Association of anti-emetic efficacy of ondansetron with G2677T polymorphism in a drug transporter gene ABCB1 in Pakistani population

To determine the association of ABCB1polymorphism G2677T with anti-emetic efficacy in patients treated with ondansetron for preventing postoperative nausea and vomiting. A clinical trial. Combined Military Hospital, Rawalpindi and Institute of Biomedical and Genetic Engineering, Islamabad, from 2012 to 2013. Four mg ondansetron was administered intravenously 30 minutes before the end of surgery. A total of 246 patients with the complaints of nausea and vomiting and 244 patients without nausea and vomiting were analyzed for G2677T polymorphism using PCR-RFLP method. Results were described as frequency percentages and chi-square test with significance at p < 0.05. The patients with TT genotype had significantly lower incidence of postoperative nausea and vomiting during the first 2 hours [p < 0.001] and between 2 - 24 hours after surgery as compared to other genotypes [p < 0.001]. The patients with GG genotypes had significantly higher incidence of this complaint [p=0.014]. Polymorphism of ABCB1 has an association with responsiveness for ondansetron. There is a role for genetics in the management of PONV

Evaluating effectiveness of warming endotra-cheal tube in blind nasotracheal intubation in maxillofacial surgery

Objective: to compare the intubation time, number of attempts to intubation and complications of BNTIbyusing normal ETTs against those softened by warming them with water at 50[degree]C

Methodology: eighty adult patients both male and female scheduled to undergo elective maxillofacial surgery under general anesthesia [GA] were randomly divided into two groups; Group A: BNTI carried out in patients using ETT without warming, Group B: BNTI using ETT warmed and softened with water at 50[degree]C for 5 minutes. The intubation time, number of attempts to intubation and complications of BNTI in both the groups were recorded and compared

Results: we found that BNTI in group B required lesser time and lesser number of attempts for intubation, with low incidences of complications as compared to group A. We found that the most frequent position of nasotracheal tube was tracheal followed by esophageal and anterior positions

Conclusion: ETT softened by warm water facilitated BNTIwith reduced frequency and severity of observed complications like epistaxis, bronchospasm, laryngospasm, painful nose and post-operative sore throat

Effects of rocuronium pretreatment on muscle enzyme levels following succinylcholine

Succinylcholine revolutionized anaesthetic practice by providing intense neuromuscular blockade of very rapid onset and ultrashort duration, thereby greatly easing the maneuver of tracheal intubation. However the worth of succinylcholine is limited by the frequent occurrence of muscular side effects which manifest biochemically in the form of rise in serum creatine kinase [CK]. The administration of small doses of nondepolarizing muscle relaxants before the administration of succinylcholine has been shown to decrease the incidence and severity of muscular side effects experienced by the patients. This study was aimed at evaluating the efficacy of technique in reducing the muscular side effects of succinylcholine, biochemically manifested as rise in CK. Sixty healthy adults were enrolled in the study who were scheduled for minor muscle cutting surgeries under general anaesthesia. They were assigned at random to two groups of thirty patients each. They randomly received succinylcholine for intubation and a precurarization dose of rocuronium followed by succinylcholine for intubation. Blood samples were drawn for estimation of serum creatinine kinase. There was a significantly raised CK in the succinylcholine group. In the precurarization group the rise in CK was prevented and the levels were significantly less as compared to the group which received succinylcholine alone. Present study concluded that precurarization with rocuronium was effective in reducing the succinylcholine-induced rise in creatinine kinase

Effects of Rocuronium pretreatment on muscle enzyme levels following succinylcholine

Succinylcholine revolutionized anaesthetic practice by providing intense neuromuscular blockade of very rapid onset and ultrashort duration, thereby greatly easing the maneuver of tracheal intubation. However the worth of succinylcholine is limited by the frequent occurrence of muscular side effects which manifest biochemically in the form of rise in serum creatine kinase [CK]. The administration of small doses of nondepolarizing muscle relaxants before the administration of succinylcholine has been shown to decrease the incidence and severity of muscular side effects experienced by the patients. This study was aimed at evaluating the efficacy of technique in reducing the muscular side effects of succinylcholine, biochemically manifested as rise in CK. Sixty healthy adults were enrolled in the study who were scheduled for minor muscle cutting surgeries under general anaesthesia. They were assigned at random to two groups of thirty patients each. They randomly received succinylcholine for intubation and a precurarization dose of Rocuronium followed by succinylcholine for intubation. Blood samples were drawn for estimation of serum creatine kinase. There was a significantly raised CK in the succinylcholine group. In the precurarization group the rise in CK was prevented and the levels were significantly less as compared to the group which received succinylcholine alone. Present study concluded that precurarization with Rocuronium was effective in reducing the succinylcholine-induced rise in creatine kinase

Comparative study of succinylcholine and precurarization with rocuronium on muscular effects in patients undergoing surgery under general anaesthesia

Succinylcholine remains the drug of choice in conditions where rapid paralysis and airway control are priorities. However it is associated with muscular side effects that have an overall incidence ranging from five to 83 percent. The administration of small doses of nondepolarizing muscle relaxants before the administration of succinylcholine has been shown to decrease the incidence and severity of muscular side effects experienced by the patients. This study was aimed at evaluating the efficacy of technique in reducing the muscular side effects of succinylcholine. Sixty healthy adults were enrolled in the study who were scheduled for minor muscle cutting surgeries under genera lanaesthesia. They were assigned at random to two groups of thirty patients each. They randomly received succinylcholine for intubation and a precurarization dose of rocuronium followed by succinylcholine for intubation. Intraoperative fasciculations and postoperative myalgia were graded and scored. There was a significantly increased incidence of fasciculations and myalgia in the succinlcholine group. In the precurarization group the incidence and severity of fasciculations and myalgia was significantly less as compared to the group which received succinylcholine alone. We found significant correlation between fasciculations and myalgia in the succinylchloine group. Present study concluded that precurarization with rocuronium was effective in reducing the succinylcholine-induced fasciculations and myalgia