ABSTRACT
Background: Spinal anaesthesia is an accepted and most convenient anaesthetic technique for lower abdominal and lower limb surgeries. Opioids have been used intrathecally as adjuvant for improvement in quality and extending the duration of spinal block. We conducted this prospective randomised double blind study to compare effects of intrathecal isobaric 0.5% levobupivacaine with fentanyl and isobaric 0.5% ropivacaine with fentanyl in spinal anaesthesia. Methods: After taking approval from institutional ethical committee,80 patients of ASA grade I or II were randomly allocated into two groups.Group I received 3ml of 0.5% isobaric levobupivacaine with 25μg fentanyl and group II received 3 ml of 0.5% isobaric ropivacaine with 25μg fentanyl intrathecally .The level of sensory blockade and motor blockade was assessed. Results: The onset of sensory and motor blockade was earlier in group I as compared to group II . In group I sensory and motor blockade lasted significantly longer than group II. The duration of analgesia and time for rescue analgesia was prolonged in Group I as compared to Group II. Conclusion:Intrathecal 0.5 % isobaric ropivacaine-fentanyl combination provides satisfactory anaesthesia with shorter duration of motor blockade which is a desirable feature for early ambulation favouring day care ambulatory surgeries as compared to intrathecal 0.5% isobaric levobupivacaine-fentanyl combination which can be used in surgeries of longer duration.
ABSTRACT
Background: Laryngoscopy and intubation may cause undesirable increase in blood pressure and heart rate. The aim of the present study was to investigate the effect of Pregabalin premedication on hemodynamic responses to laryngoscopy and intubation. Methods: Sixty ASA physical status I or II patients undergoing elective surgery under general anesthesia were randomly allocated into two equal groups who received either oral Pregabalin 150 mg (Group PB)or placebo (Group PL)1 hour prior to surgery. Heart rate, Systolic, Diastolic and Mean arterial blood pressures were recorded preoperative, at laryngoscopy and 0,1,3,5 and 10 minutes after tracheal intubation. Results: Demographic data and base-line values for Heart rate, Systolic, Diastolic and Mean arterial blood pressures were comparable between groups. During laryngoscopy and intubation there was significant attenuation of SBP, DBP and MBP in PB group as compared to PL group. Although increase in heart rate was less in pregabalin group during laryngoscopy and intubation but it was not statistically significant. Conclusion: In the present study design, oral Pregabalin premedication at a dose of 150 mg one hour prior to surgery attenuates pressor response associated with laryngoscopy and endotracheal intubation but not the tachycardia significantly.
ABSTRACT
Background: The need of securing the airway quickly in an easier and safer way, especially in paediatric patients still remains a major concern. Newer and safer alternates to endotracheal intubations are being introduced. LMA supreme is one of such advancement in the field of paediatric anaesthesiology. Easy and quick insertion without any introducer, gastric access and high seal pressure are few advantages claimed by LMA Supreme. Apart from a few studies; the safety and efficacy of its paediatric version is yet to be established in Indian paediatric population. Thus, we have conducted an observational study for evaluation of Supreme LMA in paediatric patients. Observational clinical study. Methods: After obtaining approval from institutional ethical committee and consent from patient’s attendants, 50 patients of ASA grade I and II, weighing 10-20 kg of either sex undergoing general anaesthesia were included. After induction of anaesthesia and muscle relaxation, the LMA Supreme size 2 was inserted. Number of insertion attempts, ease of insertion, time taken for insertion, hemodynamic responses, ease of NGT insertion and incidence of airway trauma were recorded. Results: In 90% of patients, LMA Supreme was inserted in first attempt. In 94% of cases, insertion was easy. Average time required to insert LMA Supreme was 11.66 ± 0.81 seconds. There were no significant hemodynamic changes noted. In 2 % of cases, airway trauma was observed. Conclusion: LMA supreme emerged as a good alternate airway device. It is quick and easy to insert with fast learning curve with least alteration of hemodynamic status in paediatric population.
ABSTRACT
Background: The aim of study is to compare I-gel and Air-Q supraglottic airways in terms of - success rate of device insertion, number of attempts taken, haemodynamic parameters before and after device insertion, incidence of trauma and postoperative sore throat, dysphagia. Methods: This randomised single blind study was conducted on 90 patients of age 18-60 years, undergoing elective surgery requiring general anaesthesia. Patients were randomly allocated in two groups- Group I: I-gel (n= 45), Group II: Air-Q (n=45). After preoxygenation, induction and muscle relaxation appropriate size I-gel or Air-Q was inserted and all parameters were noted by an independent observer. For statistical analysis, Student t-test was employed to compare the means and Chi-square test was used for categorical variables. Complications were compared using Fisher’s exact test. Results: The demographic profile of patients in both groups was similar. In all patients supraglottic airway device was inserted within 3 attempts. Mean insertion time in first attempt for I-gel (25.85 ±1.7 sec) was found to be significantly lower than Air-Q (26.73±1.51 sec) [P=0.0128]. Conclusion: We conclude that I-gel is easier and safer than Air- Q when ventilation through LMA is intended during surgery.