ABSTRACT
BACKGROUND: Etomidate injection is often associated with myoclonus. Etomidate injection technique influences the incidence of myoclonus. This study was designed to clarify which of the two injection techniques—slow injection or priming with etomidate—is more effective in reducing myoclonus. METHODS: This prospective randomized controlled study was conducted on 189 surgical patients allocated to three study groups. Control group (Group C, n = 63) received 0.3 mg/kg etomidate (induction dose) over 20 s. Priming group (Group P, n = 63) received pretreatment with 0.03 mg/kg etomidate, followed after 1 min by an etomidate induction dose over 20 s. Slow injection group (Group S, n = 63) received etomidate (2 mg/ml) induction dose over 2 min. The patients were observed for occurrence and severity of myoclonus for 3 min from the start of injection of the induction dose. RESULTS: The incidence of myoclonus in Group P (38/63 [60.3%], 95% CI: 48.0–71.5) was significantly lower than in Group C (53/63 [84.1%], 95% CI: 72.9–91.3, P = 0.003) and Group S (49/63 [77.8%], 95% CI: 66.0–86.4, P = 0.034). Myoclonus of moderate or severe grade occurred in significantly more patients in Group C (68.3%) than in Group P (36.5%, P < 0.001) and Group S (50.8%, P = 0.046), but the difference between Groups P and S was not significant (P = 0.106). CONCLUSIONS: Priming is more effective than slow injection in reducing the incidence of myoclonus, but their effects on the severity of myoclonus are comparable.
Subject(s)
Humans , Etomidate , Incidence , Myoclonus , Prospective StudiesABSTRACT
Objective: Carboprost is used to prevent postpartum hemorrhage in pregnant patients but is associated with severe nauseaandvomiting. This a study was done to compare ondansetron and P6 point acupuncture stimulation for prevention of carboprost induced nauseaandvomiting. Methodology: Fifty ASA class I and II full term pregnant patients scheduled for elective cesarean section were r and omly allocated into Group-O [n=25] and Group-P [n=25]. Subarachnoid block [SAB] was administered in both groups using inj.0.5% hyperbaric bupivacaine in L3-L4 interspace to achieve a level between T4 to T6. Inj.carboprost 250 mcg was given intramuscularly after the delivery of anterior shoulder in both groups. In addition Group-O inj. Ondansetron was given and in Group-P acupuncture was applied at P6 acupoint. Mean arterial pressures were maintained within 20% of baseline. Both groups were observed for nauseaandvomiting for two hours postoperatively. Results: Overall incidence of nauseaandvomiting was significantly less in Group-P than in Group-O, however, there was no significant difference in incidence of nauseaandvomiting among the two groups when considered individually. Conclusion: We conclude that stimulation of P6 point by acupuncture in comparison to ondansetron decreases the overall incidence of carboprost induced nauseaandvomiting in the immediate postoperative period. Key words: Carboprost, Cesarean section, Nauseaandvomiting, P6 acupuncture, Ondansetron
ABSTRACT
Background: Laryngoscopy and tracheal intubation increase blood pressure [BP] and heart rate [HR]. The aim of the present study was to investigate the effect of gabapentin given before operation on the hemodynamic response to laryngoscopy and intubation in patients undergoing laparoscopic cholecystectomy. Methodology: 90 ASA I and II patients undergoing elective laparoscopic cholecystectomy were r and omly allocated to three groups of 30 each. Group C received placebo drug; group G6 received gabapentin 300 mg night before surgery and 300 mg at 6:00 AM on the day of surgery; group G9 received gabapentin 300 mg night before surgery and 600 mg at 6:00 AM on the day of surgery. Anesthesia was induced with inj. thiopentone and inj. rocuronium. Heart rate, systolic BP, diastolic BP and mean arterial pressure were recorded as baseline, after induction, at tracheal intubation [0 min.]; and then at 1, 3, 5, 10, 15 min following tracheal intubation. Results: MAP was significantly lower in G9 group as compared to the control group at 0, 1, 3, 5, 10 and 15 minutes. Heart rate did not differ amongst the three groups at any time interval. Conclusions: Gabapentin, under present study design, attenuates the pressor response but not tachycardia associated with laryngoscopy and intubation. Key words: Intubation; Laryngoscopy; Gabapentin Citation: Aggarwal S, Baduni N, Jain A. Attenuation of pressor response to laryngoscopy and intubation a comparative study between two doses of gabapentin in patients undergoing laparoscopic cholecystectomy. Anaesth Pain and Intensive Care 2015;19[1]:33-36