ABSTRACT
Context: Block augmentation by epidural volume extension has been adequately documented but therehave been not enough studies comparing different volumes of normal saline used in this technique toaugment the level of block achieved. The study compares different volumes of normal saline(5,10 and 20ml) for epidural volume extension in combined spinal epidural anaesthesia for lower abdominal surgeries.120 women, aged between 20-60 years belonging to ASA grade I-II undergoing elective lower abdominalsurgeries were included in this study. The patients were randomly allocated into 3 groups and each groupcomprised of 40 patients. GROUP 1(EVE 5) received 10 mg 0.5% bupivacaine heavy (H) intrathecallywith 5 ml normal saline through the epidural catheter as a part of Epidural volume extension. GROUP 2(EVE10) and GROUP 3 (EVE20) received 10 ml and 20 ml of normal saline as a part of Epidural volumeextension respectively in addition to the intrathecal drug. The patients were assessed for sensory blocklevel to loss of pain from pin prick and for motor block using Bromage scale. Peak sensory block height,highest Bromage score, time taken to achieve maximum sensory and motor block and the time to theirrecovery were recorded.Statstical Analysis. was done using statistical software SSPS version 16.0 andEpi- info version 6.0 .Outcome measures were presented as % for qualitative variables and mean±SD forquantitative variables.Demographic data and duration of surgery were similar in all the groups.Sensoryblock augmentation was found to be significantly higher in the EVE10 and EVE 20 groups. There was nodifference in the peak motor block score between the groups during the study. Time to achieve the blockswere significantly shorter for the 20 ml group than the 10 and 5 ml groups; the latter two being comparable.This was associated with a significantly faster motor recovery to Bromage 0 in groups EVE10 and EVE20.
ABSTRACT
The current study was done to compare the safety profile of Ondansetron, Ramosetron and Palonosetron. 150 female patients undergoing elective Laparoscopic Cholecystectomy were randomly divided into 3 groups with 50 patients each and received 4mg of Ondansetron, 0.3mg of Ramosetron and 0.075mg of Palonosetron respectively for PONV prophylaxis. Patients were observed for QTc interval changes &other side effects like headache, dizziness, drowsiness and myalagia in addition to incidence of post operative nausea & vomiting. The incidence of QTc interval prolongation at various time intervals and side effects like headache, dizziness, drowsiness, myalagia also did not show any statistically significant difference. We concluded that safety profile and side effects of all the three drugs were comparable when used in this manner. As for as QTc interval change is concerned both ondansetron & Ramosetron caused the prolongation of corrected QTc interval but in no patient it was found to be more than 470 ms
ABSTRACT
Direct laryngoscopy and endotracheal intubation frequently induces a cardiovascular stress response due to reflex symbathetic stimulation. This response may be hazardous in patients with Hypertension, Coronary artery disease, Myocardial disease, cerebrovascular disease. Numerous agents have therefore been utilized to blunt this response. The present study was undertaken in view of above mentioned facts, to compare effectiveness of intravenous esmolol and lignocaine in suppressing the cardiovascular stress response. Patients were divided in to three groups of 20 patients each. Group-C did not receive any drug under study. Group-L received lignocaine and Group-E received esmolol three minutes before intubation. All the groups were observed for changes in haemodynamic parameters i.e. heart rate (HR) systolic and diastolic blood pressure every minute after intubation till 5 minutes post intubation. It was found that patients given esmolol had better attenuation of stress response to laryngoscopy and intubation than patients given lignocaine.
ABSTRACT
The aim of the present study was to compare the antiemetic effect of intravenous Granisetron, Ondansetron & Metoclopramide in a randomized blinded study for prophylaxis of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy under general anaesthesia. 60 patients (ASA I & II) undergoing laparoscopic cholecystectomy under general anaesthesia were randomly allocated into three equal groups (n=20). Emetic episodes in first 24 hours were recorded and compared in different study groups. Results were analyzed. Minimal emetic episodes were observed in early post-operative period (1-12hrs) in patients who had received intravenous granisetron in comparison to ondansetron and metoclopramide. However, after 12 hours emesis free periods were statistically insignificant between group A and B while patients in group C had no antiemetic effect.