ABSTRACT
Introduction: Surgery and anesthesia can be a traumatic experience for a child. Stormy induction of anesthesia in children canlead to an increased incidence of post-operative behavioral problems. Thus, sedative premedication may be used in childrento aid smooth induction of anesthesia. Hence, this study was conducted to compare the preanesthetic sedative effects ofintranasal midazolam and ketamine.Materials and Methods: This study was carried out on 60 ASA Grades I and II pediatric patients aged 2–5 years undergoingemergency or elective surgery lasting for 30 min–2 h. The exclusion criteria were established. Patients were included after writteninformed consent of the parent/guardian. They were randomly divided into two groups: Group M and Group K. Pre-operative,intraoperative, and post-operative parameters were observed.Results: Statistically significant tachycardia and increased blood pressure (BP) (both clinically insignificant) were observed inboth the groups (more persistent in the ketamine group). The sedation by both the drugs was adequate in terms of parentalseparation score, acceptance of facemask and response to venipuncture with no statistically significant difference. There werealso no significant side effects (namely, respiratory depression, increased secretions or emergence reaction).Conclusion: Both the drugs midazolam and ketamine provide adequate preanesthetic sedation through intranasal route andare safe to use in pediatric patients without any significant side effects.
ABSTRACT
Introduction: Laryngoscopy and tracheal intubation cause significant changes in the hemodynamics of patients. Manypharmacological methods have been devised to reduce the extent of hemodynamic events. This study compares the efficacyof two such agents, dexmedetomidine and esmolol, for the attenuation of response to extubation.Materials and Methods: This study was carried out on 100 patients aged 18–60 years, belonging to the American Society ofAnesthesiologists Grades I and II, having no major systemic comorbidities, and undergoing abdominal or lower-limb surgeriesunder general anesthesia. They were randomly divided into two groups: Group D (dexmedetomidine) and Group E (esmolol).Pre-operative, intraoperative, and post-operative vitals and side effects were monitored.Results: Both the groups were comparable in terms of demographic variables, physical attributes, and baseline vitalparameters. It was observed that dexmedetomidine is better at controlling heart rate and systolic, diastolic, and mean bloodpressures during extubation than esmolol. There was no significant respiratory depression. No significant side effects wereobserved.Conclusion: Dexmedetomidine is an effective and safe drug to provide stable hemodynamics and protects against the stressresponse to extubation in patients undergoing abdominal and lower-limb surgeries under general anesthesia.
ABSTRACT
Introduction: Spinal anesthesia is preferred over general anesthesia due to the ease of administration, minimal systemiceffects, and reduced post-operative morbidity. A number of anesthetic agents and adjuvants have been tried over the years, toachieve optimal effects. This study compares the efficacy of ropivacaine versus ropivacaine plus fentanyl as spinal anesthetics.Materials and Methods: This study was carried out on 100 American Society of Anaesthesiologists Grades I and II patients,having no comorbidities and scheduled for surgery of up to 200 min. They were randomly divided into two Groups: Group I(Ropivacaine) and Group II (Ropivacaine and Fentanyl). Intraoperative and post-operative vitals, analgesic parameters, andside effects were monitored.Results: The onset of both sensory and motor blockade was faster, and the duration of the blockade was longer with theaddition of fentanyl to ropivacaine. Ropivacaine is a safe drug in terms of cardiorespiratory stability and other side effects. Theaddition of fentanyl did not alter the beneficial side effect profile of ropivacaine.Conclusion: Ropivacaine is a safe anesthetic in terms of cardiorespiratory stability and side effects. The addition of fentanyl toropivacaine significantly potentiates the block, both sensory and motor, without altering the beneficial effects of cardiorespiratorystability and side effect profile.