ABSTRACT
Gabapentin is an anticonvulsant drug that has been shown useful in postoperative nausea and vomiting (PONV). AIM: We compared the effects of gabapentin on PONV with ondansetron, dexamethasone and placebo in patients undergoing laparoscopic cholecystectomy under general anesthesia. One-hundredtwenty patients undergoing elective laparoscopic cholecystectomy were randomly assigned to one of the following four groups: gabapentin group (G) received 600mg oral gabapentin capsule two hours before surgery +IV 2ml saline 10-15 minutes before surgery; ondansetron group (O) received an oral placebo two hours before surgery +IV 4mg ondansetron 10-15 minutes before surgery; dexamethasone group (D) received oral placebo two hours before surgery +IV 8mg dexamethasone 10-15 minutes before surgery and placebo group (P) received oral placebo two hours before surgery +IV 2ml saline 10-15 minutes before surgery. Granisetron IV 1mg was used as rescue medication for emesis. Nausea and vomiting were assessed by direct questioning of the patients at 1, 2, 6, 12 and 24 hours after surgery. RESULTS: We found that the incidence of PONV (by simple yes or no) in first 24 hours was significantly lower in gabapentin (40%) dexamethasone (30%) and ondansetron group (36.7%) as compared to placebo group (66.7%) (P<0.05). The number of patients requiring rescue antiemetics was significantly decreased in gabapentin (30%), dexamethasone (26.7%) and ondansetron (26.7%) group versus placebo group (60%) (P<0.05). Gabapentin is as effective as ondansetron and dexamethasone as an antiemetic in laparoscopic cholecystectomy patients.
ABSTRACT
To compare the effectiveness of intravenous lignocaine and tramadol in reducing the incidence and severity of pain on propofol injection in a prospective randomized open labeled placebo controlled parallel study. A total of 120 patients admitted for different elective general surgical procedures were randomized and divided in four groups. Group I received intravenous (i.v.) propofol 2mg/kg only, while group II, III and IV received 1% lignocaine 0.5mg/kg, tramadol 1mg/kg ,normal saline 2ml (n=30 in each group) respectively with venous occlusion for 1 minute, followed by administration of propofol 2mg/kg into a dorsal hand vein. Pain was assessed on a four point scale (0=none, 1=mild, 2=moderate, 3=severe) during propofol injection. Both incidence and severity of pain was calculated in all the four groups. The incidence of pain in group I, II, III and IV was 100.0%, 30.0%, 26.7%, and 96.7% respectively with statistical significant reduction in group 11 and group 111 ( P 0.000). Mean pain score showed statistically significant difference between group I(1.9+0.4) and group II (0.3+0.5), group I (1.9+0.4) and group III (0.3+0.4), group II (0.3+0.5), and group IV(1.9+0.7), group III (0.3+0.4) and group IV(1.9+0.7) with P= 0.000. There was also significant difference in severity of pain between group I and II, group I and III, group II and IV, group III and group IV (P 0.000). Lignocaine and tramadol are equally effective in reducing both incidence and severity of pain due to propofol injection. Tramadol being as effective as lignocaine in prevention of propofol induced pain, may replace lignocaine, thereby minimizing risk to the population, as lignocaine is well known to have cardiorespiratory depressant property.
ABSTRACT
A randomized, open labeled comparative analysis for 2-week therapy of inhaled Tiotropium (T) (n=30) and Tiotropium plus Formoterol (TF) (n=30) once daily was carried in stable COPD patients. Objective parameters like lung functions (FEV1 and FVC), SBP, DBP, pulse and subjective parameters like improvement in respiratory symptoms & safety were assessed at baseline and after 2 weeks of treatment. Mean FEV1 was 1.0963±0.3826 & 1.1657±0.3701 as well as 1.1227±0.4129 & 1.2260±0.3830 before & after treatment with inhaled T & TF respectively. A statistically significant p<0.05 and p<0.001 improvement was only observed for FEV1 without significantly affecting other study parameters with two treatment modalities respectively when analyzed from respective base lines. However, on comparing the post drug improvement in objective & subjective parameters among T & TF treatment arms showed statistically insignificant p>0.05 variation. Both the regimens were well tolerated and no case warranted withdrawal of treatment. The present study suggests that in the treatment of COPD, inhaled long acting bronchodilators (T & TF) on comparison appear equally effective & safe.