurrence of cardiovascular responses to laryngoscopy and tracheal intubation has attracted the attention of anaesthesiologists for more than five decades. The reason for this is the occasional report of sudden death immediately after intubation and increasing awareness about the common occurrence of potentially dangerous responses such as tachycardia, hypertension and arrhythmiasWe wanted to study, measure and compare the haemodynamic responses to laryngoscopy and oral endotracheal intubation in healthy normotensive adults with prior administration of injection lignocaine and injection esmolol hydrochloride.METHODS75 patients belonging to ASA 1, ASA 2 status, in the age group of 18-60 years scheduled for elective non-cardiac surgical procedures under general anaesthesia were selected for this prospective randomized controlled study conducted after obtaining institutional approval. They were randomly divided into 3 groups of 50 each. Group C (control group), Group Lignocaine and Esmolol Group. All the patients irrespective of group to which they belonged received tablet diazepam 0.15 mg/Kg the previous night followed by intramuscular Pethidine 1 mg/Kg 1 hour prior to the scheduled surgery.RESULTSIn esmolol group, there has significant attenuation of heart rate, SAP, DAP and mean arterial pressure following laryngoscopy and endotracheal intubation compared to lignocaine group. Lignocaine group has significant attenuation of heart rate, SAP, DAP and mean arterial pressure following laryngoscopy and endotracheal intubation compared to control group.CONCLUSIONSEsmolol hydrochloride given in the dose of 1.5 mg/Kg body weight 3 minutes prior to intubation provided consistent and reliable protection against increase in mean heart rate. SAP, DAP and MAP during laryngoscopy and intubation compared to lignocaine (1.5 mg/Kg).
ABSTRACT
Background: Subjects who are suffering from osteoarthritis of the knee will have problems including progressive loss of function, depending on walking, climbing stairs, and it may affect lower extremity functions. Balance is a major component required for the activities of daily living and functions. The objective of the study was to compare the effectiveness of perturbation training and conventional physiotherapy in improving balance and function in the rehabilitation of knee osteoarthritis. Method: Study design was an experimental study. Thirty subjects (16 males and 14 females) suffering from knee osteoarthritis were randomized into a control group and experimental group. Fifteen subjects in the control group were treated with traditional methods like ultrasound, stretching and strengthening, and fifteen subjects in the experimental group were given perturbation training along with the conventional method. Outcome measures used were Timed get up and go test score (TUG) and Functional reach test score (FRT) scales, pre-assessed on Day 1. Each group received 14 sessions of treatment, after which post-assessment of outcome measures was done. Results: Timed get up and go test score was reduced in both groups after training, which was statistically significant (p<.05). The functional reach test score was increased after training in both groups, which was statistically significant (p<.05). However, comparing between groups, the experimental group showed more reduction in TUG score and improvement in the FRT score, which was statistically significant (p<.05). Conclusion: Perturbation training given with conventional treatment was found to have a significantly better effect in improving the function of the lower extremity in OA knee subjects. However, a well-designed trial, including a larger sample size with repeated measurements, is needed to find out the effectiveness of training with perturbation in the management of knee osteoarthritis and generalize it in a larger population.