Evaluation of ketamine as a co-sedation with midazolam and propofol in severe head trauma patients: a non-invasive assessment of cerebral hemodynamics using transcranial doppler ultra sonography

The current study investigates the effect of ketamine bolus injection 3 mg/kg every 6 hours for 48 hours in patients with severe head injury [GCS

Evaluationof psychomoter performance and quality of recovery during propofol auto. co.sedation as an alterenative to fentanyl, midazolam and ketamine co-sedation during monitored anaesthesia care

Supplemental analgesics and anxiolytics are commonly used to improve patients comfort during procedures performed under local anesthesia and sedation. Eighty female out patients ASA I or II undergoing breast biopsy procedures under local anaesthesia were participated in this study. Patients divided into four groups [n = 20 each]. They recieved either 20 mg propofol in first group, 50 micro g fentanyl, in second group, 2 mg midazolam in the third group or 30 mg ketamine in the fourth group. Two minute later propofol infused at a rate 50 micro g/kg/min. Increasing rate of propofol infusion were used as needed to treat patients response [if any] to local infiltration or surgical stimulation with maintaing respiratory and haemodynamic function. Psychomotor tests and anxiety level were performed before operation and at 30, 60, 120, 240 min post operatively. There were asignificant reduction in psychomotor tests in all groups from baseline after 30 minute postoperative but in propofol-propofol [P.P] group and fentanyl-propofol group [EP] group were associated with the most rapid recovey and least impairment compared with preoperative baseline. Ketamine-propofol [K.P] group associatel with delayed recovey in psychomotor test at 60 min post operatively, [K.P.] group showed the least level of haemodynamic instability but P.P. and F.P. groups showed the highest level of reduction of MAP and HR from baseline [P < 0.001]. Patients satisfaction were high and equal among groups

Effect of premedication with lidocasine on the dose of atracurium and its reversal time

The effect of premedication with lidocaine as a local anaesthetic drug that used for blunting laryngeal reflexes and hypertensive reaction to laryngoscopy and intubation on the dose of atracurium as short acting non depolarizing muscle relaxant is investigated in this paper. At the same time we estimate its effect on the revesal and total assisted recovery time after administratikon of neostigmine as a cholinesterase inhibitor. Twenty adults, ASA physical before induction of anaesthesia. All the patients received thiopental 5 mg/kg. Atropine 0.01 mg/kg, 100% 0 and 0.5 mg/kg attracurium to facilitate intubation. Anaeshesia maintained by Halothane, 1%, O2 100%, and fentany 1 micro g/kg. Neuro muscular blockade was monitored by T.O.F. [train of four] stimulatikon using peripheral nerve stimulator. The reversal was done by neostigmine 0.07 mg/kg and atropine 0.01 mg/kg after appearances of first twitch of T.O.F. The total assisted recovery time [time from last incremental dose of atracurium till apperance of fourth twitch of T.OF. and reversal time [time from neostigmine abministration till apperence of fourth twitch of T.OF] were estimated. Statistics: all parameters expressed by mean +/- stander deviation and correlation coefficient factor. The dose of atracurium expressed in mg/kg/hr. There was moderat reduction in the dose of atracurium in cases premedicated weith lidocaine [0.634 +/- 0.361] compared to control group [0.905 +/- 0.195] which equal 30%. There was non significant negative correlation between the dose of atracurium and the reversal time in lidocaine group. The same result was in control group. But there was a significant positive correlation between the dose of atracurium and total assisted recovery time in control group. This correlation was highly significant positive correlation in lidocaine group